Iranian Journal of Nursing Research
نشریه پژوهش پرستاری ایران
IJNR
Medical Sciences
http://ijnr.ir
137
journal137
1735-7012
1735-9074
10.22034/ijnr
fa
jalali
1404
12
1
gregorian
2026
3
1
21
1
online
1
fulltext
fa
تأثیر ملاقات برنامهریزیشده ی خانواده بر کیفیت خواب بیماران بستری در بخش مراقبت ویژه : یک مطالعه ی نیمهتجربی
Effect of Scheduled Family Visiting on Sleep Quality in ICU Patients: A Quasi-Experimental Study
پرستاری
nursing
پرستاری بخش های ویژه
Critical Care Nursing
<span style="font-size:12pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Aptos,sans-serif"><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">مقدمه</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:">: </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">اختلال خواب در بیماران</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">بستری در بخش های ویژه</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">شایع است و پیامدهای نامطلوب فیزیولوژیک و روانی دارد. شواهدی مبنی بر اثربخشی رویکردهای خانوادهمحور وجود دارد؛ با این حال تأثیر حضور برنامهریزیشده</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> خانواده بر کیفیت خواب کمتر بررسی شده است. این مطالعه با هدف ارزیابی اثر ملاقات زمانبندیشده</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> خانواده بر کیفیت خواب بیماران</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">در بخش های مراقبت ویژه</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">انجام شد</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:">.</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">روشها</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:">: </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">این پژوهش نیمهتجربی روی </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۷۰</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> بیمار بزرگسال</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">بخش مراقبت ویژه</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">(</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۳۵</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> مداخله، </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۳۵</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> کنترل) در بیمارستانهای آموزشی دانشگاه علوم پزشکی زاهدان انجام شد. گروه کنترل ملاقات روتین بخش را دریافت کرد؛ در گروه مداخله علاوه بر روال روتین، ملاقات برنامهریزیشده</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> خانواده بهمدت </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۳</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> روز و روزانه دو نوبت </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۲۰</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> دقیقهای اجرا شد. کیفیت خواب با نسخه</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> فارسی بازساخته</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> مقیاس ورن و اسنایدر</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">–</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">هالپرن</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">سنجیده شد که روایی و پایایی آن در جمعیت ایرانی تأیید شده است (آلفای کرونباخ=</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۰</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۸۳</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">؛ پایایی دونیمه=</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۰</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۷۰). </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">برای مقایسه</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> نهایی، تحلیل کوواریانس</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">با کنترل نمره </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> پیشآزمون و کووارییتهای سن، جنس، </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:">GCS</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">، سیگار، سابقه</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> مصرف داروی خوابآور و مواد مخدر بهکار رفت.</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Aptos,sans-serif"><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> کد اخلاق</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:">: IR.ZAUMS.REC.1399.063.</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Aptos,sans-serif"><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">یافتهها</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:">: </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">گروهها در شروع مطالعه از نظر متغیرهای دموگرافیک و بالینی همتراز بودند</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">. </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">میانگین </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span calibri="" style="font-family:">±</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">انحراف معیار کیفیت خواب پیشآزمون در کنترل </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۱</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۱۰</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span calibri="" style="font-family:">±</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۶</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۰۵</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> و در مداخله </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۱</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۰۹</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span calibri="" style="font-family:">±</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۶</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۱۱</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> بود و پسآزمون بهترتیب </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۱</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۱۴</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span calibri="" style="font-family:">±</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۶</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۰۸</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> و </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۱</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۰۲</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span calibri="" style="font-family:">±</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۷</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">٫</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">۳۵</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> گزارش شد .</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">در</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">انکوا، اثر اصلی گروه معنادار بود</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:"> F(1,63)=6.27</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">؛</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:"> p=0.015</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">؛</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:"> η² </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">جزئی=0.091) و نشان داد پس از تعدیل کووارییتها، نمره</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> کیفیت خواب در گروه مداخله بهطور معناداری بالاتر از کنترل است</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">. </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">نمره</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> پیشآزمون نیز پیشبین معنادار پیامد بود</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:"> (p=0.020).</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Aptos,sans-serif"><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">نتیجهگیری</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:">: </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">ملاقات برنامهریزیشده</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> خانواده در</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">بخش مراقبت ویژه</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">کیفیت خواب بیماران را بهصورت معنادار و با اندازه</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> اثر متوسط بهبود میدهد؛ این مداخله</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span arial="" style="font-family:">ی</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar=""> کمهزینه و قابلاجرا میتواند بهعنوان جزء مکمل مراقبت خانوادهمحور</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" style="font-family:" zar="">به کار رود</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:115%"><span aptos="" display="" style="font-family:">.</span></span></span></span></span></span></span></span>
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<div id="ftn1"><br>
<span style="font-size:10pt"><span style="font-family:Aptos,sans-serif"><span lang="FA" dir="RTL" style="font-family:"Arial",sans-serif"></span></span></span></div>
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<p lang="en"></p>
<p lang="en"><strong>Background :</strong>Sleep disturbance is common among patients hospitalized in intensive care units (ICUs) and is associated with adverse physiological and psychological outcomes. Evidence supports the effectiveness of family‑centered approaches; however, the impact of scheduled family presence on patients’ sleep quality has been less frequently examined. This study aimed to evaluate the effect of scheduled family visits on sleep quality among ICU patients.</p>
<p lang="en"><strong>Methods:</strong>This quasi‑experimental study was conducted on 70 adult ICU patients (35 in the intervention group and 35 in the control group) in teaching hospitals affiliated with Zahedan University of Medical Sciences. The control group received routine ward visiting practices. In the intervention group, in addition to routine care, scheduled family visits were implemented for three consecutive days, twice daily for 20 minutes each session. Sleep quality was measured using the reconstructed Persian version of the Verran and Snyder–Halpern Sleep Scale, whose validity and reliability have been confirmed in the Iranian population (Cronbach’s alpha = 0.83; split‑half reliability = 0.70). For final comparison, analysis of covariance (ANCOVA) was performed while controlling for baseline sleep score and the covariates of age, gender, Glasgow Coma Scale (GCS), smoking status, history of hypnotic medication use, and substance use.</p>
<p lang="en">Ethics code: IR.ZAUMS.REC.1399.063.</p>
<p lang="en"><strong>Results:</strong>The groups were comparable at baseline in terms of demographic and clinical characteristics. The mean ± standard deviation of baseline sleep quality scores was 6.05 ± 1.10 in the control group and 6.11 ± 1.09 in the intervention group. Post‑test scores were 6.08 ± 1.14 and 7.35 ± 1.02, respectively. ANCOVA revealed a significant main effect of group (F(1,63) = 6.27, p = 0.015, partial η² = 0.091), indicating that after adjusting for covariates, sleep quality scores in the intervention group were significantly higher than in the control group. The baseline score was also a significant predictor of the outcome (p = 0.020).</p>
<p lang="en"><strong>Conclusion:</strong>Scheduled family visits in the ICU significantly improve patients’ sleep quality with a moderate effect size. This low‑cost and feasible intervention can be implemented as a complementary component of family‑centered care.</p>
بخش مراقبت ویژه, خانوادهمحور, ملاقات, کیفیت خواب,تحلیل کوواریانس
Intensive Care Unit, Family-centered care, Visiting policy, Sleep quality, ANCOVA
77
87
http://ijnr.ir/browse.php?a_code=A-10-6088-2&slc_lang=fa&sid=1
alireza
salar
علیرضا
سالار
salar@zaums.ac.ir
13700319475328460027866
13700319475328460027866
No
communty nursing research center
مرکز تحقیقات پرستاری جامعه
fatemeh
rigi
فاطمه
ریگی
f.rigi2011@gmail.com
13700319475328460027867
13700319475328460027867
Yes
communty nursing research center
مرکز تحقیقات پرستاری جامعه
maryam
azizi
مریم
عزیزی
mar.azizi@iau.ir
13700319475328460027868
13700319475328460027868
No
islamic azad university,qum branch
دانشگاه ازاد اسلامی .واحد قم
mehdi
rezvaniamin
مهدی
رضوانی امین
ma.rezvaniamin@zaums.ac.ir
13700319475328460027869
13700319475328460027869
No
communty nursing research center
مرکز تحقیقات پرستاری جامعه
Nazanin
Yousefian miandoab
نازنین
یوسفیان میاندواب
n.yoosefian@yahoo.com
13700319475328460027870
13700319475328460027870
No
communty nursing research center
مرکز تحقیقات پرستاری جامعه