ﻣﻘﺎﻳﺴﻪ ﺗﺄﺛﻴﺮ آﻣﻮزش ﺧﻮدﻣﺮاﻗﺒﺘﻲ ﺑﻪ روش وﻳﺪﻳﻮﻳﻲ و ﻧﻮﺷﺘﺎري ﺑﺮ اﺿﻄﺮاب ﺑﻴﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن دﺳﺘﮕﺎه ﮔﻮارش ﻓﻮﻗﺎﻧﻲ ﺗﺤﺖ ﺷﻴﻤﻲ درﻣﺎﻧﻲ

A comparison of the effect of video and written self-care education on anxiety in patients with upper gastrointestinal cancer undergoing chemotherapy

زﻣﻴﻨﻪ و ﻫﺪف: اﺿﻄﺮاب ﻳﻜﻲ از ﻋﻮارض ﺷﺎﻳﻊ در ﺑﻴﻤﺎران ﺳﺮﻃﺎﻧﻲ اﺳﺖ ﻛﻪ ﻣﻲ ﺗﻮاﻧﺪ ﺑـﺮ ﺳـﻼﻣﺖ ﺟﺴـﻢ و روان ﺑﻴﻤﺎران اﺛﺮ ﺑﮕﺬارد و در روﻧﺪ درﻣﺎن اﺧﺘﻼل اﻳﺠﺎد ﻛﻨﺪ. ﺑﻪ ﻫﻤﻴﻦ دﻟﻴﻞ ﺑﻴﻤﺎران ﻣﺒﺘﻼ ﺑـﻪ ﺳـﺮﻃﺎن ﻛـﻪ ﺗﺤﺖ ﺷﻴﻤﻲ درﻣﺎﻧﻲ ﻫﺴﺘﻨﺪ، ﻧﻴﺎزﻣﻨﺪ آﻣﻮزش درﺑﺎره ﺑﻴﻤﺎري و راﻫﻜﺎرﻫﺎي ﻣﻘﺎﺑﻠﻪ ﺑـﺎ ﻋـﻮارض و ﻣﺸـﻜﻼت آن ﻫﺴﺘﻨﺪ. ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﻣﻘﺎﻳﺴﻪ ﺗـﺄﺛﻴﺮ دو روش آﻣـﻮزش وﻳـﺪﻳﻮﻳﻲ و ﻧﻮﺷـﺘﺎري ﺑـﺮ اﺿـﻄﺮاب ﺑﻴﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﻣﻌﺪه و ﻣﺮي ﻛﻪ ﺗﺤﺖ ﺷﻴﻤﻲ درﻣﺎﻧﻲ ﺳﺮﭘﺎﻳﻲ ﻫﺴﺘﻨﺪ، اﻧﺠﺎم ﻳﺎﻓﺘﻪ اﺳﺖ. روش ﺑﺮرﺳﻲ: اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻳﻚ ﻛﺎرآزﻣﺎﻳﻲ ﺑﺎﻟﻴﻨﻲ ﺗﺼﺎدﻓﻲ ﺷﺪه اﺳﺖ ﻛﻪ در ﻣﻮرد 58 ﺑﻴﻤﺎر ﻣﺒﺘﻼ ﺑـﻪ ﺳـﺮﻃﺎن ﻣﻌﺪه و ﻣﺮي ﻛﻪ ﺗﺤﺖ ﺷﻴﻤﻲ درﻣﺎﻧﻲ ﺳﺮﭘﺎﻳﻲ در ﺑﻴﻤﺎرﺳﺘﺎن ﻫﺎي ﺷﺮﻳﻌﺘﻲ و اﻣﺎم ﺧﻤﻴﻨﻲ ﺗﻬـﺮان ﺑﻮدﻧـﺪ، اﻧﺠـﺎم ﮔﺮﻓﺘﻪ اﺳﺖ. ﺷﺮﻛﺖ ﻛﻨﻨﺪﮔﺎن ﺑـﻪ ﺻـﻮرت ﺗﺼـﺎدﻓﻲ در ﮔـﺮوه آﻣـﻮزش وﻳـﺪﻳﻮﻳﻲ )28 ﻧﻔـﺮ ( و ﮔـﺮوه آﻣـﻮزش ﻧﻮﺷﺘﺎري )30 ﻧﻔﺮ( ﻗﺮار ﮔﺮﻓﺘﻨﺪ. داده ﻫﺎ ﺑـﺎ اﺳـﺘﻔﺎده از ﭘﺮﺳﺸـﻨﺎﻣﻪ اﺿـﻄﺮاب ﺣﺎﻟـﺖ اﺷـﭙﻴﻞ ﺑﺮﮔـﺮ )STAI( در اﺑﺘﺪاي ﻣﻄﺎﻟﻌﻪ و ﺑﻪ ﺻﻮرت ﻫﻔﺘﮕﻲ در ﻃﻲ 12 ﻫﻔﺘﻪ ﺟﻤﻊ آوري و در ﻧﺮم اﻓﺰار SPSS ﻧﺴﺨﻪ 20 ﺗﺤﻠﻴﻞ ﺷﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﻧﺘﺎﻳﺞ ﭘﮋوﻫﺶ ﻧﺸﺎن داد ﻛﻪ ﻣﻴـﺰان اﺿـﻄﺮاب در ﻫـﺮ دو ﮔـﺮوه ﻧﺴـﺒﺖ ﺑـﻪ ﻗﺒـﻞ از ﻣﺪاﺧﻠـﻪ ﺑـﻪ ﻃـﻮر ﻣﻌﻨﺎداري ﻛﺎﻫﺶ داﺷﺘﻪ اﺳﺖ )p<0/05(. در ﺑﺮرﺳﻲ ﻣﻴﺎﻧﮕﻴﻦ ﻧﻤﺮه اﺿﻄﺮاب ﺑﻴﻦ ﮔﺮوه وﻳـﺪﻳﻮ )56/07±9/85( و ﮔﺮوه ﻧﻮﺷﺘﺎري )56/40±8/13 ( ﺑﻌﺪ از اﻧﺠﺎم ﻣﺪاﺧﻠﻪ ﺗﻔﺎوت آﻣﺎري ﻣﻌﻨﺎداري ﻣﺸﺎﻫﺪه ﻧﺸﺪ )0/89=p(. ﻧﺘﻴﺠﻪ ﮔﻴﺮي: ﺑﻪ ﻃﻮر ﻛﻠـﻲ ﻧﺘـﺎﻳﺞ اﻳـﻦ ﻣﻄﺎﻟﻌـﻪ ﻧﺸـﺎن داد ﻛـﻪ آﻣـﻮزش ﺧـﻮدﻣﺮاﻗﺒﺘﻲ در روش وﻳـﺪﻳﻮﻳﻲ و ﻧﻮﺷﺘﺎري، اﺿﻄﺮاب ﺑﻴﻤﺎران ﺳﺮﻃﺎﻧﻲ ﺗﺤﺖ ﺷﻴﻤﻲ درﻣﺎﻧﻲ را ﻛﺎﻫﺶ ﻣﻲ دﻫﺪ و ﻫﺮ دو روش ﻣـﻲ ﺗﻮاﻧﻨـﺪ در ﻛﺎﻫﺶ اﺿﻄﺮاب ﺑﻴﻤﺎران ﻣﺆﺛﺮ ﺑﺎﺷﻨﺪ.

Background & Aim: Anxiety is one of the most common complications in cancer patients that can affect the physical and mental health of patients and disrupt the treatment process. For this reason, cancer patients undergoing chemotherapy need education about the disease and ways to cope with its complications and problems. The aim of this study was to compare the effects of video and written training methods on anxiety in patients with gastric and esophageal cancer undergoing outpatient chemotherapy. Methods & Materials: This study is a randomized clinical trial that was conducted on 58 patients with gastric and esophageal cancer who underwent outpatient chemotherapy in Shariati and Imam Khomeini hospitals in Tehran. Participants were randomly assigned to either the video training group (n=28) or the written training group (n=30). Data was collected using the Spielberger State Anxiety Inventory (STAI), at the beginning of the study and then weekly for 12 weeks. The SPSS software version 20 was used to analyze the data. Results: The results showed that the level of anxiety in both groups was significantly lower compared to before the intervention (P<0.05). There was no statistically significant difference in the anxiety mean score between the video group (56.07±9.85) and the written group (56.40±8.13) after the intervention (P=0.89). Conclusion: In general, the results of this study showed that self-care education using video and written methods reduces the anxiety of cancer patients undergoing chemotherapy and both methods can be effective in reducing patients' anxiety.