fa تاثیر آموزش مجازی بر آماده شدن فیستول شریانی وریدی در بیماران تحت همودیالیز عمومى General پژوهشی-کمی Quantitative-Research <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">مقدمه:</span></span></b> <span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">فیستول شریان وریدی یکی از مناسب&shy;ترین روش</span></span><span dir="LTR" style="font-size:12.0pt"><span arabic="" fixed="" simplified="" style="font-family:">&shy;</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">های دسترسی عروقی در بیماران همودیالیزی محسوب می&shy;شود. عملکرد نامناسب فیستول، شایع</span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">&shy;</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">ترین علت مداخلات ثانویه و بستری شدن مکرر در این بیماران می</span></span><span dir="LTR" style="font-size:12.0pt"><span arabic="" fixed="" simplified="" style="font-family:">&shy;</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">باشد</span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">. لذا مطالعه حاضر با هدف </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">تعیین تاثیر آموزش مجازی بر آماده شدن فیستول شریانی وریدی در بیماران تحت همودیالیز انجام شد. </span></span><span dir="LTR" style="font-size:12.0pt"><span style="font-family:"Simplified Arabic Fixed""></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">روش کار: </span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">این پژوهش یک </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">کارآزمایی بالینی شاهد&shy;دار تصادفی</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> شده بود. </span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">44 نفر از </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">بیماران </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">مراکز همودیالیز نیکان، پژوهش و صالح افشار مشهد</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> در سال 1403 به روش دردسترس انتخاب و با استفاده از </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">بلوک&shy;های جایگشتی چهارتایی</span></span> <span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">به دو گروه آزمون و گروه کنترل تقسیم شدند. گروه آزمون</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">آموزش شیو&shy;های مراقبت از دسترسی&shy;های عروقی جهت </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">آماده شدن فیستول شریانی وریدی در بیماران تحت </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">همودیالیزی را طی 6 جلسه (هر هفته یک جلسه) از طریق شبکه اجتماعی واتساپ</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> دریافت نمودند. داده&shy;ها با استفاده از پرسشنامه دموگرافیک و</span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> چک لیست بررسی وضعیت عروقی بیمار</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> قبل و بعد از مداخله جمع&shy;آوری شدند. داده‌ها با استفاده از آ</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">زمون&shy;های آماری</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">تی&shy;مستقل،کای اسکوئر </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">و</span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> آزمون دقیق فیشر</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> با </span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">نرم&shy;&shy;افزار</span></span> <span dir="LTR" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">SPSS</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> نسخه 20 در سطح معنی&shy;داری کمتر از 05/0</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">تجزیه&shy;&shy; و تحلیل</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> شدند.</span></span><span dir="LTR" style="font-size:12.0pt"><span style="font-family:BMitra"></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">یافته&shy; ها: </span></span></b><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">نتایج نشان داد که در دو گروه آزمون و کنترل از نظر متغیرهای نبض دیستال، حس انگشتان دست، طول مناسب فیستول</span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">، عفونت،</span></span> <span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">انوریسم،</span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> اختلال حرکتی و درد تفاوت آماری معنی&shy;داری مشاهده نشد (</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">05/0</span></span><span dir="LTR" style="font-size:12.0pt"> p></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">) اما بین دو گروه </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">آزمون </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">و کنترل از نظر وجود تریل، تورم، برویی، دیسپنه و ماندگاری تفاوت آماری معنی&shy;داری مشاهده شد</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">(</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">05/0</span></span><span dir="LTR" style="font-size:12.0pt"> p<</span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">).</span></span><span dir="LTR" style="font-size:12.0pt"></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری:</span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> با توجه به نتایج ب</span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">ه </span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">دست آمده،</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">آموزش شیو&shy;ه&shy;های مراقبت از دسترسی&shy;های عروقی </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">به صورت<b> </b>مجازی </span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">می&shy;تواند به عنوان یک روش موثر </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">جهت </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">آماده شدن فیستول شریانی وریدی در بیماران تحت </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">همودیالیزی</span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:"> استفاده گردد. لذا از یافته&shy;های این پژوهش می&shy;توان جهت آموزش به بیماران </span></span><span lang="FA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">کلیــوی </span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" mitra="" style="font-family:">در کلینیک&shy;ها و مراکز درمانی استفاده کرد.<b>&nbsp; </b></span></span><b><span dir="LTR" style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"></span></span></b></span></span></span></span></span><br> <br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:55.35pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><strong><span style="color:#0e101a">Introduction:</span></strong><span style="color:#0e101a"> The arteriovenous fistula is considered one of the most suitable methods for vascular access in patients undergoing hemodialysis. Inadequate fistula function is the most common cause of secondary interventions and repeated hospitalizations in these patients. Therefore, the present study was conducted to determine the effect of virtual training on arteriovenous fistula maturation in hemodialysis patients. </span></span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><strong><span style="color:#0e101a">Methods:</span></strong><span style="color:#0e101a"> This study employed a randomized controlled clinical trial design. Forty-four patients from the Nikan, Pazhohesh, and Saleh Afshar hemodialysis centers in Mashhad in 2024 were selected using the available method and divided into experimental and control groups, with quadruple permutation blocks. The experimental group received training on care methods for service access during arteriovenous fistula preparation in hemodialysis patients in six sessions (one session per week) via the WhatsApp social network. Data were collected using a demographic questionnaire and checklist to assess the status of patients before and after the intervention. Data were analyzed using independent t-tests, chi-square tests, and Fisher&#39;s exact tests with SPSS version 20 software at a significance level of p < 0.05. </span></span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><strong><span style="color:#0e101a">Results:</span></strong><span style="color:#0e101a"> The results showed that there was no statistically significant difference between the test and control groups in terms of distal pulse, finger sensation, appropriate fistula length, change, aneurysm, movement disorder, and pain (p>0.05), but there was a statistically significant difference between the test and control groups in terms of the presence of trills, swelling, edema, dyspnea, and persistence (p>0.05). </span></span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><strong><span style="color:#0e101a">Conclusion:</span></strong><span style="color:#0e101a"> The results demonstrate that virtual training in vascular access care methods is an effective preparation method for arteriovenous fistulas in hemodialysis patients. The findings of this study can be applied to train renal patients in clinics and medical centers. </span></span></span><br> <br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Mitra""></span></span></b></span></span></span></span></span><br> <br> <span style="font-size:11pt"><span style="line-height:normal"><span style="text-autospace:none"><span calibri="" style="font-family:"><span style="font-size:10.5pt"><span style="font-family:"Segoe UI",sans-serif"></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:10.5pt"><span style="font-family:"Segoe UI",sans-serif"></span></span></b></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><span lang="AR-SA" style="font-size:10.5pt"><span style="font-family:"Segoe UI",sans-serif"></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="tab-stops:60.0pt 333.0pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span dir="LTR" style="font-size:12.0pt"><span style="line-height:107%"></span></span></span></span></span></span></span></span><br> &nbsp; آموزش مجازی, فیستول شریانی وریدی, همودیالیز. Virtual education, Arteriovenous fistula, Hemodialysis 86 98 http://jne.ir/browse.php?a_code=A-10-1920-1&slc_lang=fa&sid=1 Fatemeh Ghodsi فاطمه قدسی samane.ghodsi@yahoo.com 100319475328460030597 100319475328460030597 No Gonabad University of Medical Sciences دانشگاه علوم پزشکی گناباد Moosa Sajjadi موسی سجادی sajjadi1975@gmail.com 100319475328460030598 100319475328460030598 Yes Gonabad University of Medical Sciences دانشگاه علوم پزشکی گناباد Tahereh Baluchi Beidokhti طاهره بلوچی بیدختی tbaloochi@gmail.com 100319475328460030599 100319475328460030599 No Gonabad University of Medical Sciences دانشگاه علوم پزشکی گناباد