تأثير ماساژ استروكسطحي بر رضايتو دركبيماران از كيفيت كنترل درد بعد از جراحي پيوند عروق كرونر

Effectiveness of Light Pressure Stroking Massage Therapy on Patients' Satisfaction and Quality of Pain Control after Coronary Artery Bypass Graft Surgery

زﻣﯿﻨﻪ و ﻫﺪف: درد در ﻣﺤﻞ ﺑﺮش اﺳﺘﺮﻧﻮﺗﻮﻣﯽ ﺑﻌﺪ از ﺟﺮاﺣﯽ ﭘﯿﻮﻧﺪ ﻋﺮوق ﮐﺮوﻧﺮ ﻣﺸﮑﻞ ﺷﺎﯾﻌﯽ اﺳﺖ ﮐﻪ اﺛﺮات ﺳﻮﯾﯽ ﺑﺮ ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ و در ﻧﺘﯿﺠﻪ ﭘﯿﮕﯿﺮي روﻧﺪ درﻣﺎن ﺑﯿﻤﺎران دارد، ﻟﺬا ﻫﺪف از اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻌﯿﯿﻦ ﺗﺄﺛﯿﺮ ﻣﺎﺳﺎژ اﺳﺘﺮوك ﺳﻄﺤﯽ ﺑﺮ رﺿﺎﯾﺖ و ﮐﯿﻔﯿﺖ ﮐﻨﺘﺮل درد ﺗﺤﺖ ﺟﺮاﺣﯽ ﭘﯿﻮﻧﺪ ﻋﺮوق ﮐﺮوﻧﺮ ﻣﯽﺑﺎﺷﺪ. ﻣﻮاد و روش ﻫﺎ: ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﯾﮏ ﻣﻄﺎﻟﻌﻪ ﻧﯿﻤﻪ ﺗﺠـﺮﺑﯽ اﺳﺖ ﮐﻪ در آن 72 ﺑﯿﻤﺎر ﺑﻄﻮر ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه آزﻣـﻮن و ﺷﺎﻫﺪ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﺑﯿﻤﺎران ﮔﺮوه آزﻣﻮن ﻣﺎﺳﺎژ اﺳﺘﺮوك ﺳﻄﺤﯽ ﺑﻪ ﻣﺪت 20 دﻗﯿﻘﻪ و ﺑﻪ ﻣﺪت 4 ﺟﻠﺴﻪ درﯾﺎﻓﺖ ﮐﺮدﻧﺪ و ﺑﯿﻤﺎران ﮔﺮوه ﺷﺎﻫﺪ ﺗﻨﻬﺎ ﻣﺮاﻗﺒﺖﻫﺎي روﺗﯿﻦ را درﯾﺎﻓﺖ ﮐـﺮدﻧﺪ. ﻣﺘﻐﯿﺮﻫﺎي رﺿﺎﯾﺖ و درك ﺑﯿﻤﺎران از ﮐﯿﻔﯿﺖ ﮐﻨﺘـﺮل درد ﻗﺒﻞ و ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ ﺑﺎ اﺳﺘﻔﺎده از ﭘﺮﺳﺸﻨﺎﻣﻪﻫﺎي ﮐﯿﻔﯿﺖ ﮐﻨﺘـﺮل درد اﯾﺪوال )Idvall( اﺑﺰار ﻋـﺪدي ])Brief Pain Inventory (BPI[ ﺛﺒﺖ ﮔﺮدﯾﺪ. ﺑﺮاي ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿـﻞ اﻃﻼﻋـﺎت از ﻧﺮم اﻓﺰار SPSS ﻧﺴـﺨﻪ 18 و روشﻫﺎي آﻣﺎري ﺗﻮﺻﯿﻔﯽ و اﺳﺘﻨﺒﺎﻃﯽ )ﺗﯽ ﻣﺴﺘﻘﻞ، ﺗﯽ زوج، ﮐﺎي اﺳﮑـﻮار( اﺳﺘﻔﺎده ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ )اﻧﺤﺮاف ﻣﻌﯿﺎر( ﻧﻤﺮات رﺿﺎﯾﺖ و درك ﺑﯿﻤﺎران از ﮐﯿﻔﯿﺖ ﮐﻨﺘﺮل درد ﻗﺒﻞ از ﻣﺪاﺧﻠﻪ در ﮔﺮوه آزﻣﻮن ﺑﻪ ﺗﺮﺗﯿﺐ 1/601 ± 5/402 و 2/569 ± 49/324 و در ﮔﺮوه ﮐﻨﺘﺮل ﺑﻪ ﺗﺮﺗﯿﺐ 2/123 ± 4/452 و 2/505 ± 48/425 ﺑﻮد ﮐﻪ ﺗﻔﺎوت آﻣﺎري ﻣﻌﻨﯽداري را ﻧﺸﺎن ﻧﻤﯽداد )0/05 > P(. ﭘﺲ از ﻣﺪاﺧﻠﻪ، ﻣﯿﺎﻧﮕﯿﻦ )اﻧﺤﺮاف ﻣﻌﯿﺎر( ﻧﻤﺮات رﺿﺎﯾﺖ و درك ﺑﯿﻤﺎران از ﮐﯿﻔﯿﺖ ﮐﻨﺘﺮل درد در ﮔﺮوه آزﻣﻮن ﺑﻪ ﺗﺮﺗﯿﺐ 1/200 ± 8/402 و 2/004 ± 64/612 و در ﮔﺮوه ﮐﻨﺘﺮل ﺑﻪ ﺗﺮﺗﯿﺐ 1/500 ± 5/321 و 2/234 ± 51/513 ﺑﻮد ﮐﻪ ﺗﻔﺎوت آﻣﺎري ﻣﻌﻨﯽداري را ﻧﺸﺎن ﻣﯽداد )0/001< P(. ﻧﺘﯿﺠﻪ ﮔﯿـﺮي: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻧﺘﺎﯾﺞ ﺣﺎﺻﻞ از ﻣﻄﺎﻟﻌﻪ ﻣﯽﺗﻮان ﮔﻔﺖ، اﺳﺘﻔﺎده از ﻣﺎﺳﺎژ اﺳﺘﺮوك ﺳﻄﺤﯽ ﻣﯽﺗﻮاﻧﺪ ﺑﺎﻋﺚ اﻓﺰاﯾﺶ رﺿﺎﯾﺖ از ﮐﻨﺘﺮل درد ﺑﻌﺪ از ﻋﻤﻞ ﺑﯿﻤﺎران ﺗﺤﺖ ﺟﺮاﺣﯽ ﭘﯿﻮﻧﺪ ﻋﺮوق ﮐﺮوﻧﺮ ﺷﻮد و ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺳﺎدﮔﯽ و ﮐﻢ ﻫﺰﯾﻨﻪ ﺑﻮدن اﯾﻦ روش ﺷﺎﯾﺪ ﺑﺘﻮان ﺑﻪ ﻋﻨﻮان ﻣﮑﻤﻞ ﻣﻨﺎﺳﺒﯽ ﺑﺮاي دارو درﻣﺎﻧﯽ و ﻣﺪاﺧﻼت ﺑﻌﺪ از ﻋﻤﻞ در اﯾﻦ ﺑﯿﻤﺎران ﻣﻮرد اﺳﺘﻔﺎده ﻗﺮار ﺑﮕﯿﺮد.

Introduction & Objective: Pain on mid-sternotomy incision site after Coronary Artery Bypass Graft Surgery (CABG) is a common problem has a negative effect on quality of life and follow-up treatment. Thus the present study aimed to determine the effect of light massage therapy by patient's Light Pressure Stroking Massage Therapy on Patients' Satisfaction and Quality of Pain Control in post-CABG patients. Materials & Methods: In this semi - experimental study, 72 post-CABG patients were randomly divided into an intervention and a control group. The intervention group received Light Pressure Stroking massage by the nurse for 20 minutes in 4 sessions. The control group received routine care. Patient’s satisfaction and quality of pain control were assessed by brief pain inventory (BPI) and Idvall quality of life questionnaire before and after the intervention. Then, the data was analyzed by student t-test, paired t-test and chi-square by SPSS software version 18. Results: Mean (SD) scores for Satisfaction and Quality of Pain Control before the intervention in the case group were 5.402±1.601 and 49.324±2.569 and in the control group were 4.452±2.123 and 48.425± 2.505 respectively, that did not show a significant difference (P > 0.05). After the intervention, Mean (SD) scores for Satisfaction and Quality of Pain Control in the case group, were 8.402±1.200 and 64.612± 2.004 and in the control group were 5.321±1.500 and 51.513±2.234 respectively, that showed a significant difference (P < 0.001). Conclusions: Regarding the finding of study, use of Light Pressure Stroking massage therapy can increase Patients' Satisfaction and Quality of Pain Control of patients after coronary artery bypass surgery and due to low cost and simplicity of this method, it can perhaps be used as a complement to drug therapy and postoperative interventions used in these patients