مقایسه تاثیر آموزش مبتنی بر مدل مراقبت پیگیر و مراقبت از راه دور (تله هلث) بر شدت بی خوابی زنان باردار

ﻣﻘﺪﻣﻪ: ﯾﮑﯽ از ﺷﺎﯾﻊﺗﺮﯾﻦ اﺧﺘﻼﻻت در دوران ﺑﺎرداری، اﺧﺘﻼل ﺧﻮاب ﻣﯽﺑﺎﺷﺪ و ﺷﺎﯾﻊﺗﺮﯾﻦ آن، اﺧﺘﻼل ﺑﯽﺧﻮاﺑﯽ اﺳﺖ. ﯾﮑﯽ از راهﻫﺎﯾﯽ ﮐﻪ ﻣﻤﮑﻦ اﺳﺖ، اﺧﺘﻼل ﺧﻮاب را اﺻﻼح ﮐﻨﺪ، آﻣﻮزش اﺳﺖ. ﻟﺬا ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﻣﻘﺎﯾﺴﻪ آﻣﻮزش ﺑﺮ اﺳﺎس ﻣﺪل ﻣﺮاﻗﺒﺖ ﭘﯿﮕﯿﺮ و ﺗﻠﻪ ﻫﻠﺚ ﺑﺮ ﺷﺪت ﺑﯽ ﺧﻮاﺑﯽ زﻧﺎن ﺑﺎردار، اﻧﺠﺎم ﺷﺪ. روش ﮐﺎر: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ ﺑﺎ ﻧﻤﻮﻧﻪ ﮔﯿﺮی ﭼﻨﺪ ﻣﺮﺣﻠﻪای ﺗﺼﺎدﻓﯽ ﺳﻪ ﮔﺮوﻫﻪ، ﺑﺮ روی 91 زن ﺑﺎردار، ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﻣﺮاﮐﺰ ﺑﻬﺪاﺷﺘﯽ-درﻣﺎﻧﯽ ﺷﻬﺮ ﻣﺸﻬﺪ، در ﺳﺎل 1396 اﻧﺠﺎم ﺷﺪ. ﺑﺮای ﮔﺮوهﻫﺎی ﻣﺪل ﻣﺮاﻗﺒﺖ ﭘﯿﮕﯿﺮ و ﺗﻠﻪ ﻫﻠﺚ، ﻣﺪاﺧﻠﻪ ﺑﻪ ﻣﺪت 12 ﻫﻔﺘﻪ و ﺑﺮای ﮔﺮوه ﮐﻨﺘﺮل ﻣﺮاﻗﺒﺖﻫﺎی ﻣﻌﻤﻮل ﻣﺮﮐﺰ ﺑﻬﺪاﺷﺖ اﻧﺠﺎم ﺷﺪ. اﺑﺰار ﮔﺮد آوری دادهﻫﺎ ﭘﺮﺳﺸﻨﺎﻣﻪ ﺷﺪت ﺑﯽ ﺧﻮاﺑﯽ (i si ) ﺑﻮد ﮐﻪ ﻗﺒﻞ از ﻣﺪاﺧﻠﻪ، ﺑﻼﻓﺎﺻﻠﻪ ﺑﻌﺪ و 4 ﻫﻔﺘﻪ ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ ﺗﮑﻤﯿﻞ ﺷﺪ. ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰار آﻣﺎری spss، روشﻫﺎی آﻣﺎر ﺗﻮﺻﯿﻔﯽ و آزﻣﻮنﻫﺎی آﻣﺎری اﻧﺠﺎم ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ آزﻣﻮنﻫﺎی آﻣﺎری ﻧﺸﺎن داد ﮐﻪ ﺳﻪ ﮔﺮوه از ﻧﻈﺮ ﻣﺘﻐﯿﺮﻫﺎی ﺳﻦ، ﺳﻦ ﺑﺎرداری، ﺗﻌﺪاد ﻓﺮزﻧﺪ، ﺗﻌﺪاد ﺑﺎرداری، ﺗﺤﺼﯿﻼت ﻣﺎدر و وﺿﻌﯿﺖ ﺑﺎرداری ﺑﺎ ﯾﮑﺪﯾﮕﺮ ﻫﻤﮕﻦ ﺑﻮدﻧﺪ (0/05 < p). ﺷﺪت ﺑﯽ ﺧﻮاﺑﯽ، ﻗﺒﻞ از ﻣﻄﺎﻟﻌﻪ در ﻫﺮ ﺳﻪ ﮔﺮوه ﺗﻔﺎوت ﻣﻌﻨﯽ داری ﻧﺪاﺷﺖ (0/235 = p)؛ ﺑﻼﻓﺎﺻﻠﻪ ﺑﻌﺪ و 4 ﻫﻔﺘﻪ ﭘﺲ از ﻣﺪاﺧﻠﻪ، در ﺳﻪ ﮔﺮوه ﺗﻔﺎوت ﻣﻌﻨﯽ داری وﺟﻮد داﺷﺖ (0/001 > p).ﻧﺘﯿﺠﻪﮔﯿﺮی: آﻣﻮزش ﻣﺒﺘﻨﯽ ﺑﺮ ﻣﺪل ﻣﺮاﻗﺒﺖ ﭘﯿﮕﯿﺮ و ﺗﻠﻪ ﻫﻠﺚ ﻫﺮ دو، ﻣﻮﺟﺐ ﮐﺎﻫﺶ ﺑﯽ ﺧﻮاﺑﯽ، زﻧﺎن ﺑﺎردار ﻣﯽﺷﻮﻧﺪ. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﯾﻨﮑﻪ روش ﺗﻠﻪ ﻫﻠﺚ، ارزانﺗﺮ و آﺳﺎنﺗﺮ اﺳﺖ، ﻣﯽﺗﻮان از اﯾﻦ روش، ﺟﻬﺖ ﺑﻬﺒﻮد ﺷﺪت ﺑﯽ ﺧﻮاﺑﯽ زﻧﺎن ﺑﺎردار اﺳﺘﻔﺎده ﮐﺮد.

Comparing the Effect of Training Based on Continuous Care Model and Telehealth on Severity of Insomnia in Pregnant Women

Introduction: One of the most common disorders during pregnancy is sleep disorders and the most common is it insomnia. One of the ways that may correct sleep disorders is training. Therefore, the present study was conducted to compare the education based on continuous care model and Telehealth on the severity of insomnia in pregnant women. Methods: This clinical trial study with random multistage sampling was conducted on three groups of 91 pregnant women referring to health centers in Mashhad city in 2017. Intervention was conducted for 12 weeks for groups of continuous care model and Telehealth, and usual care of health centers was done for control group. Data collection tool was an insomnia severity index (ISI) that was completed before intervention, immediately after that and 4 weeks after the intervention. Data were analyzed using SPSS software, Descriptive statistics and statistical tests were used. Results: The results of the statistical tests showed that the three groups was matched in terms of age, gestational age, number of children, number of pregnancies, mother's education and pregnancy status (P <0.05). There was no significant difference in severity of insomnia before the study in all three groups (P = 0.235); there was a significant difference immediately after intervention and 4 weeks after it in all three groups (P <0.001). Conclusions: Training based on continuous care model and Telehealth, both lead to reduce pregnant women insomnia. Therefore, Given that the telehealth method is cheaper and easier, this method can be used to improve the sleep disorders in pregnant women.