عنوان پايان نامه: تعیین چالش هاي دریافت خدمات مراقبتي در میان بیماران مبتلا به مالتیپل اسكلروزيس مراجعه کننده به بیمارستان سینا در سال های 1395-1397

عنوان پايان نامه: تعیین چالش هاي دریافت خدمات مراقبتي در میان بیماران مبتلا به مالتیپل اسكلروزيس مراجعه کننده به بیمارستان سینا در سال های 1395-1397

11 3 1398

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بر اساس آمارھای جهانی در سال 2010 حدود 5/2 میلیون نفر در جهان به بیماری مالتیپل اسکلروزیس (ام اس) مبتلا هستند.   ام اس ناتوانی ھای زیادی را سبب می شود و مبتلایان به این بیماری کیفیت زندگی مرتبط با سلامت پایین تری نسبت به جامعه عمومی دارند. تعدادی از مطالعات نشان داده اند که افراد مبتلا به ام اس از چندین حیطه مراقبتی از قبیل توانبخشی، مشاوره های روانی و اجتماعی، هماهنگی بین خدمات و مشاوره درمورد مسایل مربوط به بیماری ام اس ناراضی اند. با توجه به نارضايتي بيماران از بخش هاي مختلف خدمات مراقبتي در اين مطالعه برآن شديم تا چالش هاي دریافت خدمات مراقبتي در میان بيماران مبتلا به مالتيپل اسكلروزيس مراجعه کننده به بیمارستان سینا را شناسايي كنيم.
این مطالعه به روش cross sectional در میان بیماران مراجعه کننده به بیمارستان سینا در سال های 1395 تا 1397 از طریق پرسشنامه ای محقق ساخته (که توسط متخصصان حوزه ام اس طراحی شده است) انجام شده است.
در اين پرسشنامه چالش هاي خدمات مراقبت در چهار حيطه بررسي مي شود :
I.          هزينه خدمات دارويي ، بستري در بيمارستان و توان بخشي
II.         حمايت خانواده و حمايت هاي شغلي  ، حمايت سيستم بيمه
III.        دسترسي به سيستم درمان و حمل و نقل
IV.        كيفيت مراكز نگه داري
نتایج:
1009 پرسشنامه وارد مطالعه شد.
اولویت بندی چالش های خدمات مراقبتی به این شکل می باشد:
هزینه های خدمات دارویی (7/49 %) عدم وجود مشاوره تلفنی (7/47 %) بیمه نبودن توانبخشی در منزل (6/44 %) کمبود مراکز نگهداری با کیفیت (2/41 %) هزینه های توانبخشی (4/40 %)
افراد با ام اس شدید و افراد غیر شاغل با اکثر موارد مشکل داشتند. در افراد با سن بالاتر مشکلات عدم وجود ویزیت در منزل و عدم حمایت خانواده بیشتر بوده است. در افراد با تحصیلات غیر دانشگاهی مشکلات هزینه های دارویی و حمل و نقل و عدم حمایت خانواده بیشتر بود.
این مطالعه چالش های خدمات مراقبتی بیماران مبتلا به ام اس را نشان می دهد که در افراد بر اساس شدت درگیری بیماری ، سن، تحصیلات و وضعیت اشتغال متفاوت است و با توجه به اهمیت این مشکلات پیدا کردن راه حل های مناسب توسط مطالعات آینده جهت برطرف کردن این چالش ها و بهبود کیفیت زندگی بیماران توصیه می شود.
 
كليد واژه ها : مالتیپل اسكلروزيس - چالش ھاي خدمات مراقبتي بیماران مبتلا به ام اس
مشخصات دانشجو:
نام و نام خانوادگی: نیلوفر جهرمی  
رشته تحصيلي: پزشکی عمومی  
مقطع:  دکتری عمومی                  گروه آموزشي: پزشکی           
niloo.jahromi@gmail.comپست الكترونيك دانشجو:
اساتيد راهنما و داور:
استاد راهنما : جناب آقای دکتر محمدعلی صحراییان
اساتيد مشاور: جناب آقای دکتر امیر رضا عظیمی - جناب آقای دکتر عبدالرضا ناصر مقدسی
اساتيد داور: سرکار خانم دکتر فهیمه وهبی زاد سرکار خانم دکتر سمانه حقیقی
زمان دفاع :
   روز  شنبه تاريخ  28 اردیبهشت 1398 ساعت 12:30
مكان دفاع به آدرس:  بیمارستان سینا ، مرکز تحقیقات ام اس
اطلاعات به زبان انگليسي
Title: Identify the challenges of health care delivery among patients with multiple sclerosis in Sina hospital in 1395-1397
 
Abstract:
Background:
Based on global statistics in 2010, about 2.5 million people in the world are affected by multiple sclerosis (MS). MS causes many disabilities and patients had significantly lower health-related quality of life than in the general population. A number of studies have shown that people with MS have been dissatisfied with several areas of care. Regarding the dissatisfaction of patients with various care services, in this study, we sought to identify the challenges of health care delivery among patients with MS in Sina hospital.
Methods:
This cross-sectional study was conducted in 2016-2018 through a researcher-made questionnaire (designed by MS Specialists in MS research center).
The questionnaire examined the challenges of care in four areas:
1)Cost of pharmaceutical, hospitalization and rehabilitation services 2) Family, social and insurance system support 3) Access to the treatment services and  4) Quality of care centers.
Results:
Completed questionnaires were received for 1009 respondents.
Prioritizing care services challenges is as follows: The cost of pharmaceutical services (49.7%), Lack of telephone counseling (47.7%), Uninsured home rehabilitation (44.6%), Lack of qualified care centers (41.2%), Rehabilitation costs (40.4%). People with severe MS and Unemployed people had more problems with most areas. Older patients had problems with the absence of home visits and lack of family support.Cost of pharmaceutical services and transportation and lack of family support were bigger challenges in non-academic education groups.
Conclusion:
This study shows the challenges of health care delivery among MS patients is that vary in severity of disease, age, employment, and education. As challenges mentioned above are of great importance in determine the quality of life of people with MS, an appropriate solution is recommended by this study to overcome these challenges.
 
Keywords:
multiple sclerosis , health care challenges , patients with MS
 
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