بررسی اثر میانجی اقدامات خود مراقبتی بر رابطه بین سواد سلامت وکیفیت زندگی بیماران پس از جراحی قلب باز
محورهای موضوعی : -مدارک پزشکی
مهدی همایون فر
1
,
سید محمد زرگر
2
,
ابوالفضل دانایی
3
1 - استادیار،گروه مدیریت، واحد رشت، دانشگاه آزاد اسلامی، رشت، ایران
2 - استادیار، گروه مدیریت، واحد سمنان، دانشگاه آزاد اسلامی، سمنان، ایران
3 - استادیار، گروه مدیریت، واحد سمنان، دانشگاه آزاد اسلامی، سمنان، ایران
کلید واژه: اقدامات خودمراقبتی, جراحی قلب باز, بیماری قلبی - عروقی, کیفیت زندگی, سواد سلامت,
چکیده مقاله :
مقدمه: به میزان توانایی افراد در به دست آوردن، تحلیل کردن و فهمیدن اطلاعات و خدمات اولیه بهداشتی که به آن نیاز دارند تا بتوانند در مورد مسائل مربوط به سلامتی خود مشارکت داشته و تصمیم‌های درستی اتخاذ کنند، سواد سلامت می‌گویند. امروزه سواد سلامت یکی از ارکان سلامت جامعه محسوب می شود. هدف از این پژوهش ارائه مدلی برای بررسی تأثیر سواد سلامت و اقدامات خودمراقبتی بر کیفیت زندگی بیماران قلبی - عروقی پس از انجام عمل قلب باز بود. روش پژوهش: این پژوهش بر مبنای هدف کاربردی و بر اساس نحوه گردآوری داده ها از نوع توصیفی - پیمایشی است که جامعه آماری تحقیق کلیه بیمارانی بودند که در مرکز قلب تهران عمل جراحی باز قلب را انجام داده بودند و از بین این افراد 138 نفر با نمونه گیری در دسترس انتخاب شدند. ابزار گردآوری اطلاعات، پرسشنامه ای محقق‌ساخته است که روایی آن از طریق روایی صوری و روایی همگرا و پایایی پرسشنامه از طریق محاسبه آلفای کرونباخ تأیید شد. برای تجزیه و تحلیل داده های جمع آوری شده از روش معادلات ساختاری استفاده شد. یافته‌ها: نتایج حاصل از آزمون فرضیه‌ها نشان دادسواد سلامت با ضریب مسیر (0/685) تأثیر مثبت و معنی داری با اقدامات خود مراقبتی، سواد سلامت با ضریب مسیر (0/350) تأثیر مثبت و معنی‌دار با کیفیت زندگی بیماران دارد و اقدامات خود مراقبتی با ضریب مسیر (0/418) تأثیر مثبت و معنی‌داری با کیفیت زندگی بیماران دارد. نتیجه‌گیری: با ارتقای سواد سلامت و آموزش رفتارهای خود مراقبتی به بیماران قلبی پس از انجام عمل قلب باز می‌توان شاهد پیشرفت کیفیت زندگی این بیماران پس از عمل و کاهش عوارض پس از جراحی شد.
Introduction: Health literacy refers to the ability of individuals to acquire, analyze and understand the information and basic health services they need to contribute to their health issues and make the right decisions. Today, health literacy is one of the pillars of community health. The purpose of this study was to provide a model for assessing the effect of health literacy and self-care measures on the quality of life of cardiovascular patients after open heart surgery. Methods: This study is an applied research and based on the method of data collection is a descriptive-survey type that the statistical population of the study was all patients who had open heart surgery at the Tehran heart center and among them, 138 people were selected by available sampling. Data gathering tool was a researcher-made questionnaire whose validity was confirmed by face validity and convergent validity and reliability of the questionnaire was confirmed by Cronbach's alpha. Structural equation method was used to analyze the collected data. Results: The results of hypothesis testing showed Health literacy with path coefficient (0.685) has a positive and significant effect on self-care measures, Health literacy with path coefficient (0. 350) has a positive and significant effect on patients' quality of life, and self-care measures with path coefficient (0.418) have a positive and significant effect on patients' quality of life. Conclusion: Improvement of health literacy and self-care behaviors in cardiac patients after open heart surgery can improve the quality of life of these patients after surgery and reduce complications after surgery.
1- Dehdari T, Hashemifard T, Heidarnia AR, Kazemnejad A. The longitudinal effect of health education on health-related quality of life in patients with coronary artery bypass surgery. MEDICAL SCIENCES, 2005; 15(1): 41-46.
2- Sabahi A, Ahmadian L, Ansari R, Salehi F, Mirzaei M. The Viewpoint of Patients with Cardiovascular Disease Regarding the Importance of Health Knowledge Acquisition and Its Role in the Treatment Process. Health Inf Manage, 2017; 13(6): 394-8.
3- Fuchs FS, Pittarelli A, Hahn EG, Ficker JH. Adherence to continuous positive airway pressure therapy for obstructive sleep apnea: impact of patient education after a longer treatment period. Respiration, 2010; 80(1): 32-7.
4. golkhandan A., Sahraei S. The Prediction of Iran's Per Capita Health Expenditures up to 2041 Horizon Using the Genetic and Particle Swarm Optimization Algorithms. Journal of healthcare management, 2019; 9(4): 53-66.
5. Maharlou H, Barati O, Maher M. The Study of Inpatient Services Costs Provided to Cardiovascular Patients Referred to Al-Zahra Heart Hospital in Shiraz During 2ndHalf of 2013 and Compare to the Same Time After Iranian Health Transformation Plan Implementation. Journal of healthcare management, 2017; 7(2): 31-38.
6- Howlett JG. Palliative care in heart failure: addressing the largest care gap. Curr Opin Cardiol, 2011; 26(2): 144-8.
7- Montazer Ghaem H, Asar O, Safaei N. Assessing patient's quality of life after open heart surgery in Bandar Abbass, Iran. MEDICAL JOURNAL OF HORMOZGAN UNIVERSITYو 2012; 15(4): 254: 59.
8- Miri A, Ghanbari MA, Najafi A. The relationship between health literacy and the recovery rate of cardiovascular patients after bypass surgery. J Health Lit, 2016; 1(2): 83-91. URL: http://literacy.ihepsa.ir/article-1-37-fa.html
9- Foruzandeh N, Delaram M, Foruzandeh M, Darakhshandeh S. Study of mental health status of cardiovascular diseases patients and determination of some effective factors on it in the patients hospitalized in CCU and cardiology wards of Hajar Hospital, Shahrekord. Journal of Clinical Nursing and Midwifery, 2013; 2(2): 18-25.
10- Mahmoudi H, Taheri A. Relation between Information Literacy and Health Literacy of Students in Ferdowsi University of Mashhad. Human Info Interact, 2015; 2(2): URL: http://hii.khu.ac.ir/article-1-2488-fa.html.(In Persian).
11- Iranian Health Center. Health literacy movement. [On Line]. 2009; Available from:http://www.salamatiran.com/NSite/FullStory/?id=33479. Accessed January 15, 2013. [In Persian]
12- Rezapour A., Alipour S, Alipour V, Soleymani Movahed M. Convergence of Per Capita Health Expenditures and Health Outcomes in Countries of the Economic Cooperation Organization. Journal of healthcare management, 2019; 9(4): 27-40.
13- Reisi M, Mostafavi F, Hasanzadeh A, Sharifirad Gh. The Relationship between Health Literacy, Health Status and Healthy Behaviors among Elderly in Isfahan. Journal of Health Systems Research, 2011; 7(4): 1-12. [In Persian]
14- Peerson A, Saunders M. Health literacy revisited: what do we mean and why does it matter? Health Promotion International, 2009; 24: 285-96.
15- Ferrans C, Powers M. Quality of life index: development and psychometric properties. Rech Soins Infirm, 2007; (88): 32-7.
16- Comin-Colet J, Lainscak M, Dickstein K, Filippatos GS, Johnson P, Lüscher TF, et al. The effect of intravenous ferric carboxymaltose on health-related quality of life in patients with chronic heart failure and iron deficiency: a subanalysis of the FAIR-HF study. Eur Heart J, 2013; 34(1): 30-8.
17- Bahador R MS, Nouhi E, Jahani Y, Quality of Life and its Related Factors in Patients with CHF, Referring to Jiroft Imam Khomeini Hospital, Iran Journal of Nursing (IJN), 2017; 30(105): 23-33.
18- Macabasco-O'Connell A, DeWalt DA, Broucksou KA, Hawk V, Baker DW, Schillinger D, et al. Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure. J Gen Intern Med, 2011; 26(9): 979-86.
19- Mosher HJ, Lund BC, Kripalani S, Kaboli PJ. Association of health literacy with medication knowledge, adherence, and adverse drug events among elderly veterans. Journal of health communication, 2012; 17(3): 241-51.
20. Peyman N, Abdollahi M. The relationship between health literacy and self-efficacy physical activity in postpartum women. Journal of Health Literacy, 2016; 1(1): 5-12.
21- Baker D W, Gazmararian J A, Williams M V, Scott T, Parker R M, Green D, Ren J, Peel J. Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. American Journal of Public Health, 2002; 92(8): 1278–1283
22- Chew LD, Bradly KA, Boyko E J. Brief Questions to Identify Patients with Inadequate Health Literacy. Fam Med, 2004; 36(8): 588-94.
23- Lee S.D, Tsai T, Tsai Y, Kuo K. N. Health Literacy, Health Status, and Healthcare Utilization of Taiwanese Adults: Results from a National Survey. BMC Public Health, 2010; 10(614): 1-8.
24- Williams MV, Davis T, Parker RM, Weiss BD. The Role of Health Literacy in Patients – physician Communication. Fam Med, 2002; 34(5): 383-9.
25- Edwards M, Wood F, Davies M., Edwards A. The Development of health Literacy in Patients with LongtermHealth Condition: the Health Literacy Pathway Model. BMC Public Health, 2012; 12: 130.
26- Rahnavard Z, Zolfaghari M, Kazemnejad A, Hatamipour K. [An investigation of quality of life and factors affecting it in the patients with congestive heart failure]. Journal of hayat, 2006; 12(1): 77-86. [In Persian]
27- Seyam S, Heidarnia A R, Tavafian S S. Quality of life and factors related to it in cardiovascular patients after heart surgery. J Birjand Univ Med Sci, 2013; 19(6): 33-41. URL: http://journal.bums.ac.ir/article-1-1227-fa.html
28- Hosieni F, Mirzaei T, Ravari A, Akbary A. The relationship between health literacy and quality of life in retirement of Rafsanjan University of Medical Sciences. J Health Lit, 2016; 1(2): 92-99. URL: http://literacy.ihepsa.ir/article-1-32-fa.html
29- Khodabandeh M, Avarasin S M, Nikniaz L. The Relationship between Health Literacy, Perceived Self-efficacy and Self-care Performance of Female Senior High School Students in Health Promoting Schools of Miyaneh, 2016-2017. J Health Lit, 2017; 2(3): 164-176.
30- Lee E H, Lee Y W, Moon S H, A Structural Equation Model Linking Health Literacy to Self-efficacy, Self-care Activities, and Health-related Quality of Life in Patients with Type 2 Diabetes, Asian Nursing Research, 2016, 10: 82-87.
31- Hooman HA. Modeling structural equations using LISREL software. Tehran; Samt Publication; 2005. [In Persian]
32- Hair J, Hult TM, Ringle CM & Sarstedt M. partial least squares stuctural equation modeling (PLS- SEM); 2013. Sage publishing
33- Zareban I, Izadirad H, jadgal K. Evaluation of health literacy, health status and health services utilization in women in Baluchistan region of Iran. J Health Lit, 2016; 1(2): 71-82. URL: http://literacy.ihepsa.ir/article-1-26-fa.html
34- Song L, Mishel M, Bensen JT, Chen RC, Knafl GJ, Blackard B, et al. How does health literacy affect quality of life among men with newly diagnosed clinically localized prostate cancer? Cancer, 2012; 118(15).
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1- Dehdari T, Hashemifard T, Heidarnia AR, Kazemnejad A. The longitudinal effect of health education on health-related quality of life in patients with coronary artery bypass surgery. MEDICAL SCIENCES, 2005; 15(1): 41-46.
2- Sabahi A, Ahmadian L, Ansari R, Salehi F, Mirzaei M. The Viewpoint of Patients with Cardiovascular Disease Regarding the Importance of Health Knowledge Acquisition and Its Role in the Treatment Process. Health Inf Manage, 2017; 13(6): 394-8.
3- Fuchs FS, Pittarelli A, Hahn EG, Ficker JH. Adherence to continuous positive airway pressure therapy for obstructive sleep apnea: impact of patient education after a longer treatment period. Respiration, 2010; 80(1): 32-7.
4. golkhandan A., Sahraei S. The Prediction of Iran's Per Capita Health Expenditures up to 2041 Horizon Using the Genetic and Particle Swarm Optimization Algorithms. Journal of healthcare management, 2019; 9(4): 53-66.
5. Maharlou H, Barati O, Maher M. The Study of Inpatient Services Costs Provided to Cardiovascular Patients Referred to Al-Zahra Heart Hospital in Shiraz During 2ndHalf of 2013 and Compare to the Same Time After Iranian Health Transformation Plan Implementation. Journal of healthcare management, 2017; 7(2): 31-38.
6- Howlett JG. Palliative care in heart failure: addressing the largest care gap. Curr Opin Cardiol, 2011; 26(2): 144-8.
7- Montazer Ghaem H, Asar O, Safaei N. Assessing patient's quality of life after open heart surgery in Bandar Abbass, Iran. MEDICAL JOURNAL OF HORMOZGAN UNIVERSITYو 2012; 15(4): 254: 59.
8- Miri A, Ghanbari MA, Najafi A. The relationship between health literacy and the recovery rate of cardiovascular patients after bypass surgery. J Health Lit, 2016; 1(2): 83-91. URL: http://literacy.ihepsa.ir/article-1-37-fa.html
9- Foruzandeh N, Delaram M, Foruzandeh M, Darakhshandeh S. Study of mental health status of cardiovascular diseases patients and determination of some effective factors on it in the patients hospitalized in CCU and cardiology wards of Hajar Hospital, Shahrekord. Journal of Clinical Nursing and Midwifery, 2013; 2(2): 18-25.
10- Mahmoudi H, Taheri A. Relation between Information Literacy and Health Literacy of Students in Ferdowsi University of Mashhad. Human Info Interact, 2015; 2(2): URL: http://hii.khu.ac.ir/article-1-2488-fa.html.(In Persian).
11- Iranian Health Center. Health literacy movement. [On Line]. 2009; Available from:http://www.salamatiran.com/NSite/FullStory/?id=33479. Accessed January 15, 2013. [In Persian]
12- Rezapour A., Alipour S, Alipour V, Soleymani Movahed M. Convergence of Per Capita Health Expenditures and Health Outcomes in Countries of the Economic Cooperation Organization. Journal of healthcare management, 2019; 9(4): 27-40.
13- Reisi M, Mostafavi F, Hasanzadeh A, Sharifirad Gh. The Relationship between Health Literacy, Health Status and Healthy Behaviors among Elderly in Isfahan. Journal of Health Systems Research, 2011; 7(4): 1-12. [In Persian]
14- Peerson A, Saunders M. Health literacy revisited: what do we mean and why does it matter? Health Promotion International, 2009; 24: 285-96.
15- Ferrans C, Powers M. Quality of life index: development and psychometric properties. Rech Soins Infirm, 2007; (88): 32-7.
16- Comin-Colet J, Lainscak M, Dickstein K, Filippatos GS, Johnson P, Lüscher TF, et al. The effect of intravenous ferric carboxymaltose on health-related quality of life in patients with chronic heart failure and iron deficiency: a subanalysis of the FAIR-HF study. Eur Heart J, 2013; 34(1): 30-8.
17- Bahador R MS, Nouhi E, Jahani Y, Quality of Life and its Related Factors in Patients with CHF, Referring to Jiroft Imam Khomeini Hospital, Iran Journal of Nursing (IJN), 2017; 30(105): 23-33.
18- Macabasco-O'Connell A, DeWalt DA, Broucksou KA, Hawk V, Baker DW, Schillinger D, et al. Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure. J Gen Intern Med, 2011; 26(9): 979-86.
19- Mosher HJ, Lund BC, Kripalani S, Kaboli PJ. Association of health literacy with medication knowledge, adherence, and adverse drug events among elderly veterans. Journal of health communication, 2012; 17(3): 241-51.
20. Peyman N, Abdollahi M. The relationship between health literacy and self-efficacy physical activity in postpartum women. Journal of Health Literacy, 2016; 1(1): 5-12.
21- Baker D W, Gazmararian J A, Williams M V, Scott T, Parker R M, Green D, Ren J, Peel J. Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. American Journal of Public Health, 2002; 92(8): 1278–1283
22- Chew LD, Bradly KA, Boyko E J. Brief Questions to Identify Patients with Inadequate Health Literacy. Fam Med, 2004; 36(8): 588-94.
23- Lee S.D, Tsai T, Tsai Y, Kuo K. N. Health Literacy, Health Status, and Healthcare Utilization of Taiwanese Adults: Results from a National Survey. BMC Public Health, 2010; 10(614): 1-8.
24- Williams MV, Davis T, Parker RM, Weiss BD. The Role of Health Literacy in Patients – physician Communication. Fam Med, 2002; 34(5): 383-9.
25- Edwards M, Wood F, Davies M., Edwards A. The Development of health Literacy in Patients with LongtermHealth Condition: the Health Literacy Pathway Model. BMC Public Health, 2012; 12: 130.
26- Rahnavard Z, Zolfaghari M, Kazemnejad A, Hatamipour K. [An investigation of quality of life and factors affecting it in the patients with congestive heart failure]. Journal of hayat, 2006; 12(1): 77-86. [In Persian]
27- Seyam S, Heidarnia A R, Tavafian S S. Quality of life and factors related to it in cardiovascular patients after heart surgery. J Birjand Univ Med Sci, 2013; 19(6): 33-41. URL: http://journal.bums.ac.ir/article-1-1227-fa.html
28- Hosieni F, Mirzaei T, Ravari A, Akbary A. The relationship between health literacy and quality of life in retirement of Rafsanjan University of Medical Sciences. J Health Lit, 2016; 1(2): 92-99. URL: http://literacy.ihepsa.ir/article-1-32-fa.html
29- Khodabandeh M, Avarasin S M, Nikniaz L. The Relationship between Health Literacy, Perceived Self-efficacy and Self-care Performance of Female Senior High School Students in Health Promoting Schools of Miyaneh, 2016-2017. J Health Lit, 2017; 2(3): 164-176.
30- Lee E H, Lee Y W, Moon S H, A Structural Equation Model Linking Health Literacy to Self-efficacy, Self-care Activities, and Health-related Quality of Life in Patients with Type 2 Diabetes, Asian Nursing Research, 2016, 10: 82-87.
31- Hooman HA. Modeling structural equations using LISREL software. Tehran; Samt Publication; 2005. [In Persian]
32- Hair J, Hult TM, Ringle CM & Sarstedt M. partial least squares stuctural equation modeling (PLS- SEM); 2013. Sage publishing
33- Zareban I, Izadirad H, jadgal K. Evaluation of health literacy, health status and health services utilization in women in Baluchistan region of Iran. J Health Lit, 2016; 1(2): 71-82. URL: http://literacy.ihepsa.ir/article-1-26-fa.html
34- Song L, Mishel M, Bensen JT, Chen RC, Knafl GJ, Blackard B, et al. How does health literacy affect quality of life among men with newly diagnosed clinically localized prostate cancer? Cancer, 2012; 118(15).