Journal of Hayat
حیات
Hayat
Medical Sciences
http://hayat.tums.ac.ir
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2008-188X
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jalali
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2023
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ارتقای برنامه مراقبت تسکینی در منزل برای بیماران مبتلا به سرطان: یک مطالعه اقدام پژوهی
Improvement of a home palliative care program in cancer patients: An action research study
مراقبتهاي پرستاري
Nursing Care
پژوهشي
Research
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.3pt">زمینه و هدف: </span></span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">سرطان بیماریی است که کیفیت زندگی بیمار را تحت تأثیر قرار میدهد و مراقبت تسکینی راهکاری است که میتواند آن را بهبود بخشد. با این حال مراقبت تسکینی در منزل در اکثر کشورهای جهان توسعه نیافته است بنابراین هدف این مطالعه ارتقای برنامه مراقبت تسکینی در منزل برای بیماران مبتلا به سرطان است</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.3pt">.</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="color:black"><span style="letter-spacing:-.3pt"></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">روش بررسی:</span></span></span></span></i></b><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">این پژوهش</span></span></span></i><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">یک </span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">مطالعه اقدام</span></span></span></i><i> </i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">پژوهی است که </span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">روش چرخهای چهار مرحلهای اولری </span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">با رویکردهای کمی و کیفی در سه مرکز مراقبت در منزل شهر تبریز در سال 1399-1397 انجام گرفته است. با 18 پرستار مراقبت در منزل که به صورت هدفمند انتخاب شدند جهت <span style="font-variant:small-caps">شناسایی نیازهای مراقبتی </span></span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="font-variant:small-caps"><span style="color:black">بیماران سرطانی</span></span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="font-variant:small-caps"><span style="color:black"> و موانع مراقبت تسکینی در منزل مصاحبه انجام یافت و </span></span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">همچنین </span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">پرسشنامه تعیین نگرش و دانش بهصورت قبل و بعد مرحله اقدام در میان 60 پرستار مراقبت در منزل توزیع شد. </span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">دادههای کیفی از طرق تحلیل محتوا و داده</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"></span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">های کمی</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"> با استفاده از نرمافزار </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">SPSS</span></span></span></i><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">نسخه </span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">14</span></span></span></i><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">تحلیل شد</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="tab-stops:163.05pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">یافتهها</span></span></span></span></i></b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">: </span></span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">نیازهای مراقبتی بیماران سرطانی در 5 طبقه و موانع مراقبت تسکینی در 3 طبقه مشخص گردید. بیماران مبتلا به سرطان دارای نیازهای جسمی، روانی، آموزشی، مالی و معنوی</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"> هستند و </span></span></span></i><i><span lang="AR-YE" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">موانع مراقبتهای تسکینی شامل </span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">نقصان دستورالعملها، استیصال خانوادهها و حرفهای نبودن مراقبان است. در مرحله کمی پرستاران دانش متوسط و نگرش منفی نسبت به مراقبت تسکینی داشتند. آموزش از طریق فضای مجازی دانش و نگرش پرستاران را بهبود بخشید و آزمون تی جفت شده میانگین نمره دانش پرستاران را بعد از مرحله اقدام، معنادار نشان داد</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">.</span></span></span></span></i></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">نتیجهگیری: </span></span></span></i></b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">براساس نتایج، جهت ارتقای مراقبتهای تسکینی در منزل برای بیماران سرطانی توجه به نیازهای جسمی، روانی، آموزشی، مالی و معنوی آنان و رفع موانع از جمله تدوین دستورالعملهای مراقبت تسکینی در منزل، حمایت از خانوادههای بیماران مبتلا به سرطان و تخصصی کردن پرستاران ویژه مراقبت تسکینی در منزل و آموزش آنها میتواند مراقبت در این بیماران را ارتقا دهد.</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Background & Aim:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">Cancer is a disease that affects the quality of life of the patient, and palliative care is a solution that can improve it.</span></span></span> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">However, home palliative care program has not developed in most countries of the world. The aim of this study is to improve a home palliative care program for cancer patients</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Methods & Materials:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">This research is an action research study that was conducted through quantitative and qualitative approaches in Tabriz over 2018-2020. Eighteen home care nurses were selected for interviews using purposive sampling in order to identify the care needs of cancer patients and the barriers to palliative care at home. In addition, a questionnaire to determine the attitude and knowledge was distributed among 60 home care nurses before and after the action stage. The qualitative data were analyzed using conventional content analysis method, and the SPSS software version 14 was used to analyze the quantitative data</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.2pt"><span style="layout-grid-mode:line">Results:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">The care needs of cancer patients were determined in five categories and barriers to palliative care in three categories. Cancer patients have physical, psychological, educational, financial and spiritual needs, and barriers to palliative care include poor instruction, families' desperation, and unprofessional caregivers. In the quantitative phase, nurses had average knowledge and negative attitude towards palliative care. Training through virtual space improved the knowledge and attitude of nurses, and the paired t-test showed that the mean score of nurses' knowledge after the action stage was significant</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.2pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"><span style="layout-grid-mode:line">Conclusion:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">according to the findings, to improve palliative care at home, the physical, psychological, educational, financial and spiritual needs of cancer patients should be considered. Removing barriers to palliative care including developing guidelines, supporting the families of cancer patients and training special nurses for palliative care at home can improve care in these patients.</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"></span></span></span></span></span></span></span></span></span><br>
مراقبت تسکینی, سرطان, مراقبت در خانه, اقدام پژوهی
palliative care, cancer, home care, action research
388
404
http://hayat.tums.ac.ir/browse.php?a_code=A-10-2535-5&slc_lang=fa&sid=1
Hadi
Hassankhani
هادی
حسنخانی