ﺑﺮرﺳﯽ ﺗﺄﺛﯿﺮ راه اﻧﺪازي ﻣﺒﺘﻨﯽ ﺑﺮ ﺷﻮاﻫﺪ ﺑﯿﻤﺎر ﺑﺮ درد ﭘﺲ از ﺟﺮاﺣﯽ ﻫﺮﻧﯽ اﯾﻨﮕﻮﯾﻨﺎل

Examining of the Effect of Patient Evidence- Based Early Ambulation on Pain After Inguinal Surgery

زﻣﯿﻨﻪ و ﻫﺪف: ﻣﺪﯾﺮﯾﺖ و ﮐﻨﺘﺮل ﻣﻨﺎﺳــﺐ درد، ﻧﯿﺎز ﺑﻪ ارزﯾﺎﺑﯽ و درﻣﺎن ﺑﺮاﺳــﺎس ﻣﺸــﺎﻫﺪه وﺿــﻌﯿﺖ ﺑﯿﻤﺎر دارد. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺑﺮرﺳــﯽ ﺗﺄﺛﯿﺮ راهاﻧﺪازي ﻣﺒﺘﻨﯽ ﺑﺮ ﺷــﻮاﻫﺪ ﺑﯿﻤﺎر ﺑﺮ درد ﭘﺲ از ﺟﺮاﺣﯽ ﻫﺮﻧﯽ اﯾﻨﮕﻮﯾﻨﺎل در ﺑﯿﻤﺎرﺳــﺘﺎن اﻣﺎم ﺣﺴﯿﻦ )ع( ﺷﺎﻫﺮود اﻧﺠﺎم ﮔﺮدﯾﺪ. ﻣﻮاد و روش ﻫﺎ: اﯾﻦ ﭘﮋوﻫﺶ ﯾﮏ ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ ﯾﮏ ﺳﻮ ﮐﻮر اﺳﺖ. ﺟﺎﻣﻌﻪ ﭘﮋوﻫﺶ، ﺑﯿﻤﺎران ﺑﺎ ﺟﺮاﺣﯽ ﻫﺮﻧﯽ اﯾﻨﮕﻮﯾﻨﺎل در ﺳﺎل 96اﺳﺖ. 60ﺑﯿﻤﺎر ﺑﻪ دو ﮔﺮوه آزﻣﻮن و ﺷﺎﻫﺪ ﺑﺎ ر وش ﺗﺨﺼﯿﺺ ﺗﺼﺎدﻓﯽ ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﺟﻤﻊ آوري اﻃﻼﻋﺎت ﺑﺎ اﺳﺘﻔﺎده از ﻓﺮم دﻣﻮﮔﺮاﻓﯿﮏ و ﻣﻘﯿﺎس دﯾﺪاري درد اﻧﺠﺎم ﮔﺮﻓﺖ. اﻃﻼﻋﺎت ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰار SPSS16و آزﻣﻮن ﻫﺎي ﮐﻮﻟﻤﻮﮔﺮوف، ﻓﯿﺸﺮ، ﻧﺴﺒﺖ درﺳﺘﻨﻤﺎﯾﯽ، ﮐﯽ دو ﭘﯿﺮﺳﻮن، ﮐﯽ دو ﻓﺮﯾﺪﻣﻦ و وﯾﻠﮑﺎﺳﻮن، ﺗﺠﺰﯾﻪ وﺗﺤﻠﯿﻞ ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﺑﯿﻤﺎران ﮔﺮوه آزﻣﻮن، ﺷﺪت درد ﮐﻤﺘﺮي در ﻣﺮﺣﻠﻪ اول )ﻗﺒﻞ از راه اﻧﺪازي او ل( ﻧﺴﺒﺖ ﺑﻪ ﺑﯿﻤﺎران ﮔﺮوه ﺷﺎﻫﺪ داﺷﺘﻨﺪ ) 6/30 در ﻣﻘﺎﺑﻞ 6/50 (. ﺑﯿﻤﺎران ﮔﺮوه آزﻣﻮن، ﺷﺪت درد ﮐﻤﺘﺮي در ﻣﺮﺣﻠﻪ دوم )ﻗﺒﻞ از راه اﻧﺪازي دوم( ﻧﺴﺒﺖ ﺑﻪ ﺑﯿﻤﺎران ﮔﺮوه ﺷﺎﻫﺪ داﺷﺘﻨﺪ ) 5/40 در ﻣﻘﺎﺑﻞ 6/83 (. ﺑﯿﻤﺎران ﮔﺮوه آزﻣﻮن، ﺷﺪت درد ﮐﻤﺘﺮي در ﻣﺮﺣﻠﻪ ﺳﻮم )ﻗﺒﻞ از راه اﻧﺪازي ﺳﻮم( ﻧﺴﺒﺖ ﺑﻪ ﺑﯿﻤﺎران ﮔﺮوه ﺷﺎﻫﺪ داﺷﺘﻨﺪ ) 5/27 در ﻣﻘﺎﺑﻞ 7/00 (. ﺑﯿﻤﺎران ﮔﺮوه آزﻣﻮن ﺷﺪت درد ﮐﻤﺘﺮي در ﻣﺮﺣﻠﻪ ﭼﻬﺎرم )ﻗﺒﻞ از راه اﻧﺪازي ﭼﻬﺎرم( ﻧﺴﺒﺖ ﺑﻪ ﺑﯿﻤﺎران ﮔﺮوه ﺷﺎﻫﺪ داﺷﺘﻨﺪ ) 5/37 در ﻣﻘﺎﺑﻞ 6/57 (. ﺑﯿﻤﺎران ﮔﺮوه آزﻣﻮن ﺷﺪت درد ﮐﻤﺘﺮي در ﻣﺮﺣﻠﻪ ﭘﻨﺠﻢ )ﻗﺒﻞ از ﺗﺮﺧﯿﺺ( ﻧﺴﺒﺖ ﺑﻪ ﺑﯿﻤﺎران ﮔﺮوه ﺷﺎﻫﺪ داﺷﺘﻨﺪ ) 3/57 در ﻣﻘﺎﺑﻞ 5/77 (. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻧﺘﺎﯾﺞ اﯾﻦ ﭘﮋوﻫﺶ ﻧﺸﺎن داد ﮐﻪ راه اﻧﺪازي ﻣﺒﺘﻨﯽ ﺑﺮ ﺷﻮاﻫﺪ ﺑﻌﺪ از ﻋﻤﻞ ﺟﺮاﺣﯽ ﺑﺎ ﮐﺎﻫﺶ ﺷﺪت درد ﺑﯿﻤﺎران ﻫﻤﺮاه اﺳﺖ.

Proper management and control of pain requires evaluation and treatment based on observation of the patient's condition. The aim of this study was to examining of the effect of patient evidence-based ambulation on pain after inguinal hernia surgery in Imam Hossein (AS) Hospital in Shahroud. Materials and Methods: This is a single-blind clinical trial. In witch the study population was with hernia surgery in 2017.60 patients were divided into experimental and control groups by random allocation. Data collecting was done by the help of demographic forms and visual simulation scale of pain. Data were analyzed using SPSS16 software and Kolmogorov, Fisher, Friedman’s chi-2 and Wilkason tests. Results: The pain intensity among the experimental group's participants was less than control group's at the first step ,before the first ambulation (6.30 versus6.50) At the second step,befor the second ambulation,the experimental group’s participants suffered from less pain intensity in comparison with the control group (5.40 versus6.83) and also the pain intensity at the third step was less in experimental group than the control group (5.27 versus7.00) At the fourth step before the fourth ambulation, the experimental group's participants felt a less pain intensity than the control group's patients (5.37versus6.57) At the fifth step, before dismissal, the adnauseam intensity in the experimental group was also less than control group (3.57 versus 5.77) Conclusion: The research results shows that evidence based ambulation, after surgery is accompanied with decreasing the patient's pain intensity.