بررسي ميزان اضطراب قبل و بعد از عمل جراحي پيوند عروق كرونر در بيمارستانهاي تابعه دانشگاه علوم پزشكي تهران سال 1387

Study of pre and post anxiety of coronary artery bypass graft surgery inpatients in hospitals affiliated With Tehran University of Medical Sciences

زمينه و هدف: علل و عوامل محيطي متعددي در بروز اضطراب ايفاي نقش مي كنند و تفاوتهاي فردي و شرايط محيطي در شدت و ميزان اضطراب موثرند.در چارچوب اين شرايط ، محيط بيمارستاني و بخش جراحي قلب كه با حيات انسان سر و كار دارد، از اهميت ويژه اي برخوردار است. اين مطالعه تعيين و مقايسه ميزان اضطراب قبل و بعد از جراحي پيوند عروق كرونر در بيمارستانهاي تابعه دانشگاه علوم پزشكي تهران را به عنوان اهداف اصلي خود برگزيده است . مواد و روشها: اين مطالعه از نوع توصيفي- تحليلي است .افراد تحت مطالعه اين بررسي را 150 نفر از بيماران بستري در بيمارستانهاي منتخب دانشگاه علوم پزشكي تهران تشكيل ميدهند . ميزان اضطراب اين افراد در 24 ساعت قبل از عمل و سپس در هفته دوم بعد از عمل توسط پرسشنامه با استفاده از آزمون استاندارد اسپيل برگر ((Spielberger سنجيده شد. نتايج: يافته هاي پژوهش نشان مي دهد كه ميزان اضطراب قبل از عمل پيوند عروق كرونر بيشتر از ميزان اضطراب بعد از عمل بوده است و تغييرات اضطراب با متغيرهايي مثل جنسp<0/05)،سن(p<0/05)، تعداد فرزندان( p<0/05) و وضعيت تاهل (p<0/05) ارتباط معني داري داشته است اما با متغيرهاي ديگر مانند وضعيت شغلي، سطح تحصيلات، سابقه بيماري غير قلبي،سابقه جراحي غير قلبي، سابقه MI ارتباط معني داري نداشت. نتيجه گيري: به نظر مي رسد كاهش اضطراب دراين بيماران متاثر از متغيرهاي دموگرافيك ،اقتصادي- اجتماعي و فرهنگي است.اعتقادات ، ارزشها و باورها به عنوان ابعاد و نتايج فرهنگي تجربه زندگي مي تواند در بروز اضطراب و شدت و ضعف آن نقش اساسي ايفا نمايد.

Background: Multiple environmental factors have roles in producing anxiety. Individualized differences and environmental conditions can affect the anxiety level. So, hospital environment and especially cardiac surgery ward have a great importance because they can save the patient's life. Material & Methods: The present study is a descriptive- analytical one which has been conducted upon studying the level of anxiety pre and post coronary artery bypass graft surgery in the hospitals of Tehran University of Medical Sciences and preparing an educational program for such patients, was the other goal of the study. Study population consists of 150 patients under examination that at the time of the study have been voluntaries to coronary artery bypass graft surgery. The sample was studied 24 hours before and weeks after surgery. The sample was selected randomly and data collected through a questionnaire with two separate parts. For the purpose of data analysis, SPSS software was employed. Results: The result of the study shows that the level of anxiety before coronary artery bypass graft have been more than the level of anxiety after the operation. The difference between of the levels of anxiety have had significant relations with some of independent variables of the study such as sex, age, number of children and marital status, but there were not significant relations between occupation, educational level, non cardiac disease background, background of MI, non cardiac surgery background, the period of suffering from coronary disease background of hospitalization. Conclusion: It seems that the men's ability to return to pre-operation socio-economic condition reduces their post operation anxiety. When people become older, they will be more fearful regarding the future's events but people older than 46 years old will obtain more life expectancy after surgery due to more extended familial relationship. Married people experience less anxiety due to post operation, familial responsibilities and relief of cardiac symptoms. It can be concluded that anxiety reduction in these patients can result from cultural, socio-economic and demographic variables. Believes as cultural factors in the life have a great role in appearance and the level of anxiety.