پديد آورندگان :
رﺿﺎﯾﯽ، ﻣﺎﻧﺪاﻧﺎ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﺗﺒﺮﯾﺰ - داﻧﺸﮑﺪه ﺗﻮاﻧﺒﺨﺸﯽ - ﮔﺮوه ﻓﯿﺰﯾﻮﺗﺮاﭘﯽ , ﺣﻮاﺋﯽ، ﻧﺎﺻﺮ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ اﯾﺮان - داﻧﺸﮑﺪه ﺗﻮاﻧﺒﺨﺸﯽ - ﮐﺎردرﻣﺎﻧﯽ , آﻗﺎزاده، اﻓﺸﯿﻦ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ اﯾﺮان - داﻧﺸﮑﺪه ﺗﻮاﻧﺒﺨﺸﯽ - ﮔﺮوه ﻓﯿﺰﯾﻮﺗﺮاﭘﯽ
كليدواژه :
ﭘﯿﺮوي , درﻣﺎن , ﺳﯿﺴﺘﯿﮏ ﻓﯿﺒﺮوزﯾﺲ , واﻟﺪ , ﺑﯿﻤﺎر
چكيده فارسي :
ﭘﯿﺮوي از درﻣﺎن ﺑﻪ ﻣﻌﻨﺎي ﻣﺸﺎرﮐﺖ ﻓﻌﺎل و داوﻃﻠﺒﺎﻧﻪ ﺑﯿﻤﺎر در ﺗﻌﺎﻣﻠﯽ دو ﻃﺮﻓﻪ و ﻣﻮرد ﻗﺒﻮل از ﻃﺮف درﻣﺎﻧﮕﺮ ﺑﻮده و ﻫﺪف از آن ﮐﺴﺐ ﻧﺘﯿﺠﻪ درﻣﺎﻧﯽ ﻣﻄﻠﻮب ﯾﺎ ﭘﯿﺸﮕﯿﺮاﻧﻪ اﺳﺖ. ﻫﺪف از اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﺮوري ﺑﺮرﺳﯽ ﺟﺎﻣﻊ اﺑﻌﺎد ﻣﺨﺘﻠﻒ ﻋﺪم ﭘﯿﺮوي از درﻣﺎن و اراﺋﻪ راﻫﮑﺎرﻫﺎي ﻣﻨﺎﺳﺐ در ﻣﺒﺘﻼﯾﺎن ﺑﻪ ﺳﯿﺴﺘﯿﮏ ﻓﯿﺒﺮوزﯾﺲ ﻣﯽ ﺑﺎﺷﺪ.
در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﺮوري ﻣﻨﺎﺑﻊ اﻃﻼﻋﺎﺗﯽ SID ،Medline ،Pub Med ،Google Scholar و Magiran در ﻣﺤﺪوده زﻣﺎﻧﯽ 2015-2008 ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ واژﮔﺎن ﮐﻠﯿﺪي ﺳﯿﺴﺘﯿﮏ ﻓﯿﺒﺮوزﯾﺲ، درﻣﺎن، ﭘﯿﺮوي، ﮐﻮدﮐﺎن و واﻟﺪﯾﻦ ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ و ﺗﻌﺪاد 29 ﻣﻘﺎﻟﻪ ﻣﺮﺗﺒﻂ ﺑﻮﺳﯿﻠﻪ ﺳﻪ ﻣﺤﻘﻖ ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﮔﺮدﯾﺪ.
ﺳﯿﺴﺘﯿﮏ ﻓﯿﺒﺮوزﯾﺲ ﯾﮏ ﺑﯿﻤﺎري ژﻧﺘﯿﮑﯽ و ﮐﺸﻨﺪه ﺑﻮده و روﻧﺪ درﻣﺎن آن وﻗﺖﮔﯿﺮ و ﭘﺮﻫﺰﯾﻨﻪ اﺳﺖ. ﭘﯿﺮوي از درﻣﺎن در اﯾﻦ ﺑﯿﻤﺎري در ﺟﻮاﻣﻊ ﭘﯿﺸﺮﻓﺘﻪ، ﺣﺘﯽ ﺑﺎ اراﺋﻪ ﺑﻬﺘﺮﯾﻦ روشﻫﺎي درﻣﺎﻧﯽ، ﮐﻤﺘﺮ از 50 درﺻﺪ ﮔﺰارش ﺷﺪه اﺳﺖ. ﻋﻮاﻣﻞ ﻣﺘﻌﺪدي از ﻗﺒﯿﻞ ﺳﻦ، ﺟﻨﺲ، ﺳﻄﺢ ﺗﺤﺼﯿﻼت واﻟﺪﯾﻦ و ﮐﻮدك، ﺳﻄﺢ آﮔﺎﻫﯽ و اﻋﺘﻘﺎدات واﻟﺪﯾﻦ و ﮐﻮدك از ﺑﯿﻤﺎري و درﻣﺎنﻫﺎي ﻣﺨﺘﻠﻒ، ﺗﻔﺎوتﻫﺎي ﻓﺮﻫﻨﮕﯽ در ﻣﻠﻞ ﻣﺨﺘﻠﻒ، دﻓﻌﺎت ﺑﺴﺘﺮي، ﺷﺪت ﺑﯿﻤﺎري، ﻣﺤﻞ اراﺋﻪ درﻣﺎن در ﺑﯿﻤﺎرﺳﺘﺎن، ﺧﺎﻧﻪ ﯾﺎ درﻣﺎﻧﮕﺎه، اﺳﺘﺮس و اﺿﻄﺮاب واﻟﺪﯾﻦ و ﮐﻮدﮐﺎن، ﺳﻄﺢ ﺣﻤﺎﯾﺖﻫﺎي اﺟﺘﻤﺎﻋﯽ و ﮐﯿﻔﯿﺖ و ﮐﻤﯿﺖ ﺧﺪﻣﺎت درﻣﺎﻧﯽ ﺑﺮ ﻣﯿﺰان ﭘﯿﺮوي از درﻣﺎن ﺗﺎﺛﯿﺮﮔﺬارﻧﺪ.
ﺑﺮﻗﺮاري ارﺗﺒﺎﻃﯽ ﭘﻮﯾﺎ و ﻣﺤﺘﺮﻣﺎﻧﻪ ﺑﺎ ﺑﯿﻤﺎر، ﺑﯿﺎن ﻧﺘﺎﯾﺞ ﺳﻮدﻣﻨﺪ، ﻣﺮاﺟﻌﺎت ﻣﮑﺮر و اﻧﺠﺎم ﺗﻮﺻﯿﻪﻫﺎي ﻣﻮﺟﻮد ﺑﺎ ﻫﺪف اﻓﺰاﯾﺶ ﻣﯿﺰان ﺑﻘﺎء، اﻧﮕﯿﺰه و اﻣﯿﺪ ﺑﯿﻤﺎر را اﻓﺰاﯾﺶ داده و ﺗﻮاﻧﺎﯾﯽ وي را در ﺟﻬﺖ ﺗﻄﺎﺑﻖ ﺑﺎ درﻣﺎنﻫﺎي ﭘﺮﻫﺰﯾﻨﻪ و زﻣﺎنﺑﺮ اﻣﮑﺎنﭘﺬﯾﺮ ﻣﯽﺳﺎزد. ﺑﻪ ﺗﻤﺎﻣﯽ ﻣﺮاﻗﺒﯿﻦ ﺣﻮزه ﺳﻼﻣﺖ ﺗﻮﺻﯿﻪ ﻣﯽﺷﻮد ﺑﺎ ﻣﻔﻬﻮم ﭘﯿﺮوي از درﻣﺎن آﺷﻨﺎﯾﯽ ﯾﺎﻓﺘﻪ، ﻣﻮاﻧﻊ و ﻣﺤﺮكﻫﺎي آن را ﺷﻨﺎﺳﺎﯾﯽ ﮐﺮده و اﺳﺘﺮاﺗﮋيﻫﺎي ﻣﻨﺎﺳﺐ را ﺟﻬﺖ ﺣﺼﻮل ﻧﺘﺎﯾﺞ ﺑﻬﺘﺮ درﻣﺎﻧﯽ اﺗﺨﺎذ ﮐﻨﻨﺪ.
چكيده لاتين :
Adherence to treatment is an active and acceptable interaction between patient and therapist to achieve the desired therapeutic and preventive outcomes. The objective of this study is the overview of the aspects and factors affecting non-adherence and offering proper strategies in patients with cystic fibrosis.
A database search for relevant articles related to adherence to treatment in cystic fibrosis, published from 2008 to 2015, was conducted using the key words of cystic fibrosis, adherence, treatment, children and parent. Three investigators reviewed 29 relevant articles.
Cystic fibrosis is a multisystem fatal disease and its treatment process is costly and time consuming. However, adherence to treatment is lower than 50% even in industrial and developed societies. Many factors such as age, gender, education level of parents and children, attitudes and beliefs of parents and children about the disease, different treatment strategies, cultural differences, frequency of hospitalization, severity of the disease, location of treatment in hospital, home or clinic, stress of parents and children, social support and quality and quantity of health care system are effective in adherence to treatment.
Dynamic and respectful communication between the patient and the therapist, introducing benefits of adherence and providing recommendations with the aim of increasing of the survival rate will motivate patient in hopeful manner and enable him/her to comply with costly and time-consuming treatment process. So, it is recommended to all health care professionals to be familiarized with the concept of adherence, identify the barriers and facilitators of adherence and adapt appropriate strategies to achieve better results.
