بررسی ارتباط شدت علائم هموروئید با کیفیت زندگی در زنان مبتلا به هموروئید داخلی درجه I و II در دوره پس از زایمان

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 کارشناس ارشد مامایی، مرکز تحقیقات علوم اعصاب و شفاء، بیمارستان خاتم‌الانبیاء، تهران، ایران.

3 دانشیار گروه مامایی، مرکز تعیین‌کننده‌های اجتماعی مؤثر بر سلامت، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

4 دانشیار گروه زنان، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

5 استادیار گروه طب سنتی، دانشکده طب سنتی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: هموروئید به قسمت­های متسع­شده وریدهای کانال مقعدی گفته می­شود که به کنترل دفع مدفوع کمک می­کنند و یکی از شایع‌ترین بیماری­های گوارشی است. با توجه به اینکه ﻣﺸﻜﻼت پس از زایمان از جمله هموروئید ﺗﺄﺛﻴﺮ ﻣﻌﻨﺎداری، ﺑﺮ ﺳﻼﻣﺖ ﺟﺴﻤﻲ، روﺣﻲ اﺟﺘﻤﺎﻋﻲ، ﺷﻴﺮدﻫﻲ، ﻣﺮاﻗﺒﺖ از نوزاد و ارﺗﺒﺎط ﺑﺎ ﺧﺎﻧﻮاده و ﺟﺎﻣﻌﻪ دارﻧﺪ و ﺑﺮ ﺳﻼﻣﺖ ﻣﺎدران و کودکان تأثیرگذار هستند و ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﻫﻤﻴﺖ ﻛﻴﻔﻴﺖ زﻧﺪﮔﻲ ﭘﺲ از زاﻳﻤﺎن و ﺑﻪ دﻟﻴﻞ اﻧﺠﺎم ﻣﻄﺎﻟﻌﺎت ﻣﺤﺪود در اﻳﻦ زﻣﻴﻨﻪ، مطالعه حاضر با هدف تعیین ارتباط شدت علائم هموروئید با کیفیت زندگی در زنان مبتلا به هموروئید داخلی درجه I و II در دوره پس از زایمان انجام شد.
روش‌کار: این مطالعه مقطعی در سال 1396 بر روی 131 زن در دوره پس از زایمان در شهر تهران انجام گرفت. برای جمع­آوری داده­های مربوط به علائم هموروئید و کیفیت زندگی از پرسشنامه­های ارزیابی درمانی بالینی کولورکتال و کیفیت زندگی سازمان بهداشت جهانی استفاده شد. تجزیه و تحلیل داده­ها با استفاده از نرم­‌افزار آماری SPSS (نسخه 21) و آزمون‌های پیرسون و اسپیرمن انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ها: بیشترین و کمترین میانگین نمره کیفیت زندگی به ترتیب در زیردامنه­های سلامت محیط و سلامت جسمانی به‌دست آمد. کمترین و بیشترین میانگین نمره علائم هموروئید به‌ترتیب مربوط به علائم خارش و تأثیر منفی هموروئید بر روی حس سلامتی زنان بود. بین نمره کلی کیفیت زندگی با تمام علائم هموروئید به جز خارش، همبستگی منفی و معنی­داری وجود داشت (28/0- تا 20/0-=r؛ 05/0>p). بین علامت تورم در ناحیه مقعد و ابعاد سلامت اجتماعی (24/0=r؛ 006/0=p) و سلامت محیط (20/0=r؛ 02/0=p) کیفیت زندگی همبستگی منفی و معنی­داری وجود داشت. همچنین بین علامت احساس ناراحتی در مقعد و زیردامنه سلامت جسمانی کیفیت زندگی همبستگی منفی و معنی‌داری وجود داشت (18/0=r؛ 04/0=p). هیچ‌کدام از مشخصات فردی- اجتماعی با کیفیت زندگی ارتباط آماری معنی­داری نداشتند (05/0<p).
نتیجه­گیری: علائم هموروئید بر کیفیت زندگی زنان در دوران پس از زایمان تأثیر منفی دارد.

کلیدواژه‌ها

عنوان مقاله [English]

The relationship between severity of hemorrhoid symptoms and quality of life in Postpartum Women with Grade I and II Internal Hemorrhoid

نویسندگان [English]

  • Jamileh Malekuti 1
  • Khadijeh Samadi 2
  • Mojgan Mirghafurvand 3
  • Fatemeh Abbasalizadeh 4
  • Laleh Khodaei 5
1 M.Sc. in Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
2 M.Sc. in Midwifery, Neuroscience and Healing Research Center, Khatam Al-Anbia Hospital, Tehran, Iran.
3 Associate professor, Department of Midwifery, Health Social Determinants Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
4 Associate Professor, Department of Gynecology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
5 Assistant Professor, Department of Traditional Medicine, School of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: The hemorrhoid is referred to dilated parts of the anal canal veins, which help to control fecal excretion and is one of the most common digestive diseases. Since postpartum problems such as hemorrhoid have significant effect on physical health and psychological well-being, lactation, baby care, and communication with family and society and affect the health of mothers and children, and considering the importance of postpartum quality of life, and due to the limited studies in this field, this study was performed with aim to determine the association between the severity of hemorrhoid symptoms and quality of life in women with grade I and II internal hemorrhoids during postpartum period.
Methods: This cross-sectional study was performed in 2017 on 131 women in postpartum period in Tehran. Clinical Therapeutic Clinical Evaluation Questionnaire and World Health Organization Quality of Life were used to collect data on hemorrhoid symptoms and quality of life. Data were analyzed using SPSS software (version 21) and Pearson and Spearman tests. P<0.05 was considered statistically significant.
Results: The highest and lowest mean score of quality of life was obtained in the sub-domains of environmental health and physical health, respectively. The lowest and the highest mean score for hemorrhoid symptoms was related to the symptoms of itching and the negative effect of hemorrhoids on the health of women. There was a significant negative correlation between the overall quality of life score with all the symptoms of hemorrhoids except pruritus (r = -0.2 to r = -0.28, p <0.05). There was also significant negative correlation between the symptoms of swelling in the anus and dimensions of social health (r = 0.24, p = 0.006) and environmental health (r = 0.20, p = 0.02) with the quality of life. There was also a negative and significant correlation between the symptom of discomfort in the anus and the subtype of physical health of the quality of life (p = 0.04, p = 0.18). None of the socio-demographic characteristics had a significant relationship with quality of life (p >0.05).
Conclusion: The symptoms of hemorrhoids have negative effect on the quality of life in postpartum period.

کلیدواژه‌ها [English]

  • Hemorrhoids
  • Postpartum period
  • Quality of life

مراجع

  1. Morgan G, Hamilton C. Practice guidelines for obstetrics & gynecology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2003.
  2. World Health Organization. Postpartum care of the mother and newborn: a practical guide: report of a technical working group. Geneva: World Health Organization; 1998.
  3. Mirmolaei ST, Valizadeh A, Mahmoodi M, Tavakol Z. Effect of home postpartum care on quality of life of low risk mothers. J Hayat 2011; 17(2):42-51. (Persian).
  4. Ebrahimi DN, Shirzad S, Taher M. An overview on irritable bowel syndrome and new treatments. J Med Council IRI 2009; 29(1):49-68. (Persian)
  5. Bao W, Ma A, Mao L, Lai J, Xiao M, Sun G, et al. Diet and lifestyle interventions in postpartum women in China: study design and rationale of a multicenter randomized controlled trial. BMC Public Health 2010; 10(1):103.
  6. Rouhi M, Heravi-karimooi M, Usefi H, Salehi K, Habibzadeh S, Shojaee M. Prevalence and persistence of health problems after child birth and maternal correlations with parity. J Health Promot Manag 2012; 1(4):51-60. (Persian).
  7. Mohseni M, Bahadoran P, Abedi H. The quality of postpartum care from mothers’ viewpoint. Hakim Res J 2009; 12(1):27-40. (Persian).
  8. Glazener CM, Abdalla M, Stroud P, Naji S, Templeton A, Russell IT. Postnatal maternal morbidity: extent, causes, prevention and treatment. Br J Obstet Gynaecol 1995; 102(4):282-7.
  9. Zhou SZ, Wang XL, Wang Y. Design of a questionnaire for evaluating the quality of life of postpartum women (PQOL) in China. Qual Life Res 2009; 18(4):497-508.
  10. Uzma A, Underwood P, Alkinston D, Thackrah R. Postpartum health in a Dhaka slum. Soc Sci Med 2005; 48(3):313-20.
  11. Davis R. The postpartum experience southest Asian women in the United States. MCN Am J Matern Child Nurs 2001; 26(4):208-13.
  12. Radmehr M, Alizadeh S, Basikhasteh M. Survey of maternal health`s problems and their help behavioral after delivery in women referring to health centers. Nurs Dev Health 2013; 3(4-5):93-9. (Persian).
  13. Bove A, Bellini M, Battaglia E, Bocchini R, Gambaccini D, Bove V, et al. Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (part II: treatment). World J Gastroenterol 2012; 18(36):4994.
  14. Sacomori C, Silveira C, Sperandio FF, Cardoso FL. Prevalence, repercussion and factors associated with intestinal constipation in women in Florianópolis. J Coloproctol 2014; 34(4):254-9.
  15. Beck D. American dictionary of colon and rectal surgenos (ASCRS). 2nd ed. New York: Springer; 2011.
  16. Schubert MC, Sridhar S, Schade RR, Wexner SD. What every gastroenterologist needs to know about common anorectal disorders. World J Gastroenterol 2009; 115(26):3201-9.
  17. Kopljar M, Balduzzi S, Patrlj L, Mihanovic J, Markulin H, Bakota B, et al. Topical treatment for hemorrhoids. Cochrane Database Syst Rev 2011; 11:CD009443.
  18. Fauci AS. Harrisons principle of internal medicine. 17th ed. New York: McGraw-Hill; 2008.
  19. Hinkle JL, Cheever KH. Brunner & suddarths textbook of medical-surgical nursing. 12th ed. Philadelphia: Lippincott Williams & Wilkin; 2008.
  20. Kasper D, Braunwald E, Hauser S, Longo D, Jameson JL, Fauci A. Harrisons principles of internal medicine. 16th ed. New York: McGraw-Hill; 2005.
  21. Corman ML, Corman ML. Colon and rectal surgery. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
  22. Alonso-Coello P, Mills E, Heels-Ansdell D, Lopez-Yarto M, Zhou Q, Johanson JF, et al. Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Am J Gastroenterol 2006; 101(1):181-8.
  23. Riss S, Weiser FA, Schwameis K, Riss T, Mittlbock M, Steiner G, et al. The prevalence of hemorrhoids in adults. Int J Colorectal Dis 2012; 27(2):215-20.
  24. Riss S, Weiser FA, Riss T, Schwameis K, Mittlbo M, Stift A. Haemorrhoids and quality of life. Colorectal Dis 2011; 13(4):e48-52.
  25. Abedian Z, Nikpour M, Mokhber N, Ebrahimi S, Khani S. Evaluation of relationship between delivery mode and postpartum quality of life. Iran J Obstet Gynecol Infertil 2010; 13(3):47-52. (Persian).
  26. Khakbazan Z, Golyan Tehrani S, Payghambardoost R, Kazemnejad A. Effect of telephone counseling during post partum period on women's quality of life. Hayat 2010; 15(4):5-12. (Persian).
  27. Mirghafourvand M, Charandabi SM, Jafarabadi MA, Tavananezhad N, Karkhane M. Predictors of health-related quality of life in Iranian women of reproductive age. Appl Res Qual Life 2016; 11(3):723-37.
  28. Ioannidis G, Gordon M, Adachi JD. Quality of life in osteoporosis. Nurs Clin North Am 2001; 36(3):481-9.
  29. Crakowski MS. Health-related quality of life outcomes in clinical research. Am J Epidemiol 1999; 283:215.
  30. Gjerdingen DK, Center BA. First-time parents' prenatal to postpartum changes in health, and the relation of postpartum health to work and partner characteristics. Am Board Fam Pract 2003; 16(4):304-11.
  31. Bahrami N, Bahrami S. The survey of quality of life in first-time women in postpartum period. Iran J Nurs Res 2008; 6(23):58-64. (Persian).
  32. Shamshiri MH, Amiri P, Heidarnia M, Abachizadeh K, Abadi A, Malekkhahi A. The effects of postpartum home care on constipation and hemorrhoids at sixty days postpartum. J Babol Univ Med Sci 2015; 17(12):26-32. (Persian).
  33. Symon A, MacDonald A, Ruta A. Postnatal quality of life assessment: introducing the mother-generated index. Birth 2002; 29(1):40-6.
  34. Cheng CY, Fowles ER, Walker LO. Postpartum maternal health care in the United States: a critical review. J Perinat Educ 2006; 15(3):34-42.
  35. Man KM, Chen WC, Wang HM, Chen HY, Shen JL, Chen LD, et al. A randomized, double-blind, placebo-controlled trial of a Chinese herbal Sophora flower formula in patients with symptomatic haemorrhoids: a preliminary study. Afr J Tradit Complement Alternat Med 2013; 10(2):343-51.
  36. Ebrahimi N, Vohra-Miller S, Koren G. Anorectal symptom management in pregnancy: development of a severity scale. J Popul Their Clin Pharmacol 2011; 18(1):e99-105.
  37. Nejat S, Montazeri A, Holakouee K, Mohammad K, Majdzadeh SR. Standardization of the world health organization quality of life questionnaire (WHOQOL-BREF): translation and psychometric Iranian version. J Sch Health Health Res Institute 1991; 4(4):1-12. (Persian).
  38. Akyn B, Ege E, Kocodlu D, Demiroren N, Yylmaz S. Quality of life and related factors in women, aged 15-49 in the 12-month post-partum period in Turkey. J Obstet Gynaecol Res 2009; 35(1):86-93.
  39. Ghodsbin F, Yazdani K, Jahanbin I. Impact of supportive efforts on the quality of life of primiparous women in the first six weeks after delivery. Iran J Obstet Gynecol Infertil 2012; 15(17):17-24. (Persian).
  40. Hung CH, Chung HH. The effects of postpartum stress and social support on postpartum women's health status. J Adv Nurs 2001; 36(5):676-84.
  41. Da Costa D, Dritsa M, Rippen N, Lowensteyn I, Khalife S. Health quality of life in postpartum depressed women. Arch Women Ment Health 2006; 9(2):95-102.
  42. Lee JH, Kim HE, Kang JH, Shin JY, Song YM. Factors associated with hemorrhoids in korean adults: korean national health and nutrition examination survey. Korean J Fam Med 2014; 35(5):227-36.
  43. Martinsons A, Narbuts Z, Bruneniek I, Pavars M, Lebedkovs S, Gardovskis J. A comparison of quality of life and postoperative results from combined PPH and conventional haemorrhoidectomy in different cases of haemorrhoidal disease. Colorectal Dis 2007; 9(5):423-9.
  44. Sailer M, Bussen D, Debus ES, Fuchs KH, Thiede A. Quality of life in patients with benign anorectal disorders. Br J Surg 1998; 85(12):1716-9.
  45. Gjerdingen DK, Center BA. First-time parents' prenatal to postpartum changes in health, and the relation of postpartum health to work and partner characteristics. Am Board Fam Pract 2003; 16(4):304-11.
مجله زنان، مامایی و نازایی ایران
دوره 22، شماره 1
فروردین 1398
صفحه 35-45

فایل ها

هم رسانی

ارجاع به این مقاله

آمار