امروز : چهارشنبه 28 شهریور 1397 Rss | صفحه اصلی دانشکده
31 شهریور 1395

بررسی شیوع افسردگی، اضطراب و استرس در همراهان خانوادگی بیماران بستری‌شده در بخش های مراقبت‌ ویژه و عوامل مؤثر بر آن در بیمارستان‌های وابسته به دانشگاه علوم پزشکی تهران در سال 94-1393.

اعضای خانواده بیماران بستری در بخش‌های بخش‌های مراقبت ویژه واکنش‌های روان‌شناختی زیادی را تجربه می‌کنند. شناخت و برطرف کردن نیازهای روانی اعضای خانواده بیماران یک ضرورت و اولویت غیرقابل‌انکار است. این مطالعه باهدف بررسی شیوع  افسردگی، اضطراب و استرس در همراهان خانوادگی بیماران بستری‌شده در بخش  مراقبت ویژه و عوامل مؤثر بر آن در بیمارستان‌های وابسته به دانشگاه علوم پزشکی تهران انجام گردید. روش کار: این مطالعه توصیفی- تحلیلی بر روی ۴۰۰ نفر از اعضای درجه اول خانواده بیماران بستری در بخش‌های مراقبت ویژه جنرال در بیمارستان‌های وابسته به دانشگاه علوم پزشکی تهران طی سال‌های 94- ۱۳۹۳ انجام شد. اطلاعات با استفاده از پرسشنامه مشخصات بیماران و همراهان و واکنش‌های روان‌شناختی افسردگی، اضطراب و استرس به‌وسیله پرسشنامه استاندارد DASS-21جمع‌آوری گردید. داده‌ها پس از جمع‌آوری با استفاده از نرم‌افزار SPSS19 و به کمک شاخص‌های آماری توصیفی، ضریب همبستگی، آزمون‌های آنالیز واریانس، تی مستقل و تحلیل رگرسیون چندگانه (به شیوه همزمان)، با سطح معناداری 05/0=α مورد تجزیه‌وتحلیل قرار گرفت. نتایج: بر اساس یافته‌های تحقیق افسردگی، اضطراب و استرس در اعضای درجه اول خانواده بیماران بستری در بخش‌های مراقبت ویژه بالا است، و به ترتیب 52٪، 67.5٪ و 61.2٪ از همراهان، سطح افسردگی، اضطراب و استرس متوسط و بالاتر رادارند. میانگین نمره افسردگی، اضطراب و استرس به ترتیب 8.11 ± 14.38، 7.95 ± 15.13 و 9.96 ± 17.71 بود که با بسیاری از عوامل مرتبط با بیمار، عوامل مرتبط با خانواده بیمار، و عوامل مرتبط با ICU و پرسنل مراقبت ارتباط معناداری دارد. به‌طوریکه متغیرهایی مانند سن و جنس بیمار، سابقه بیماری بستری قبلی بیمار، نان‌آور بودن، وضعیت هوشیاری، سن و جنس همراه، نوع خویشاوندی، وضعیت تأهل، سطح تحصیلات، شغل، محل زندگی، زندگی کردن با بیمار، مسئولیت تصمیم‌گیری، رضایت از وضعیت دسترسی و ملاقات، رضایت از ارتباط پزشکان، رضایت از عملکرد پرستاران، رضایت از ارتباط پرستاران و سایر کارکنان درمانی و رضایت از طراحی و ساختار بخش مراقبت ویژه توانسته‌اند مقدار قابل‌توجهی از واریانس نمره هر یک از متغیرهای افسردگی، اضطراب و استرس در همراهان بیماران بستری در بخش‌ مراقبت ویژه را به‌طور معناداری تبیین کنند. نتیجه‌گیری: نتایج پژوهش حاضر بیانگر فراوانی واکنش‌های روان‌شناختی در بین در اعضای درجه اول خانواده بیماران بستری در بخش‌های مراقبت ویژه است. این واکنش‌ها می‌تواند سلامت روانی مراقبین را به مخاطره انداخته و کیفیت مراقبت و نوع ارتباط با فرد بیمار را مختل نماید. باید تدابیری اتخاذ گردد تا عواملی که در بروز واکنش‌های روان‌شناختی مؤثر هستند، کاهش یابند و با شناخت سریع و به‌موقع از عواقب آن پیشگیری شود. كليد واژه ها : افسردگی، اضطراب، استرس، بخش مراقبت ویژه، بیماران بستری، خانواده، اعضای خانواده، همراه بیمار مشخصات دانشجو: نام: رستگار رحمانی تنها  رشته تحصيلي: پزشکی  مقطع:دکترای عمومی   پست الكترونيك دانشجو: Rastegar.rahmani@yahoo.com   اساتيد راهنما و داور: اساتيد راهنما: 1- دکتر مجتبی صداقت سیاهکل    2-دکتر علی اکبری ساری   اساتيد مشاور-----     اساتيد داور: 1- دکتر مژگان کاربخش  2- دکتر فرناز خاتمی زمان دفاع :    روز دوشنبه    تاريخ  29/6/1395      ساعت 10:45 مكان دفاع به آدرس: دانشکده پزشکی – گروه پزشکی اجتماعی اطلاعات به زبان انگليسي Title: Study on Prevalence of Depression, Anxiety, and Stress in Family Caregivers of Patients and Effective Factors, in Intensive Care Units of Hospitals Affiliated to Tehran University of Medical Sciences in 2015-16. Abstract: Introduction: family members of patients in intensive care units experience high psychological reactions. Identifying and meeting the psychological needs of patients' family members is an undeniable necessity and priority. This study aimed to investigate the prevalence of depression, anxiety, and stress in family caregivers of patients and effective factors, in ICUs of hospitals affiliated to Tehran University of medical sciences. Methods: This cross-sectional study was done on 400 first-degree family members of patients admitted to general ICUs of hospitals affiliated to Tehran University of Medical Sciences in 2015-16. Data were collected from the characteristics questionnaire of patients and their relatives, and psychological reactions, depression, anxiety, and stress were collected by DASS-21 standardized questionnaire. The data were statistically analyzed using SPSS19 by descriptive statistics, correlation, ANOVA, t-tests and multiple regression analysis (ENTER method) with the significance level of α=0.05. Results: The results show that depression, anxiety, and stress among family members of patients admitted to ICUs are high, and respectively 52.0%, 67.5% and 61.2% of the caregivers have a moderate and higher level of depression, anxiety, and stress. The mean score of depression, anxiety, and stress were 14.38±8.11, 15.13±7.95   and 9.96 17.71±9.96   respectively, which were significantly related to many factors associated with the patient, the patient's family, and ICU care personnel. So that variables such as patient's age and gender, history of chronic disease and previous hospitalization, the breadwinner, consciousness statues, caregivers' age and gender, relationship, marital status, education level, occupation, residence, living with the patient, responsibility for the decision, satisfaction with accessing and meeting , performance and communication of physicians, nurses and other medical staff and the design and construction of ICU predicted A significant amount of the variance of score of depression, anxiety, and stress. Conclusion: This study demonstrates a high prevalence of psychological reactions among family members of patients hospitalized in ICUs. These can endanger the mental health statues of caregivers, and limit quality of care and type of communication with the patient. Measures should be taken to reduce factors affecting psychological reactions, and there consequences to be prevented with timely diagnosis.   Keywords: Depression, Anxiety, Stress, Intensive Care Unit, Hospitalized Patients, Family, Family Members, Caregiver of Patient     فهرست منابع و ماخذ فارسي و لاتين: 1.      Du Gas, Beverly Witter. Introduction to patient care comprehensive approach to  nursing. 4th ed. ST. Louis: Mosby Inc; 2006. 2.      Lee LY, Lau YL. Immediate needs of adult family members of adult intensive care patients in Hong Kong. J Clin Nurs. 2003 Jul;12(4):490-500. 3.      Hilberman, M.(1975). The evolution of intensive care units. Critical CareMedicine, 3(4), 159-165. 4.      Hall, J. B., Schmidt, A. G., & Wood, L. D.(2005). Principal of Critical Care (3 rd Ed) (pp. 11-13). New York: Mcgraw-Hill. 5.      Kirchhoff KT, Song MK, Kehl K. Caring for the family of the critically ill patient. 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