The Journal of Shahid Sadoughi University of Medical Sciences
مجله علمي پژوهشي دانشگاه علوم پزشكي شهید صدوقی يزد
JSSU
Medical Sciences
http://jssu.ssu.ac.ir
20
journal20
2228-5741
2228-5733
fa
jalali
1397
10
1
gregorian
2019
1
1
26
8
online
1
fulltext
fa
بررسی تاثیر کاربرد پماد املا و کیسه یخ بر درد ناشی از ورود سوزن های عروقی در بیماران همودیالیزی
Study of the effect of EMLA cream and ice pack on the pain of vascular needles insertion in hemodialysis patients
پرستاری
Nursing
پژوهشي
Original article
<div style="text-align: justify;"><strong><span style="font-family:b nazanin;">مقدمه:</span></strong> <span style="font-family:b nazanin;">بیماران </span> <span style="font-family:b nazanin;">تحت</span> <span style="font-family:b nazanin;">همودیالیز به</span> <span style="font-family:b nazanin;">طور</span> <span style="font-family:b nazanin;">میانگین</span> <span style="font-family:b nazanin;">مداوم</span> <span style="font-family:b nazanin;">در</span> <span style="font-family:b nazanin;">طول</span> <span style="font-family:b nazanin;">یک</span> <span style="font-family:b nazanin;">ماه</span><span dir="LTR"> 10 </span><span style="font-family:b nazanin;">بار</span> <span style="font-family:b nazanin;">وارد شدن</span> <span style="font-family:b nazanin;">سوزن در فیستول</span> <span style="font-family:b nazanin;">را</span> <span style="font-family:b nazanin;">تجربه</span> <span style="font-family:b nazanin;">می</span> <span style="font-family:b nazanin;">کند. کاهش</span> <span style="font-family:b nazanin;">این درد</span> <span style="font-family:b nazanin;">جهت</span> <span style="font-family:b nazanin;">سازگاری</span> <span style="font-family:b nazanin;">طولانی</span> <span style="font-family:b nazanin;">مدت</span> <span style="font-family:b nazanin;">فرد</span> <span style="font-family:b nazanin;">با</span> <span style="font-family:b nazanin;">همودیالیز</span> <span style="font-family:b nazanin;">اهمیت</span> <span style="font-family:b nazanin;">زیادی دارد. این مطالعه به منظور بررسی تاثیر</span> <span style="font-family:b nazanin;">پماد املا</span> <span style="font-family:b nazanin;">و کیسه یخ بر شدت درد ناشی از وارد کردن سوزن</span> <span style="font-family:b nazanin;">های عروقی در بیماران همودیالیز انجام شد.</span><br>
<strong><span style="font-family:b nazanin;">روش بررسی:</span></strong><span style="font-family:b nazanin;"> این مطالعه شبه تجربی بود که بر روی40 بیمار همودیالیز دارای فیستول شریانی وریدی بیمارستا</span><span style="font-family:b nazanin;">ن شهید رهنمون یزد </span><span style="font-family:b nazanin;">در سال94 انجام شد. در</span> <span style="font-family:b nazanin;">این</span> <span style="font-family:b nazanin;">مطالعه</span> <span style="font-family:b nazanin;">شدت</span> <span style="font-family:b nazanin;">درد</span> <span style="font-family:b nazanin;">حین</span> <span style="font-family:b nazanin;">وارد</span> <span style="font-family:b nazanin;">نمودن</span> <span style="font-family:b nazanin;">سوزن</span> <span style="font-family:b nazanin;">های</span> <span style="font-family:b nazanin;">عروقی</span> <span style="font-family:b nazanin;">با استفاده</span> <span style="font-family:b nazanin;">از</span> <span style="font-family:b nazanin;">پماد املا و کیسه یخ</span> <span style="font-family:b nazanin;">با</span> <span style="font-family:b nazanin;">مقیاس</span> <span style="font-family:b nazanin;">عددی</span> <span style="font-family:b nazanin;">اندازه</span> <span style="font-family:b nazanin;">گیری</span> <span style="font-family:b nazanin;">شدت</span> <span style="font-family:b nazanin;">درد</span> <span style="font-family:b nazanin;">اندازه</span> <span style="font-family:b nazanin;">گیری</span> <span style="font-family:b nazanin;">شد</span><span style="font-family:b nazanin;">.</span> <span style="font-family:b nazanin;">تجزیه</span> <span style="font-family:b nazanin;">و</span> <span style="font-family:b nazanin;">تحلیل</span> <span style="font-family:b nazanin;">داده ها</span> <span style="font-family:b nazanin;">با</span> <span style="font-family:b nazanin;">استفاده از</span> <span style="font-family:b nazanin;">آزمون آنالیز واریانس با اندازه های تکراری</span> <span style="font-family:b nazanin;">و</span> <span style="font-family:b nazanin;">نرم افزار </span><span dir="LTR">SPSS16</span><span style="font-family:b nazanin;"> انجام شد.</span><br>
<strong><span style="font-family:b nazanin;">نتایج:</span></strong> <span style="font-family:b nazanin;">نتایج</span> <span style="font-family:b nazanin;">نشان</span> <span style="font-family:b nazanin;">داد</span> <span style="font-family:b nazanin;">که</span> <span style="font-family:b nazanin;">میانگین</span> <span style="font-family:b nazanin;">نمره</span> <span style="font-family:b nazanin;">درد</span> <span style="font-family:b nazanin;">در</span> <span style="font-family:b nazanin;">سه</span> <span style="font-family:b nazanin;">روش بدون بکارگیری کنترل درد، استفاده</span> <span style="font-family:b nazanin;">از کیسه یخ و پماد املا به ترتیب 88/0 </span><span dir="LTR">±</span><span style="font-family:b nazanin;"> 45/7 ،83/0</span><span dir="LTR">±</span><span style="font-family:b nazanin;">38/5 و 70/0 </span><span dir="LTR">±</span><span style="font-family:b nazanin;"> 80/2 بود. کاهش میانگین شدت درد در هر دو روش استفاده از پماد املا و کیسه یخ نسبت به روش بدون بکارگیری روش کنترل درد مشهود تر بود</span><span dir="LTR"><span style="font-size:10.0pt;">) </span></span><span style="font-family:b nazanin;"><span style="font-size:10.0pt;">001/0</span></span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">(P</span></span></span> <span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;"><</span></span></span> <span style="font-family:b nazanin;"> هم</span> <span style="font-family:b nazanin;">چنین کاهش میانگین شدت درد در روش استفاده از پماد املا به طور چشم</span> <span style="font-family:b nazanin;">گیری</span> <span style="font-family:b nazanin;">بیشتر</span> <span style="font-family:b nazanin;">از</span> <span style="font-family:b nazanin;">روش کیسه یخ بوده</span> <span style="font-family:b nazanin;">و</span> <span style="font-family:b nazanin;">معنی</span> <span style="font-family:b nazanin;">دار</span><span style="font-family:b nazanin;"> بود</span><span dir="LTR"><span style="font-size:10.0pt;">)</span></span> <span style="font-size:10.0pt;">001/0</span><span dir="LTR"><span style="font-size:10.0pt;">( P <</span></span><br>
<strong><span dir="RTL"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نتیجهگیری:</span></span></span></strong><span dir="RTL"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">هر دو روش کیسه یخ و پماد املا در کاهش درد موثر بود اما با توجه به این</span></span></span> <span dir="RTL"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">که پماد املا در کاهش درد موثر</span></span></span> <span dir="RTL"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تر بود می</span></span></span> <span dir="RTL"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">توان آن را به بیماران همودیالیزی پیشنهاد نمود.</span></span></span></div>
<strong>Introduction:</strong> patients undergoing hemodialysis experience fistula puncture pain an average of 10 times per month. Reduction of these complications is important for adjusting the patients with long-term hemodialysis. This study aimed at investigating the effects of EMLA cream and ice pack on severity of pain induced by vascular needle punctures in hemodialysis patients.<br>
<strong>Methods:</strong> This was a quasi-experimental design carried out on 40 hemodialysis patients with arteriovenous fistula at Shahid Rahnemoon Hospital<span dir="RTL">.</span>, Yazd, Iran, in 2015. In this study, the pain severity was measured in the patients upon insertion of vascular needles using EMLA cream and ice pack with numeric scale of pain severity measurement. The data were analyzed using SPSS16 and repeated measure ANOVA.<br>
<strong>Results:</strong> Our findings showed that the mean score of pain in three methods of uncontrolled pain method, ice pack method, and EMLA cream method, was 7.45±0.88, 5.38±0.83, and 2.80±0.70, respectively. Reduction in average pain intensity was more obvious with both EMLA cream and ice pack methods compared to the uncontrolled pain method (<em>P </em>< 0.001). Also, the mean of pain reduction was significantly greater with EMLA cream compared to ice pack (<em>P </em>< 0.001)<br>
<strong>Conclusion:</strong> Both methods of ice pack and EMLA cream were effective in reducing pain, but due to EMLA cream was more effective in decreasing fistula puncture pain, it could be suggested to hemodialysis patients.
همودیالیز, فیستول شریانی وریدی, پماد املا ,کیسه یخ, درد
Hemodialysis, Arteriovenous fistula, EMLA cream, Ice pack, Pain.
694
705
http://jssu.ssu.ac.ir/browse.php?a_code=A-10-3455-1&slc_lang=fa&sid=1
Mostafa
Javadi
مصطفی
جوادی
javadi@gmail.com