بررسي شدت و الگوي مصرف دخانيات و مواد مخدر در بيماران مبتلا به COPD

The Study of Severity and Pattern of Smoking and Drug Abuse in COPD Patients

در درﻣﺎن ﻫﻤﻪﺟﺎﻧﺒﻪ ﻧﮕﺮ Holistic ﺑﻪ ﺑﯿﻤﺎر ﺑﻪ ﻋﻨﻮان ﯾﮏ اﻧﺴﺎن ﮐﺎﻣﻞ و ﻧﻪ ﺻﺮﻓﺎ ﯾﮏ ﻋﻀﻮ ﺑﯿﻤﺎر ﻧﮕﺮﯾﺴﺘﻪ ﻣﯽﺷﻮد. از اﯾﻦ رو ﺑﺪون درﻣﺎن ﻫﻤﻪ ﺟﺎﻧﺒﻪ و ﻫﻤﺰﻣﺎن ﺟﺴﻢ و روان، اﻣﮑﺎن دﺳﺖ ﯾﺎﺑﯽ ﺑﻪ ﻧﻬﺎﯾﺖ درﻣﺎن ﻣﻄﻠﻮب ﻓﺮاﻫﻢ ﻧﻤﯽ ﺷﻮد. ﻫﺪف اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﯽ اﻟﮕﻮي ﺳﻮ ﻣﺼﺮف ﻣﻮاد در ﺑﯿﻤﺎران ﺑﺴﺘﺮي ﻣﺒﺘﻼ ﺑﻪ اﻧﺴﺪاد ﻣﺰﻣﻦ رﯾﻪ (COPD) ﺑﻮده اﺳﺖ ﺗﺎ درﻣﺎن ﻣﻨﺎﺳﺐ ﺗﺮي ﺑﺮاي آنﻫﺎ ﻓﺮاﻫﻢ ﺷﻮد. در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﯽ ﺗﺤﻠﯿﻠﯽ 90 ﺑﯿﻤﺎر ﻣﺒﺘﻼ ﺑﻪ COPD ﺑﺎ ﺳﺎﺑﻘﻪ اﺧﺘﻼل ﻣﺼﺮف ﻣﻮاد ﺑﺎ 90 ﺑﯿﻤﺎر ﺑﺪون ﺳﺎﺑﻘﻪ اﺧﺘﻼل ﻣﺼﺮف ﻣﻮاد از ﻧﻈﺮ ﺷﺪت و اﻟﮕﻮ ﻣﺼﺮف ﻣﻮاد در ﺑﯿﻤﺎرﺳﺘﺎن دﮐﺘﺮ ﻣﺴﯿﺢ داﻧﺸﻮري ﺑﺮرﺳﯽ ﺷﺪﻧﺪ. ﭘﺮﺳﺸﻨﺎﻣﻪ ASI ﺟﻬﺖ اﺧﺬ اﻃﻼﻋﺎت از ﺑﯿﻤﺎران ﻣﻮرد اﺳﺘﻔﺎده ﻗﺮار ﮔﺮﻓﺖ و ﻧﺮم اﻓﺰارSPSS 21 ﺟﻬﺖ ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ اﻃﻼﻋﺎت ﺑﮑﺎر رﻓﺖ. ﺳﻦ ﻣﺘﻮﺳﻂ ﺷﺮﮐﺖ ﮐﻨﻨﺪﮔﺎن در ﻣﻄﺎﻟﻌﻪ 66±11 ﺳﺎل ﺑﻮد ﮐﻪ 90% ﻣﺬﮐﺮ و 84% ﻣﺘﺎﻫﻞ ﺑﻮدﻧﺪ. 37/9% در زﻣﺎن اﻧﺠﺎم ﻣﻄﺎﻟﻌﻪ ﺳﯿﮕﺎر ﻣﺼﺮف ﻣﯽ ﮐﺮدﻧﺪ و 51/2 % ﺗﺎ 5 دﻗﯿﻘﻪ اول ﭘﺲ از ﺑﯿﺪار ﺷﺪن، ﺳﯿﮕﺎر ﺧﻮد را روﺷﻦ ﻣﯽ ﻧﻤﻮدﻧﺪ. ﺑﯿﺸﺘﺮﯾﻦ ﺗﻌﺪاد ﺑﯿﻤﺎران )50/9 %( در 20 ﺗﺎ 39 ﺳﺎﻟﮕﯽ ﺷﺮوع ﺑﻪ ﻣﺼﺮف ﺗﺮﯾﺎك ﮐﺮده ﺑﻮدﻧﺪ. 71% ﺑﯿﻤﺎران ﻣﺼﺮف ﻣﻨﻈﻢ ﺗﺮﯾﺎك داﺷﺘﻨﺪ ﮐﻪ 64/8% آن از راه ﺗﺪﺧﯿﻦ و 35/2% ﺑﺼﻮرت ﺧﻮراﮐﯽ ﺑﻮده اﺳﺖ. اﻟﮕﻮي ﻣﺼﺮف ﺗﺮﯾﺎك و ﺗﻌﺪاد دﻓﻌﺎت ﺑﺴﺘﺮي ﺑﺎ ﻫﻢ ﻣﺮﺗﺒﻂ ﺑﻮدﻧﺪ. ﺑﯿﻦ ﺷﻐﻞ و اﻟﮕﻮي ﻣﺼﺮف ﺳﯿﮕﺎر و ﻣﻮاد ﻣﺨﺪر ارﺗﺒﺎط ﻣﻌﻨﯽ دار دﯾﺪه ﺷﺪ. ﻧﺘﺎﯾﺞ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد ﮐﻪ درﺻﺪ ﺑﺎﻻﯾﯽ از ﺑﯿﻤﺎران ﺑﺎ وﺟﻮد اﯾﻨﮑﻪ ﻣﺒﺘﻼ ﺑﻪ ﺑﯿﻤﺎري رﯾﻮي ﭘﯿﺸﺮﻓﺘﻪ ﻫﺴﺘﻨﺪ ﺳﯿﮕﺎري ﺑﻮده و ﻣﺼﺮف ﺗﺮﯾﺎك دارﻧﺪ و اﯾﻦ ﻋﺎدات از ﻃﺮﻓﯽ ﻣﻮﺟﺐ ﮐﺎﻫﺶ ﭘﺬﯾﺮش درﻣﺎن ﺑﯿﻤﺎري ﺟﺴﻤﯽ و از ﻃﺮﻓﯽ ﺑﺎﻋﺚ اﻓﺰاﯾﺶ ﺗﻌﺪاد دﻓﻌﺎت ﺑﺴﺘﺮي ﮔﺮدﯾﺪهاﻧﺪ. از اﯾﻦ رو ﺑﻬﺘﺮ اﺳﺖ ﮐﻪ ﺑﺎ ﺑﺮﻧﺎﻣﻪ رﯾﺰي ﻫﻤﻪ ﺟﺎﻧﺒﻪ و ﮐﻠﯽ، ﺑﯿﻤﺎري ﻫﺎي رﯾﻮي و اﻋﺘﯿﺎد ﺑﻄﻮر ﻫﻤﺰﻣﺎن ﻣﻮرد ﺑﺮرﺳﯽ و درﻣﺎن ﻗﺮار ﮔﯿﺮﻧﺪ.

In holistic care the patients are considered comprehensively, not merely as an involved organ. So, the physical and psychological managements are needed to achieve the optimum treatment results. The current analytic cross-sectional study tried to assess the amount and pattern of substance abuse among the hospitalized COPD patients of Dr. Masih Daneshvari Hospital, in order to provide more appropriate treatment for them. Ninety COPD patients with the history of substance abuse were compared with 90 ones without any abuse history. Using ASI questionnaire and SPSS software (V21) software, the patient’s information was obtained and analyzed. The participant’s mean age was 66±11 years, while 90% were male and 84% were married. At the time of study 37.9% was smoker which among them, 51.2% lit their cigarettes in the first 5 minutes upon waking up. Most patients (50.9%) started to use opium at the age of 20-39 years. Regular opium usage was seen in 71%; in them inhalation (64.8%) and oral (35.2%) were the intake routes. The Pattern of opium usage and number of hospital admission were related. Also, job and pattern of substances abuse were significantly related. Most of the COPD patients continue to smoke and use opium, regardless of their progressive pulmonary disease. Thus, they are noncompliant with treatment and have obligatory multiple hospitalizations. As a result, comprehensive treatment of these patients - including both pulmonary disease and addiction - is needed to be addressed.