تاثیر آموزش برنامه‌ی خود‌مراقبتی بر کیفیت زندگی افراد با ضایعات نخاعی

زمینه و هدف: از آنجایی که ضایعه نخاعی معمولاً ناتوان کننده بوده و به علت وجود عوارض ثانویه، تاثیرات منفی زیادی بر کیفیت زندگی افراد مبتلا دارد لذا مطالعه‌ی حاضر با هدف تعیین اثر آموزش خود‌مراقبتی بر کیفیت‌زندگی افراد با ضایعه نخاعی مراجعه کننده به بیمارستان خاتم الانبیاء (ص) شهر تهران انجام شد. روش بررسی:.پژوهش حاضر از نوع نیمه تجربی با گروه کنترل بوده و به همین منظور 84 نفر از افراد با ضایعه نخاعی مراجعه کننده به بیمارستان خاتم الانبیاء (ص) شهر تهران در شش ماه اول سال 1399 با شیوه نمونه‌گیری تصادفی سیستماتیک انتخاب و در دو گروه مداخله و کنترل قرار گرفتند. پرسشنامه به کار رفته در این پژوهش، فرم کوتاه شده پرسشنامه کیفیت ‌زندگی سازمان بهداشت جهانی who quality of life group. whoqolbref introduction) ) است. پس از جمع آوری داده‌ها با استفاده از نرم‌افزار آماری spss نسخه 16 و از طریق آزمون‌های توصیفی و استنباطی مورد تجزیه و تحلیل قرار گرفتند.یافته‌ها: نتایج این بررسی نشان داد که بین دو گروه مداخله و کنترل از نظر توزیع متغیرهای زمینه‌ای تفاوتی وجود نداشت. میانگین سطح کیفیت زندگی افراد قبل از انجام مداخله درگروه مداخله، 14.57 ± 13.10 و در گروه کنترل، 13.97 ± 13.43 بود. یک هفته بعد از انجام مداخله، میانگین سطح کیفیت زندگی در گروه مداخله به 13.98 ± 22.38 و در گروه کنترل به 14.48 ± 15.00 رسید. این اختلاف در گروه مداخله معنی‌دار بود (p<0.001).نتیجه‌گیری کلی: نتایج به دست آمده حاکی از آن است که آموزش برنامه‌ی خود‌مراقبتی در افزایش کیفیت زندگی افراد مبتلا به ضایعه نخاعی موثر است. بنابراین می‌توان روش به کار گرفته شده در پژوهش حاضر را به عنوان یک روش ساده، غیر تهاجمی، کم هزینه و موثر در افزایش کیفیت زندگی افراد با ضایعه نخاعی را به پرستاران پیشنهاد نمود.

Evaluation of The effect of Self-Care Education on Quality of Life in People with Spinal Cord Injury

Background Aims: Spinal cord injury is usually debilitating and has many negative effects on the quality of life of people due to secondary complications. Therefore, improving the quality of life of people with spinal cord injury is one of the main priorities in the nursing profession. Also, educating selfcare behaviors and obtaining information from nurses can be helpful for people with this problem. Selfcare is also the most important form of primary care for chronic diseases in the health sector. The aim of this study was to determine the effect of selfcare education on the quality of life of people with spinal cord injury referred to Khatam OlAnbia Hospital in Tehran.Materials Methods: The present study was a quasiexperimental study with a control group. 84 patients with spinal cord injury referred to Khatam OlAnbia Hospital in Tehran in the first 6 months of 2020 were selected through systematic random sampling and divided in two groups; an intervention group and a control group. The questionnaire used in this study is an abbreviated form of WHO Quality of Life Assessment Group. WHOQOLBREF Introduction is a 26item questionnaire that measures a person #39;s overall quality of life. This questionnaire has four subscales and an overall score. These subscales include: physical health, mental health, social relationships, environmental health, and an overall score. The reliability of Quality of Life questionnaire was achieved through Cronbach #39;s alpha which was equal to alpha;= 0.79 and internal correlation coefficient was calculated for relative reliability which was equal to 0.85. After coordination with the officials of Khatam OlAnbia Hospital in Tehran, the researcher referred to the spinal cord injury wards and after introducing himself, explaining the nature and objective of the research, and the procedures to conduct the study to the ward staff, the patients, and their companions, received informed consent from the patients.The pretest was performed for both groups and before the intervention, the questionnaires of demographic characteristics and WHO Quality of Life were completed by patients admitted to the spinal cord injury wards. Then, the intervention group was formed in the social network entitled Selfcare and spinal cord injuries and in addition to the usual training, 30session selfcare training was conducted every day for 30 minutes which lasted a month. The training included description of the disease, complications of the disease, types of pharmacological and nonpharmacological treatments for disease control, selfcare and its importance in rehabilitation, how to follow a proper diet, how to follow the prescribed medication and daily activities, exercise and physical activity, counseling and talking with friends, family and non family support, the skills of how to change the position, transfer, increase performance and independence of patients with spinal cord injury.In this study, 42 patients participated in each group, and 4 patients in the intervention group and 2 in the control group were excluded from the study for reasons such as cancellation of cooperation, not completing the questionnaire in pretest or posttest stages, not studying the material submitted for more than three sessions (according to the feedback, the daily review of message information, analyzing Read or Delivered option in the social network), and finally a total of 38 patients comprised the intervention group and 40 patients the control group. At first, the patients were asked not to post irrelevant material and to express their views if they had any questions or concerns about the training provided. Also, only routine trainings were performed for the control group. To perform the posttest, one month after the end of the educational intervention, the tools were completed again by the two groups. The posttest was performed for the patients who returned to the hospital and the spinal cord injury wards on time, but for other patients, the questionnaires were sent privately to the social network and were completed remotely. After the posttest, the educational booklet was given to the control group. In this research, educational content was prepared by referring to the available library resources and with the guidance of supervisors and consultants.The validity of the educational content was assessed qualitatively by a survey of 3 faculty members. After collecting data, the results were analyzed through descriptive and inferential tests such as Fisher #39;s exact test, Chisquare, independent ttest, and paired ttest in SPSS 16.Results: The results indicated no difference between the two groups in terms of distribution of underlying variables. Comparison of quality of life showed that the quality of life in patients with spinal cord lesions was not statistically significant before and after the intervention (P >0.05) and also the quality of life in the two groups was improved after the intervention and a statistically significant difference was observed (P <0.001). Regarding the changes in quality of life score, the mean quality of life of patients with spinal cord injury before the intervention was 13.10 ± 14.57 in the intervention group and 13.43 ± 13.97 in the control group. One week after the intervention, the mean quality of life of patients with spinal cord injury was 22.38 ± 13.98 in the intervention group and 15 ± 14.48 in the control group.Conclusion: The results indicate that selfcare program training is effective in improving the quality of life of patients with spinal cord injury. According to the researcher, several factors affect the results, including the nature of the disease, involvement of all body systems, and difficult conditions (lack of definitive treatment, dependence on nurses and informal caregivers) that make it difficult to control the disease. On the other hand, environmental conditions and economic situation, as well as lack of easy access to some drugs may have been involved in assessing the quality of life of these patients. According to the results, the method used in the present study can be suggested to nurses as a simple, noninvasive, lowcost, and effective method in improving the quality of life of patients with spinal cord injury.