نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار، گروه پرستاری داخلی و جراحی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

2 استاد، مرکز تحقیقات مراقبت‌های مامایی و پرستاری، گروه مدیریت، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران

3 دانشیار، مرکز تحقیقات پیوند کبد بیمارستان امام خمینی، تهران، ایران

چکیده

زمینه و هدف  بیماران نیازمند پیوند کبد به دلیل مشکلات فراوان تبعیت از رژیم درمانی‌شان مختل می‌شود که بر نتیجه درمان و عوارض قبل و بعد از پیوند، تأثیرگذار است؛ لذا این مطالعه با هدف تأثیر برنامه مراقبتی بر تبعیت از درمان بیماران در انتظار پیوند کبد انجام شد.
مواد و روش‌ها این پژوهش، یک مطالعه نیمه‌تجربی است که در سال 1397 روی 117 بیمار منتظر پیوند کبد در بیمارستان امام خمینی تهران انجام شد. براساس معیارهای ورود، نمونه‌ها به‌صورت هدفمند انتخاب و تبعیت از رژیم درمانی بیماران بررسی شد. سپس آن‌ها تحت برنامه مراقبتی قرار گرفتند. ابزار جمع‌آوری داده‌ها پرسش‌نامه تبعیت از درمان بیماران بود که قبل و شش هفته بعد از مداخله، تکمیل شد. تجزیه‌وتحلیل داده‌ها با استفاده از نرم‌افزار آماری spss انجام گرفت.
یافته‌ها نتایج نشان داد که میانگین سن بیماران منتظر پیوند کبد 1/39±44/95بود. همچنین تبعیت از درمان در رژیم غذایی و دارویی پس از اجرای برنامه مراقبتی در بیماران نسبت به قبل بهبود یافته بود (P<0/01) ولی با برنامه حرکتی، ارتباط معناداری یافت نشد (0/89=P).
نتیجه‌گیری نتایج مطالعه، حاکی از تأثیرات مثبت اجرای برنامه مراقبتی بر ارتقای تبعیت از رژیم غذایی و دارویی در بیماران منتظر پیوند کبد بود. رفع مشکلات این بیماران، نیازمند توجه و حمایت برنامه‌ریزان و همکاری مدیران می‌باشد تا بتوان برنامه‌های مراقبتی را توسعه داد و توسط نیروهای آموزش‌دیده به خصوص پرستاران به کار گرفته شوند.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of care program on the Compliance of patients awaiting liver transplantation

نویسندگان [English]

  • shima aghahosseini 1
  • nahid dehghan nayeri 2
  • mohsen nasiri tosi 3

1 Assistant Professor, Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Professor, Nursing and Midwifery Care Research Center, Management Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

3 Associate Professor, Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran

چکیده [English]

Introduction: Compliance of patients in need of liver transplantation is impaired due to many reasons, and this affects the pre and post outcomes and complications of transplantation. Therefore, the aim of this study was to evaluate the effect of a care program on the compliance of patients awaiting liver transplantation.
Materials and Methods: This quasi-experimental study was conducted in 2018 on 117 patients waiting liver transplantation in Imam Khomeini Hospital of Tehran. Based on entry criteria, the samples were selected purposefully and their compliance was evaluated. Then, a care program was implemented for them. The data collection tool was a compliance questionnaire, which was completed before and six weeks after the intervention. Data analysis was done by SPSS software.
Results: The results showed that, the compliance of diet and medication improved after the implementation of care program in patients waiting for liver transplantation (P<0.01). But there was no significant relationship with physical activity.
Conclusion: The results of this study indicated a positive effect of the care program on improving the compliance of diet and medication in patients awaiting liver transplantation. Eliminating the problems of these patients requires the attention and support of planners and the cooperation of managers in order to develop care programs that can be used by healthcare professionals, especially nurses. 

کلیدواژه‌ها [English]

  • Liver Transplantation
  • Patient Care Program
  • Patient Compliance
[1]. Bahram Nejad F, Sanayi N, Farokh Nejad Afshar P, Arefi S, Moradi Majd P, Cheraghi M.A. Transplantation nursing. Tehran: JameNegar Publication; 2013. (persian)
[2]. Smeltzer SC, Bare GB, Hinkle JL, Cheever KH. Brunner & Suddarths, Textbook of Medical Surgical Nursing, Lippincott Williams and wilkins; 2018.
[3]. www.irna.ir/news/83150800.The-latest-results-of-25years-of-Iran-liver-transplantation-and-Shiraz-climbingto-the-roof-of-the-world
[4]. Sharma P, Schaubel DE, Gong Q, Guidinger M, Merion RM. Hepatology. 2012;55(1): 192–8. doi: 10.1002/hep.24632
[5]. Shariat E. lived experiences of waiting among patients liver transplantat candidates: a phenomenology study. [Dissertation], Nursing and Midwifery Faculty of Tehran University of Medical Sciences, 2016. (Persian).
[6]. Findlay JY, Fix OK, Paugam-Burtz C, Liu L, Sood P, Tomlanovich SJ and et al. Critical Care of the End-Stage Liver Disease Patient a Waiting Liver Transplantation. Liver Transpl. 2011;17(5): 496-510.
[7]. Carey EJ, Steidley DE, Aqel BA, Byrne TJ, Mekeel KL, Rakela J, and et al. Six-Minute Walk Distance Predicts Mortality in Liver Transplant Candidates. Liver Transpl. 2010;16(12): 1373-8.
[8]. Leise MD, Yun BC, Larson JJ, Benson JT, Yang JD, Therneau TM, and et al. The Effect of Pretransplant Serum Sodium Concentration on Outcome Following Liver Transplantation. Liver Transpl. 2014;20(6): 687-97.
[9]. Anastácio LR, Ferreira LG, de Sena Ribeiro H, Lima AS, Vilela EG, Toulson Davisson Correia MI. Body composition and overweight of liver transplant recipients. Transplantation. 2011; 92(8):947–51.
[10]. Germani G, Lazzaro S, Gnoato F, Senzolo M, Borella V, Rupolo G, and et al. Nonadherent Behaviors After Solid Organ Transplantation. Transplant Proc. 2011;43(1):31823.
[11]. Ordin, Y. S., Karayurt, O. Wellard, S. Investigation of adaptation after liver transplantation using Roy's Adaptation Model. Nurs Health Sci. 2013;15(1):31-8.
[12]. Aghahosseini SS, Dehghan Nayeri N, Shahsavari H, Nasiri Tosi M. Life Experiences of Hepatitis Patients Waiting for Liver Transplantation. Hepat Mon. 2017; 17(10):e57775.
[13]. Baldoni L, Stefanini A, Ducci Y, Viti G, Tellini C, Masetti M, et al. The role of the nursing coordinator in an Italian liver transplantation center. Transplant Proc. 2003 May;35(3):985-6.
[14]. Sokhak F. The effect of cognitive-behavioral intervention on adherence to treatment regimen and its barriers in hemodialysis patients. [Dissertation], Nursing and Midwifery Faculty of Tehran University of Medical Sciences, 2013. (Persian).
[15]. Asgari P. Comparison of the effect of family-centered and patient-centered education on adherence to treatment and complications during dialysis. [Dissertation], Nursing and Midwifery Faculty of Tehran University of Medical Sciences, 2013. (Persian).
[16]. Zandi M, Alavian S.M, Memarian R, Kazem Nejad A. Assessment of the Effect of Self Care Program on Quality of Life in Patients with Cirrhosis referred to Tehran Hepatitis Center in 2003. RJMS. 2004; 11(41):411-420. (Persian)
[17]. de Piano A, Prado WL, Caranti DA, Siqueira KO, Stella SG, Lofrano M, et al. Metabolic and nutritional profile of obese adolescents with nonalcoholic fatty liver disease J Pediatr Gastroenterol Nutr. 2007;44(4):446-52.
[18]. Beraz S, Mohammadi E, Boromand B. Effects of diet on laboratory parameters and weight gain between the two sessions dialysis in patients undergoing maintenance hemodialysis. Shahrekord university of medical sciences. 2006; 8:20-27.
[19]. Karimi Moonaghi H, Hasanzadeh F, Shamsoddini S, Emamimoghadam Z, Ebrahimzadeh S. A Comparison of Face to Face and Video-based Education on Attitude Related to Diet and Fluids Adherence in Patients. Iran J Nurs Midwifery Res. 2012;17(5):360-4.
[20]. Anderson RM, Davidson PL, Baumeister SE. improving access to care. Changing the US health care system: key issues in health services policy and management. 2013; 12(4):33-69.
[21]. Davoodi M, Moosavi H, Nikbakht M. The effect of eight weeks selected aerobic exercise on liver parenchyma and liver enzymes (AST, ALT) of fat liver patients. J Shahrekord Univ Med Sci. 2012; 14 (1):84-90. (Persian)
[22]. Booth F. Exercise prevents fatty liver. University of Missouri–Columbia. Lateest Science Newsletter. 2008; 29:14-15. [23]. Kruger C, McNeely ML, Bailey R.J, Yavari M, G. Abraldes J, Carbonneau M, et al. Home Exercise Training Improves Exercise Capacity in Cirrhosis Patients: Role of Exercise Adherence. Sci Rep. 2018;8;8(1):99.