Zdravstvena vzgoja pacientov po akutnem miokardnem infarktu v Univerzitetnem kliničnem centru Ljubljana : analiza zdravstvenovzgojnega delovanja pri pacientih

Aristovnik, Ela (author), Hoyer, Silvestra (mentor), Kvas, Andreja (comentor)

Uvod: Problem, ki ga obravnava magistrsko delo, je področje izvajanja zdravstvene vzgoje pacientov po akutnem miokardnem infarktu v Univerzitetnem kliničnem centru v Ljubljani. K večji pojavnosti miokardnih infarktov prispeva stresen in nezdrav načina življenja. Da bi zmanjšali posledice miokardnega infarkta, je pomembno prizadetim pacientom nuditi tudi ustrezno zdravstveno vzgojo. S kakovostno zdravstveno vzgojo dosežemo pri pacientu spoznanje, da lahko z zmanjšanjem oziroma odpravo dejavnikov tveganja prepreči nastajanje ateroskleroze in ponovitev bolezni. Namen: Namen magistrskega dela je bil ugotoviti, ali je zdravstvena vzgoja v Univerzitetnem kliničnem centru v Ljubljani zadovoljiva ter skladna z evropskimi in slovenskimi smernicami o rehabilitaciji po miokardnem infarktu. Poudarek je bil na posredovanju informacij s strani zdravstvenih delavcev o zdravstveni vzgoji pacientov. Z raziskavo smo želeli dokazati potrebo po uvedbi delovnega mesta medicinske sestre s posebnimi znanji, ki bi izvajala samo zdravstveno vzgojo pacientov po miokardnem infarktu. Metode dela: Uporabljena je bila deskriptivna metoda dela. Strategija raziskave je presečna študija. Instrumenta, s katerim smo zbrali podatke, sta dva za raziskavo oblikovana anketna vprašalnika. Vzorec predstavljajo pacienti po prebolelem miokardnem infarktu, ki so se zdravili v bolnišnici v času od 1. 12. 2015 do 1. 3. 2016. Drugi vzorec predstavljajo medicinske sestre, ki izvajajo zdravstveno vzgojo pri pacientih po miokardnem infarktu. Kvantitativni podatki so bili obdelani z naslednjimi statističnimi metodami: SPSS-program, izračun frekvenc in deležev, izračun srednjih vrednosti, Kolmogorov-Smirnov in Shapiro-Wilk test, Linearna regresijska analiza, Pearsonov korelacijski koeficient, t-test za neodvisne vzorce, Mann-Whitney U-test, Binominalni test. Rezultati: Anketirali smo 50 pacientov, od tega 28 % žensk in 72 % moških v starosti od 26 do 88 let. 15 medicinskih sester je izpolnilo vprašalnik, od tega samo 4 na Kliničnem oddelku za kardiologijo, kjer se je zdravilo 40 pacientov. Glede na rezultate raziskave lahko zaključimo, da je informiranost pacientov po miokardnem infarktu slaba. Pri 62 % pacientov medicinske sestre niso izvajale zdravstvene vzgoje, zato hipotezo, da medicinske sestre večinoma ne izvajajo zdravstvene vzgoje pri pacientih po akutnem miokardnem infarktu po evropskih in slovenskih smernicah sekundarne preventive sprejmemo. Samo 25 % pacientov je motiviranih za spremembo življenjskega sloga. 92 % pacientov ni prejelo pisnih navodil. 40 % pacientov si želi možnost kontakta na posebno telefonsko številko po odpustu iz bolnišnice. Razprava in zaključki: Rezultati so pokazali, da je potrebno izvajanje zdravstvene vzgoje pri pacientih po miokardnem infarktu v Univerzitetnem kliničnem centru v Ljubljani izboljšati. Predlagamo, da se uvede novo delovno mesto medicinske sestre, ki bo sistematično in dosledno izvajala zdravstveno vzgojo pacientov po akutnem miokardnem infarktu po vnaprej določenem učnem načrtu v skladu s slovenskimi in evropskimi smernicami, ki ga bo prilagajala individualno vsakemu pacientu.

• Language: Slovenian
• Keywords: pacient, medicinska sestra, zdravstvena vzgoja, zdravstvenovzgojna etapa, akutni miokardni infarkt, sekundarna preventiva, rehabilitacija po akutnem miokardnem infarktu.
• Work type: Master's thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2016
• PID: 20.500.12556/RUL-88481
• COBISS.SI-ID: 5203563
• Publication date in RUL: 07.01.2017

Secondary language

• Language: English
• Title: Health education of patients after acute miocardic infarct in University Medical Center Ljubljana : analysis of health education activities in patient

Abstract

Introduction: This study focuses on health education of patients who suffered acute myocardial infarction and were treated in University Medical Center Ljubljana. Stressfull and unhealthy lifestyle increase the incidence of myocardial infarction. In order to decrease consequences of myocardial infarction, and prevent further worsening of atherosclerosis and its consequences, we need to offer patients a good health education. Aim: The aim of this study was to determine whether health education in University Medical Center Ljubljana is adequate and in accordance to European and Slovene post- myocardial infarction rehabilitation guidelines. The emphasis was on medical presonnel informing patients, and patient education. With this research we wanted to justify that a workplace of a nurse wit special skills and knowledge to educate patients after myocardial infarction exists. Methods: Descriptive method was used with overview of domestic and international literature. For the cross-sectional study, two questionnaires were used. The data was processed with statistical methods: SPSS program, Kolmogorov-Smirnov test, Shapiro-Wilk test, linear regression, Pearson's chi-square test, T test for independent samples, the Mann-Whitney U test, binominal test. The cohort studied were patients after acute myocardial infarction that were treated in University Medical Center Ljubljana from 1. 12. 2015 until 1. 3. 2016. The second cohort were nurses that carry out medical education in patients with acute myocardial infarction. Results: 50 patients were included, 28 % women and 72 % men from 26 to 88 years. Fifteen nurses entered the survey, only four of them work in Department of Cardiology where most of the patients were treated. We can conclude from the study that patients after acute myocardial infarction do not get enough information. In 62% patients nurses did not carry out medical education so our hypothesis that nurses do not carry out enough medical education after acute myocardial infarction according to Slovene and European guidelines, was confirmed. Only 25 % of patients was motivated for healthy lifestyle changes. 92 % of patients didn't recieve paper informations. 40 % of patients would like a telephone number where they could contact medical personnel. Discussion and Conclusion: The results of our study show that we should improve the way medical education is carried out in University Medical Center Ljubljana. We should introduce a new working place for a nurse that would systematically and consistently carry out medical education for patients after acute myocardial infarction. They would to that on a prescheduled learning plan according to Slovene and European guidelines that could be tailored to needs of individual patients.

• Keywords: the patient, nurse, acute myocardial infarction, health education, health education stage, secondary prevention, rehabilitation after acute myocardial infarction.