بررسي تأثير متقابل سبك‌هاي مقابله و هموديناميك بر كيفيت زندگي بيماران قلبي- عروقي بستري در بيمارستان‌هاي علوم پزشكي مازندران

Evaluating the coping styles and Hemodynamic interaction on quality of life in cardiovascular patients in Mazandaran

مقدمه: امروزه الگوي حاكم بر بيماري، الگوي زيستي- رواني و اجتماعي است. در اين الگو انسان به عنوان موجودي چند بعدي است و هر يك از ابعاد زيستي-رواني و اجتماعي او به صورت نظام‌هاي تعاملي عمل مي‌كنند و بر يكديگر تأثير مي‌گذارند. اين پژوهش به بررسي تأثير سبك‌هاي مقابله با استرس و هموديناميك بر كيفيت زندگي بيماران قلبي- عروقي مي پردازد. روش كار: روش تحقيق پس رويدادي (عليّ–مقايسه اي) بود. جامعه آماري پژوهش حاضر را كليه بيماران قلبي- عروقي بيمارستا‌ن‌هاي فاطمه الزهرا و نيمه شعبان و افراد سالم شهرستان ساري تشكيل مي‌دادند. نمونه اين تحقيق 232 نفر شامل تعداد 87 نفر افراد سالم، 77 نفر از بيمار قلبي- عروقي سكته‌اي بستري و 68 نفر بيماران قلبي غير سكته‌اي بودند. يافته ها: نتايج اين تحقيق نشان داد كه كيفيت زندگي در بيماران قلبي، پايين‌تر از افراد سالم و در بيماران قلبي سكته‌اي، پايين‌تر از بيماران قلبي غير سكته‌اي قرار دارد. علاوه بر اين نتايج تحقيق نشان داد كه متغير هموديناميك از جمله تغييرات فشار خون و ضربان قلب در بيماران قلبي و سكته‌اي، قبل و بعد از آزمون يكسان نبود. نتيجه‌گيري: نتايج اين تحقيق نشان داد كه در تمامي مولفه‌هاي كيفيت زندگي در بين گروه‌هاي مختلف سبك‌هاي مقابله‌اي تفاوت معنادار مشاهده شد. همچنين در برخي از مولفه‌هاي هموديناميك، قبل و بعد از آزمون، تفاوت معناداري بين گروه هاي آزمودني وجود داشت.

Background: Nowadays, the disease pattern has adopted a biological – psychosocial and social pattern, in which humans are seen as multi-dimensional beings and all these biological – psychosocial and social patterns act as interactive systems influencing each other. As a result, this study sought to examine coping styles and hemodynamic effect on the life quality in patients with cardiovascular symptoms and changes in their psychophysiology functioning and their mental status. Cardiovascular diseases are considered as the major stress factors that often lead to changes in patients› mental status. Methods: The study adopted a post event approach (causal – comparative design). The population of the study included all patients with cardiovascular diseases in Nime-e-Shaban and Al-Zahra hospital and healthy individuals (students and employees) in Sari. The sample consisted of 232 people 87 of whom were healthy subjects, 77 patients were admitted as the coronary heart attack and stroke patients and 68 non-stroke patients who were grouped through available sampling. It should be noted that the data for this study was obtained through a questionnaire. Results: the findings of this study showed that the quality of life among cardiovascular patients was lower than that of healthy people. Besides, the quality of life among patients with heart stroke was lower than those without any heart stroke. As these results show, regarding the hemodynamic variable such as blood pressure changes and heart beat variations in cardiovascular patients and those with stroke showed significant differences before and after the test. Conclusion: The results show that in all components of quality of life among different coping styles groups significant differences have existed. In addition, these results indicate that some hemodynamic parameters (such as changes in heart beat, blood pressure, percentage changes in heart beat, systolic blood pressure and increased sympathetic and regular night sleep) showed significant differences among groups of subjects before and after the test, and the stroke patients had higher scores, thus, were more vulnerable.