مقايسه تاثير آموزش چهره به چهره و آموزش ازطريق فيلم بر اضطراب بيماران متقاضي پيوند مغز استخوان بيمارستان افضلي پور كرمان: يك مطالعه كارآزمايي باليني تصادفي شده

Comparison of the Effect of Face to Face Education and Video Training on the Anxiety of Patients Referring to Bone Marrow Transplantation in Afzalipour Hospital in Kerman: A Randomized Clinical Trial

زﻣﯿﻨﻪ و ﻫﺪف: آﻣﻮزش ﺑﯿﻤﺎران ﻗﺒﻞ از ﺟﺮاﺣﯽ ﻣﻮﺟﺐ ﮐﺎﻫﺶ درد و اﺿﻄﺮاب ﭘﺲ از ﻋﻤﻞ ﻣﯽﺷﻮد. ﻫﺪف ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺗﻌﯿﯿﻦ و ﻣﻘﺎﯾﺴﻪ ﺗﺄﺛﯿﺮ آﻣﻮزش ﭼﻬﺮهﺑﻪﭼﻬﺮه و آﻣﻮزش ازﻃﺮﯾﻖ ﻓﯿﻠﻢ ﺑﺮ اﺿﻄﺮاب ﺑﯿﻤﺎران ﻣﺘﻘﺎﺿﯽ ﭘﯿﻮﻧﺪ ﻣﻐﺰ اﺳﺘﺨﻮان ﺑﻮد. ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ ﺗﺼﺎدﻓﯽ ﻃﯽ ﻣﺪت 9 ﻣﺎه در ﺑﺨﺶ ﭘﯿﻮﻧﺪ ﻣﻐﺰ اﺳﺘﺨﻮان ﺑﯿﻤﺎرﺳﺘﺎن اﻓﻀﻠﯽ ﭘﻮر ﮐﺮﻣﺎن در ﺳﺎل 1397 اﻧﺠﺎم ﺷﺪ. روش ﻧﻤﻮﻧﻪﮔﯿﺮي ﺑﻪﺻﻮرت در دﺳﺘﺮس ﺑﻮد. 34 ﻧﻔﺮ در ﻫﺮ ﯾﮏ از دو ﮔﺮوه ﻗﺮار ﮔﺮﻓﺘﻨﺪ. آﻣﻮزش ﭼﻬﺮهﺑﻪﭼﻬﺮه در ﺳﻪ ﺟﻠﺴﻪ، ﻫﺮ ﺟﻠﺴﻪ 40 دﻗﯿﻘﻪ ﯾﮏ ﻫﻔﺘﻪ ﻗﺒﻞ از ﭘﺬﯾﺮش ﺑﯿﻤﺎران اﻧﺠﺎم ﮔﺮدﯾﺪ. در آﻣﻮزش ازﻃﺮﯾﻖ ﻓﯿﻠﻢ، ﻓﯿﻠﻢ ﺗﻬﯿﻪﺷﺪه از ﻣﺮاﺣﻞ درﻣﺎن و ﭘﯿﻮﻧﺪ، ﯾﮏ ﻫﻔﺘﻪ ﻗﺒﻞ از ﭘﺬﯾﺮش در اﺧﺘﯿﺎر ﺑﯿﻤﺎر ﻗﺮار ﮔﺮﻓﺖ. در دو ﮔﺮوه ﻣﯿﺰان اﺿﻄﺮاب ﺑﯿﻤﺎران ﻗﺒﻞ و ﺑﻌﺪ از آﻣﻮزش ﻣﻮردﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ. اﺑﺰار ﻣﻄﺎﻟﻌﻪ، ﭘﺮﺳﺶﻧﺎﻣﻪ اﻃﻼﻋﺎت ﺟﻤﻌﯿﺖ ﺷﻨﺎﺧﺘﯽ و ﭘﺮﺳﺶﻧﺎﻣﻪ اﺳﺘﺎﻧﺪارد اﺿﻄﺮاب )State-Trait Anxiety Inventory (STAI ﺑﻮد ﮐﻪ ﺑﻪﺻﻮرت ﻣﺴﺘﻘﻞ ﺗﮑﻤﯿﻞ ﺷﺪﻧﺪ. ﺑﺮاي ﺗﺠﺰﯾﻪوﺗﺤﻠﯿﻞ دادهﻫﺎ از آزﻣﻮنﻫﺎي t ﻣﺴﺘﻘﻞ، t زوﺟﯽ، آزﻣﻮن ﻣﺠﺬور ﮐﺎي و آزﻣﻮن دﻗﯿﻖ ﻓﯿﺸﺮ اﺳﺘﻔﺎده ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮه اﺿﻄﺮاب ﺑﯿﻤﺎران در ﮔﺮوه آﻣﻮزش ﭼﻬﺮهﺑﻪﭼﻬﺮه ﭘﺲ از ﻣﺪاﺧﻠﻪ آﻣﻮزﺷﯽ 25/32±12/54 ﻧﻤﺮه ﮐﺎﻫﺶ ﯾﺎﻓﺖ )0/001=P(. ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮه اﺿﻄﺮاب ﺑﯿﻤﺎران در ﮔﺮوه آﻣﻮزش ازﻃﺮﯾﻖ ﻓﯿﻠﻢ ﭘﺲ از ﻣﺪاﺧﻠﻪ آﻣﻮزﺷﯽ، 24/94±16/77 ﻧﻤﺮه ﮐﺎﻫﺶ ﯾﺎﻓﺖ )0/001=P(. ﺑﯿﻦ آﻣﻮزش ﭼﻬﺮهﺑﻪﭼﻬﺮه و آﻣﻮزش ازﻃﺮﯾﻖ ﻓﯿﻠﻢ ﺗﻔﺎوت ﻣﻌﻨﯽداري وﺟﻮد ﻧﺪاﺷﺖ )0/921=P(. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻧﺘﺎﯾﺞ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد آﻣﻮزش ﭼﻬﺮهﺑﻪﭼﻬﺮه و آﻣﻮزش ازﻃﺮﯾﻖ ﻓﯿﻠﻢ ﻣﯽﺗﻮاﻧﻨﺪ ﻣﻮﺟﺐ ﮐﺎﻫﺶ ﺳﻄﺢ اﺿﻄﺮاب ﺑﯿﻤﺎران ﻣﺘﻘﺎﺿﯽ ﭘﯿﻮﻧﺪ ﺷﻮﻧﺪ. ﺑﻨﺎﺑﺮاﯾﻦ ﺑﺮﺣﺴﺐ ﺷﺮاﯾﻂ ﺑﯿﻤﺎر ﻣﯽﺗﻮان ﯾﮑﯽ از روشﻫﺎي آﻣﻮزش را اﻧﺘﺨﺎب ﻧﻤﻮد.

Training patients before surgery can reduce postoperative pain and anxiety. This study aimed to compare the effect of face to face education and video training on the anxiety of patients requesting bone marrow transplantation. Materials and Methods: This randomized clinical trial study was performed over a period of 9 months in the bone marrow transplant ward of Afzalipour hospital affiliated to Kerman University of Medical Sciences (KMU) in 2018. The sampling method was convenience. 34 cases were assigned to each of two groups. Face-to-face training was conducted in three sessions, each session 40 minutes one week before admission. In the video training, the video of treatment and transplantation was given to the patient one week before admission. In both groups, patients' anxiety levels were examined before and after training. Demographic questionnaire and State-Trait Anxiety Inventory (STAI) were used for data collection and people completed the questionnaires independently. Independent samples t-test, paired sample t-test, Chi-square test and Fisher's exact test were used to analyze the data. Results: The mean score of patients' anxiety in the face-to-face training group decreased 25.32±12.54 score after the educational intervention (p=0.001). The mean score of patients' anxiety in the video training group also decreased 24.94±16.77 score after the educational intervention (p=0.001). There was no significant difference between face-to-face education and video training group (p=0.921). Conclusion: The results of this study showed that face-to-face and video-based educational interventions can reduce the level of anxiety in transplant patients. Therefore, according to the patient's condition, one of the training methods can be selected.