نوع مقاله : مقاله پژوهشی

نویسندگان

چکیده

مقدمه: امروزه یکی از مسایل مهم بهداشتی جوامع، افزایش تعداد و نسبت سالمندان در قسمت اعظم دنیا است که مورد توجه اندیشمندان علوم مختلف قرارگرفته است. تحقیق حاضر با هدف تعیین چگونگی مصرف خدمات بستری و سرپایی سالمندان در بیمارستان نمازی دانشگاه علوم پزشکی شیراز در سال1392 انجام شد.مواد و روش: در این مطالعه توصیفی و تحلیلی، 260 نفر از بین بیماران بالاتر از 60 سال که در بازه زمانی یک‌ساله (آذرماه 91 تا دی‌ماه 92) در بیمارستان نمازی شیراز بستری‌شده بودند، به روش نمونه‌گیری طبقه‌ای تصادفی انتخاب شدند. داده‌های مربوط به مصرف خدمات بستری نمونه‌ها ازجمله (ویژگی‌های دموگرافیک، استفاده از خدمات پاراکلینیک، پیامد بستری) از پرونده‌های آنان به وسیله چک‌لیست که روایی و پایایی آن مورد تایید قرارگرفته است گردآوری گردید. داده ها پس از ورود به نرم‌افزار spss نسخه 20 با استفاده از آمار توصیفی و استنباطی (تی مستقل، من ویتنی و کروسکال والیس) تحلیل شدند.یافته‌ها: میانگین مدت اقامت سالمندان موردمطالعه 87/7 روز بود. میزان بهره‌گیری سالمندان بستری از خدمات آزمایشگاه و رادیولوژی در این مطالعه به ترتیب 75 درصد و 2/64 در صد بود. مدت اقامت سالمندان در بیمارستان با وضعیت تاهل آنان رابطه معنی‌داری نشان داد  (p=0.32). سالمندان متوفی نسبت به سایر سالمندان بستری بطور معنیداری مدت بیشتری را در بیمارستان اقامت داشتند (p=0.22).بحث و نتیجه­گیری: با توجه به میزان استفاده سالمندان از خدمات آزمایشگاه و رادیولوژی و همچنین میانگین مدت اقامت سالمندان در بیمارستان، در عرصه خدمات بستری سالمندان توجه به بخشها و بیماریهایی که بیشترین بار بستری سالمندان به آن‌ها مربوط می‌شود و همچین توجه به خدمات تشخیصی و درمانی ازجمله آزمایشگاه ورادیولوژی شود تا از اقامت طولانی بیماران دربیمارستان جلوگیری شود.

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of Maternal Attachment Behaviors Program on Physiological Indicators of Preterm Infants: A Clinical Trial

نویسندگان [English]

  • Mitra Edraki
  • Sahra Zendeh-Zaban
  • Noushin Beheshti Pour
  • Fariba Hemati
  • Sazaneh Haghpanah

چکیده [English]

Background: Hospitalization of premature newborns in intensive care unit leads to separation of parents from their infants and chaos in family life. This study aimed to determine the effect of maternal attachment behaviors program on physiological indicators of preterm infants admitted to neonatal intensive care units.
Methods: This clinical trial was conducted on 64 premature infants hospitalized in neonatal intensive care unit. The subjects were randomly divided into control and intervention groups by block randomization. The mothers in the intervention group received attachment behaviors training program (touching, massage, and Kangaroo Mother Care) by individual and face-to-face training. On the other hand, the mothers in the control group received the routine care (Kangaroo Mother Care). Physiological indicators (respiratory rate, heart rate, temperature, and oxygen saturation) were measured 3 times. Then, the data were entered into the SPSS statistical software, version 17 and were analyzed by t-test and chi-square test.
Results: The mean scores of respiratory rate and heart rate, which were measured during three consecutive days, significantly decreased in the intervention group compared to the control group (P<0.001). Additionally, the mean scores of oxygen saturation and temperature measured during three consecutive days significantly increased in the intervention group compared to the control group (P<0.001).
Conclusion: The results showed that the attachment behaviors program in neonatal intensive care units resulted in improvement of physiological indicators in premature infants. Therefore, this program is recommended to be used for such infants hospitalized in these units.

کلیدواژه‌ها [English]

  • Maternal-fetal relationship
  • physiological indicators
  • Premature infant
  • Neonatal intensive care units
1. Edwards LD. Adaptation to parenthood. In: Lowdermilk BP, editor. Maternity nursing. 5th ed. St. Louis: Mosby; 1999. P: 450.
2. Bowlby J. Attachment and loss: vol. I. Attachment. London: The Hogarth press and institute of psycho and lysis; 1969: 70-433.
3. Bretherton I. The Origins of Attachment Theory: John Bowlby & Maty Ainsworth. Developmental Psychology 1992; 28: 759-775.
4. Dadestan, P. Evolutionary psychology of childhood illness to adult 1nded. Tehran: Semat; 2009:12-150. (Persian)
5. Van Wanger, K. Attachment theory [On-line]. Available: http://psychology.
about.com; 2008:10-132.
6. Fallahi M, Jodaki N, Mohseni H. The causes of mortality of hospitalized neonatal in Tajrish Hospital in 2004-2007. Journal of Pajohande 2009; 14(1):43-6.
7. Ohgi S, Fukuda M, Moriuchi H, Kusumoto T, Akiyama T, Nugent JK, et al. Comparison of kangaroo care and standard care: Behavioral organization and temperament in healthy, low birth weight infants through 1 year. J Perinatol 2002; 22(5):374-349.
8. Ockenberry MJ, Wilson D .Wong's Nursing Care of Neonatal and Children.8nd ed. Louis: Mosbey Elsevier Co; 2007:55-91.
9. Imani A. The effect of foot massage on physiologic indicators in critically ill patients. M.S thesis nursing of Shahid Beheshti Medical University 2004; 40-46. (Persian)
10. Kadivar M, Noorbakhsh SH. Kangaroo Care. 1st edition. Tehran: Nashre Vista 2008; 6:17-45. (Persian)
11. Moore E R, Anderson GC. Randomized control trail of very early mother-infant skin to skin contact and breast feeding status. J Midwifery Womens Health 2007;52(2):16-25
12. Huntsinger ET, Luecken LJ. Attachment relationships and health behavior: the meditational role of self-esteem. Psychol Health 2004; 19(4):515-26.
13. Mok E, Loung SF. Nurses as providers of support for mothers of premature infant. Journal of Clinical
Nursing 2006;15(6):726-34
14. Melnyk BM, Fischbeck-Feinstein N, Alpert-Gillis L, Fairbanks E, Crean HF , Sinkin RA, et al. Reducing premature infants' length of stay and improving parents' mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) neonatal intensive care unit program: a randomized controlled trial. Pediatrics 2006; 118: 1414-37.
15. Colville G, Darkinsb J, Heskethb J, Bennett V, Alcock J, Noyes J. The impact on parents of a child's admission to
intensive care: integration of qualitative findings from a cross-sectional study. Intensive Crit Care Nurs 2009;25(2):72-9
16. Johnson AN. Promoting maternal confidence in the NICU. Pediatr Health care J 2008; 22(4):254-257.
17. Valizadeh L, Hasani P. Mothers and nurses’ viewpoint about experience mother of premature newborn. Journal of Tehran University of Medical Sciences 2009; 6(1):38-48. (Persian)
18. Marandy S, Soltanizadeh M. Neonatals. 1st edition. Tehran: Nashre Moalefan; 1998. (Persian)
19. Hutti MH. Social and Professional Support Needs of Families after Perinatal Loss. JOGNN; 2004. 34(5), 630-638
20. Jarvi A, Haapamaki ML, Paavilainen E, Emotional and Informational during Their Child’s Illness. Support for Families Int Nurs Rev 2006; 53:205-210
21. Johnson AN. Kangaroo holding beyond the NICU. Pediatr Nurs 2005; 31:53-56
22. Nagafii GT. The effect of foot massage on the physiological responses of women with cancer. Iranian Journal of Nursing 2004; 36(16): 16-21.
23. Whaley & Wong. Nursing Care of Infants and Children. 6th edition. Mosby Co; 1999; P: 418
24. Prodromidis M, Field T, Arendt R et al. Mothers touching newborns: A camparison of rooming –in versuse minimal contact birth. 1995: 22(4): 196-200
25. Blackburn S, Lowen L. Impact of an Infant’s Premature Birth on the grandparents & Parents. JOGNN; 1985. 173-178.
26. Lightbody T. The importance of family-centered care in the NICU. Can Nurse 2009; 105(1):11-20.
27. Salim IT, Shahbazy L, Eslami Z, Dehghanpoor M. Review’s effect contact skin on vital sign and behavioral status of hospitalization in premature infant. University of Medical Sciences Tehran - Iran 2009; (16):93-85. (Persian
28. . Fisher CB, Sontheimer D, Scheffer F, Bauer J. Cardiorespiratory stability of premature boys & girls during kangaroo care. Early Human Dev 1998; 52 (2):145 –153
29. Diego MA, Field T, Hernandez R. Temperature increases in preterm infants during massage therapy. Infant Behavior & Development 2008; 31: 149–152.
30. Kramer NA. Comparison of therapeutic touch and casual touch in stress reduction of Hospitalized children. Pediatr Nurs 1990; 16(5): 483 –485.
31. Gebreily M. Effect massage skin on physiological status premature infant. Journal of Medical Sciences Tabriz 2012; (34):26-21