پديد آورندگان :
يونسي، زهرا دانشگاه علوم پزشكي بيرجند - دانشكده پرستاري و مامايي - گروه آموزشي پرستاري سلامت جامعه , افشاري، غزل دانشگاه علوم پزشكي بيرجند - دانشكده پرستاري و مامايي - گروه آموزشي پرستاري سلامت جامعه , سالاري دستگرد دانشگاه علوم پزشكي بيرجند - مركز خدمات جامع سلامت مهرشهر , گندمي، حميده دانشگاه علوم پزشكي بيرجند - مركز بهداشت شهرستان بيرجند
كليدواژه :
مديريت درد , واكسيناسيون , شيرخوار , وسيله كاهنده درد
چكيده فارسي :
زﻣﻴﻨﻪ و ﻫﺪف: واﻛﺴﻴﻨﺎﺳﻴﻮن دوران ﻛﻮدﻛﻲ ﺑﻪ ﻋﻨﻮان ﺷﺎﻳﻊ ﺗﺮﻳﻦ ﻣﻨﺒـﻊ درد اﻳﺎﺗﺮوژﻧﻴـﻚ ﻣﻨﺒـﻊ اﺻـﻠﻲ درد، اﺿﻄﺮاب و اﺳﺘﺮس در واﻟﺪﻳﻦ و ﻛﻮدﻛﺎن اﺳﺖ ﻛﻪ در اﻛﺜﺮ اوﻗﺎت ﺑﺪون ﻣﺪﻳﺮﻳﺖ درد اﻧﺠﺎم ﻣﻲ ﮔﻴﺮد. ﻟﺬا ﺑـﺎ ﺗﻮﺟﻪ ﺑﻪ اﻫﻤﻴﺖ ﻛﻨﺘﺮل درد در ﻛﻮدﻛﺎن و ﻧﻴﺰ ﺷﻨﺎﺧﺖ و ﺑﻪ ﻛﺎرﮔﻴﺮي روش ﻫﺎي ﻛﻨﺘﺮل درد ﺗﻮﺳﻂ اﻋﻀـﺎي ﺗﻴﻢ ﺑﻬﺪاﺷﺘﻲ، اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺗﺄﺛﻴﺮ ShotBlocker ﺑﺮ درد ﻧﺎﺷﻲ از ﺗﺰرﻳﻖ واﻛﺴـﻦ در ﺷـﻴﺮﺧﻮاران6 ﻣﺎﻫﻪ اﻧﺠﺎم ﮔﺮﻓﺘﻪ اﺳﺖ.
روش ﺑﺮرﺳﻲ: در اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻛﺎرآزﻣﺎﻳﻲ ﺑﺎﻟﻴﻨﻲ 80 ﺷـﻴﺮﺧﻮار ﻣﺮاﺟﻌـﻪ ﻛﻨﻨـﺪه ﺑـﻪ ﻣﺮﻛـﺰ ﺑﻬﺪاﺷـﺘﻲ درﻣـﺎﻧﻲ ﻣﻬﺮﺷـﻬﺮ ﺑﻴﺮﺟﻨﺪ در ﺳﺎل 98- 97 ﺑﺎ در ﻧﻈﺮ ﮔﺮﻓﺘﻦ ﻣﻌﻴﺎرﻫﺎي ﻣﻄﺎﻟﻌﻪ ﺑﻪ روش ﻧﻤﻮﻧﻪ ﮔﻴﺮي در دﺳﺘﺮس اﻧﺘﺨـﺎب و ﺑـﺎ ﺗﺨﺼـﻴﺺ ﺗﺼﺎدﻓﻲ در دو ﮔﺮوه ﻛﻨﺘﺮل و آزﻣﻮن ﻗﺮار ﮔﺮﻓﺘﻨﺪ. در ﮔﺮوه آزﻣﻮن 20 ﺛﺎﻧﻴﻪ ﻗﺒﻞ از ﺗﺰرﻳـﻖ ﺗـﺎ ﭘﺎﻳـﺎن ﺗﺰرﻳـﻖ ﻓﺸـﺎر در ﻣﺤﻞ ﺗﺰرﻳﻖ ﺑﻪ وﺳﻴﻠﻪ ShotBlocker اﻧﺠﺎم ﮔﺮﻓﺖ و ﮔﺮوه ﻛﻨﺘﺮل ﻃﺒـﻖ ﻣﻌﻤـﻮل واﻛﺴـﻴﻨﻪ ﺷـﺪﻧﺪ . وﺿـﻌﻴﺖ درد در دو ﮔﺮوه ﺑﺎ اﺳﺘﻔﺎده از ﻣﻘﻴﺎس واﻛﻨﺶ رﻓﺘﺎري درد )FLACC( 15 ﺛﺎﻧﻴﻪ ﭘﺲ از ﺗﺰرﻳﻖ و ﻣﺪت و زﻣﺎن ﺷﺮوع ﮔﺮﻳـﻪ ﻧﻴـﺰ از زﻣﺎن ﺗﺰرﻳﻖ واﻛﺴﻦ ﺗﺎ ﭘﺎﻳﺎن ﮔﺮﻳﻪ در دو ﮔﺮوه ﺑﺎ ﻫﻤﺪﻳﮕﺮ ﻣﻘﺎﻳﺴﻪ ﺷﺪ. داده ﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮن ﻫﺎي آﻣﺎري ﺗﻮﺻﻴﻔﻲ و اﺳﺘﻨﺒﺎﻃﻲ ﻣﻦ وﻳﺘﻨﻲ، ﺗﻲ ﺗﺴﺖ، آﻧﺎﻟﻴﺰ ﻛﻮوارﻳﺎﻧﺲ در ﺳﻄﺢ p<0/05 ﺗﺠﺰﻳﻪ و ﺗﺤﻠﻴﻞ ﺷﺪ.
ﻳﺎﻓﺘﻪ ﻫﺎ: ﻧﺘﺎﻳﺞ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد ﻛﻪ ﻣﻴﺎﻧﮕﻴﻦ ﺷﺪت درد )4/32 ±0/99(، ﻣﺪت ﮔﺮﻳﻪ )14/4 ±3/92 ﺛﺎﻧﻴﻪ(، زﻣﺎن ﺷﺮوع ﮔﺮﻳﻪ )4/05 ±0/933( در ﮔﺮوه آزﻣﻮن ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﻛﻨﺘﺮل ﻛﻢ ﺗﺮ ﺑﻮده اﺳﺖ )p<0/001 (.
ﻧﺘﻴﺠﻪ ﮔﻴﺮي: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺗﺄﺛﻴﺮ ShotBlocker ﺑﺮ ﻛﺎﻫﺶ ﺷﺪت درد، ﻣﺪت ﮔﺮﻳـﻪ و ﺗـﺄﺧﻴﺮ در زﻣـﺎن ﺷـﺮوع ﮔﺮﻳﻪ، اﺳﺘﻔﺎده از اﻳﻦ وﺳﻴﻠﻪ ﺳﺎده، اﻳﻤﻦ، ﻛﻢ ﻫﺰﻳﻨﻪ ﺑﺮاي ﻣﺪﻳﺮﻳﺖ درد واﻛﺴﻦ ﭘﻴﺸﻨﻬﺎد ﻣﻲ ﺷﻮد
چكيده لاتين :
Background & Aim: Childhood vaccination as the most common iatrogenic pain is the main source of pain, anxiety and stress in children and parents, which is often done without pain management. Therefore, given the importance of pain control in children, and the recognition and application of pain control methods by the health team members, this study was conducted to evaluate the effect of ShotBlocker on vaccination pain in 6-month-old infants.
Methods & Materials: In this clinical trial study, 80 infants referred to Mehrshahr health center in Birjand in 2018-2019, were selected using the convenience sampling method based on the study criteria, and then randomly assigned to the control or experimental groups. In the experimental group, 20 seconds before the injection until the end of the injection, pressure was applied to the injection site with a ShotBlocker. The control group only received routine care. The pain status in the two groups was measured using the Pain Behavioral Response Scale (FLACC) 15 seconds after injection, and also the duration of crying from the time of vaccine injection to the end of crying was compared between the two groups. Data was analyzed using descriptive and inferential statistics including Mann-Whitney, t-test, and analysis of covariance at the significance level of less than 0.05.
Results: The study results revealed the mean pain intensity (4.32±0.99), duration of crying (14.4±3.92), and the time of onset of crying (4.05±0.933) were lower in the experimental group than those of in the control group (P<0.001).
Conclusion: Considering that ShotBlocker is effective in reducing pain intensity, the duration of crying and delay in onset of crying, it is recommended to use this simple, safe, and low-cost device to manage pain during vaccine injection.
