Ölçüm Öncesi Dinlenme Süresinin ve Dinlenme Esnasında Konuşmanın İndirekt Kan Basıncı Ölçüm Değeri Üzerine Etkisi

Yıl 2017, Cilt: 33 Sayı: 2, 36 - 52, 27.12.2017

Duygu Bayraktar Leyla Khorshtd

Öz

Başlık:Ölçüm Öncesi Dinlenme Süresinin ve Dinlenme
Esnasında Konuşmanın İndirekt Kan Basıncı Ölçüm Değeri Üzerine Etkisi

Title:

Özet:

            Amaç: Bu
araştırma, indirekt arteriyel kan basıncı ölçerken bireyin dinlenme süresinin
ve dinlenme esnasında konuşmanın ölçüm değeri üzerine etkisini incelemek
amacıyla yapılmıştır.

Gereç-Yöntem:
Örneklemini, bir üniversite hastanesinin İç Hastalıkları Polikliniği’ne
başvuran 18 yaşın üzerinde olan, 60 normotansif ve 60 hipertansif bireyler
oluşturmuştur. Veriler 31 Ekim 2012 – 27 Aralık 2012 tarihleri arasında
toplanmıştır. Katılımcılar, yaş grubu ve cinsiyete göre randomize edilerek
çalışma kapsamına alınmıştır. Uygulama grubundaki hastalara hastaneye başvuru
nedeni olan yakınmalarını ve hastalık öyküsünü anlatması istenmiştir. Kontrol
grubundaki hastalar ise 0, 10, 20 ve 30 dk süre ile dinlendirilerek ve bu süre
boyunca konuşmamaları istenmiştir. Hastaların kan basıncı 10 dakikada bir 30 dk
süreyle sağ koldan ölçülmüştür. Verilerin analizinde t testi ve paired samples
t testi kullanılmıştır.

Bulgular: Normotansif
hastalarda dinlenirken konuşmanın sistolik ve diastolik kan basıncı değerini
etkilemediği bulunmuştur. Hipertansif hastalarda kan basıncı ölçmeden önceki
dinlenme süresince sessizce beklemenin, yani konuşmamanın sistolik ve diastolik
kan basıncı ölçüm değerinin düşük çıkmasına, oysa ki hipertansif hastalarda kan
basıncı ölçmeden önceki dinlenirken konuşmanın kan basıncı ölçüm değerinin
yüksek çıkmasına yol açtığı söylenebilir. Normotansif hastalarda kan basıncı ölçümünden önce 10-20 dakika
dinlenmek yeterlidir. Hipertansif hastalarda kan basıncı ölçümünden önce 20-30
dakika dinlenmek yeterlidir.

Sonuç:
Normotansif hastaların kan basıncını ölçerken bireyler 10-20 dk, hipertansif
hastalar ise 20 dk dinlendirilmelidir. Hipertansif hastalarda kan basıncı
ölçerken, bireyler dinlenme süresince konuşturulmamalıdır.

Abstract:

Objective: This research was made to examine the effect of
resting period and talking during resting on indirect arterial blood pressure.

Methods: The
sample was consists of 60 normotansive and 60 hypertansive patients or
patients’ relatives, above 18 years old, who attended to Outpatient of Internal
Medicine of an university hospital. Data were collected between the date 31
October 2012 and 27 December 2012. Subjects were randomized according to age
group and gender. Subjects in the experimental group were asked to speaking
about symptoms of disease or the causes of hospital admission of themselves or
patients. Subjects in the control group was asked to rest during 0, 10, 20 ve
30 minute and not speaking during resting period. Patients’blood pressure was measured from the right arm in
every 10 minute during 30 minute. In analysis of the data t test and paired
samples t test was
used.

Results: It was
found that talking while resting does not changed the systolic and diastolic
blood pressure values in normotensive patients. It could be said that resting
without talking before measure blood pressure leads to reducing the blood
pressure value, in the hypertensive
patients, however when the blood pressure is measured resting with talking
before measure blood pressure leads to inducing the blood pressure value. Resting 10-20 minute before
measure blood pressure is
adequate period in normotansive patients. 
Resting about 20-30 minute before measure blood pressure is adequate period in hipertansive patients.

Conclusion: Hypertansive patients should not talking while resting before measuring
blood pressure. Normotansive
patients should rest about 10-20 minutes, hipertansive patients should rest
about 20 minutes.  

Anahtar kelimeler:   kan basıncı, sfigmomanometre, konuşma, dinlenme

Keywords: blood pressure, sphygmomanometer, speech, resting

Destekleyen kurumlar:-

Kaynakça:

1)Albertson
B. Hemşirelik Esasları İnsan Sağlığı ve Fonksiyonları.
Çevirenler: Gürol Arslan G. Ankara: Palme Yayıncılık; 2015.

2)Armstrong
RS. Nurses’ Knowledge of Error in Blood Pressure Measurement Technique.
International Journal of Nursing Practice 2002; 8: 118-126.

3)Berman A, Snyder S,
Kozier B. Fundamentals of Nursing. Concepts, Process and Practice. 8th
ed. St. Louis; 2008. 551-558.

4)Bilo G,
Sala O, Perego C & et. al. Impact of Cuff Positioning on Blood Pressure
Measurement Accuracy: May a Specially Designed Cuff Make a Difference?
Hypertension Research 2017; 1-8.

5)Bryan S, Saint-Pierre Larose M, Campbell N & et.
al. Resting Blood Pressure and Heart Rate Measurement in The Canadian Health
Measures Survey, Cycle 1. Statistics Canada. Health Reports 2010; 21(1): 71-78.

6)Choudhary
B, Rao V, Suneetha S. Cardiovascular Reactivity During Teaching: An Emerging
Occupational Stress in School Teachers. Indian Journal of Occupational and
Environmental Medicine 2004; 8(1): 22-24.

7)Denizli
N, Yılmaz B, Gücün M ve ark. Hemodiyaliz Hastalarında Hipertansiyon. Yeni Tıp Dergisi 2011; 28(3): 169-172.

8)Dickson BK, Hajjar I. Blood Pressure
Measurement Education and Evaluation Program İmproves Measurement Accuracy in
Community-Based Nurses: A Pilot Study. Journal of The American Academy of Nurse
Practitioners 2007; 19(2): 93-102.

9)Dieterle T. Blood Pressure
Measurement-An Overview. Swiss Medical Weekly
2012; 142: 1-9.

10)Di Marco LY, Zheng D, Murray A. Effects of
Deep Breathing on Blood Pressure Measurement in Healthy Subjects. Computing in
Cardiology 2012; 39: 745-748.

11)Eşer
İ, Khorshid L, Güneş Yapucu Ü & et. al. The Effect of Different Body
Positions on Blood Pressure. Journal of Clinical Nursing 2007; 16: 137-140.

12)Friedmann E, Thomas SA, Kulick Ciuffo D &
et. al. The Effect of Normal and Rapid Speech on Blood Pressure. Psychosomatic
Medicine 1982; 44(6): 545-553.

13)Gürol Arslan G. Taylor Klinik Hemşirelik Becerileri
Bir Hemşirelik Süreci Yaklaşımı. Ed: Bektaş H, Editör. Yaşamsal Bulgular. Ankara: Nobel Yayıncılık; 2015.

14)Holland M, Lewis PS. An Audit and Suggested
Guidelines for İn-patient Blood Pressure Measurement. Journal of Hypertension
2014; 32(11): 2166-2170.

15)Hsiao
JK, Lynch JJ, Foreman PJ & et. al. Cardiovascular Response to Speaking in
Schizophrenics. Psychiatry
Research 1987; 22(1): 69-79.

16)Karadakovan
A, Eti Aslan F. Dahili ve Cerrahi Hastalıklarda Bakım. 1. Baskı. Adana: Nobel
Tıp Kitabevleri; 2010. 613-616.

17)Le
Pailleur C, Montgermont P, Feder JM & et. al. Talking Effect and “White
Coat” Effect in Hypertensive Patients: Physical Effort or Emotional Content?
Behavioral Medicine 2001; 26: 149-157. 

18)Liebl
ME, Holzgreve H, Schulz M & et. al. The Effect of Clother on
Sphygmomanometric and Oscillometric Blood Pressure Measurement. Blood Pressure
2004; 13: 279-282.

19)Long JM, Lynch JJ, Machiran NM
& et. al. The Effect of Status on Blood Pressure During Verbal
Communication. J Behav Med 1982; 5(2): 165-172.

20)Lynch JJ, Thomas SA, Long JM
& et. al. Human Speech and Blood Pressure. The Journal
of Nervous and Mental Disease 1980; 168(9): 526-534.

21)Lynch
JJ, Long JM, Thomas SA & et. al. The Effects of Talking on The Blood
Pressure of Hypertensive and Normotensive İndividuals. Psychosomatic Medicine
1981; 43(1): 25-33.

22)Lynch
JJ, Thomas SA, Paskewitz DA & et. al. Interpersonal Aspects of Blood
Pressure Control. Journal of Nervous and Mental Disease 1982; 170(3): 143-153.

23)Malinow KL, Lynch JJ, Thomas SA
& et. al. Automated Blood Pressure Recording: The Phenomenon of Blood
Pressure Elevations During Speech. Angiology
1982; 33(7): 474-479.

24)Malinow
KL, Lynch JJ, Foreman PJ & et. al. Blood Pressure İncreases while Signing
in a Deaf Population. Psychosomatic Medicine
1986; 48(1/2): 95-101.

25)Netea RT, Lenders JWM, Smits P & et.
al. Both Body and Arm Position Significantly İnfluence Blood Pressure
Measurement. Journal of Human Hypertension 2003; 17: 459-462.

26)Netea
RT, Thien TH. Blood Pressure Measurement: We should All Do İt Better!
Netherland Journal of Medicine 2004; 62(8): 297-303.

27)Özcan N, Arpacı F. Arteryel
Kan Basıncını (Tansiyon) Doğru Ölçüyor Muyuz? Türkiye Klinikleri Tıp Bilimleri
1991; 11: 264-271.

28)Pan F, Zheng D, He P & et. al.  Does The Position or Contact Pressure of The
Stethoscope Make any Difference to Clinical Blood Pressure Measurements. An
Observational Study. Medicine 2014; 93(29): 1-5.

29)Potter
PA, Perry AG. Fundamentals of Nursing. 6th ed. St Louis; 2005. 657-661.

30)Sabuncu
N, Özhan F. Hemşirelik Bakımında İlke ve Uygulamalar. 2. Baskı. Ankara: Çetin
Ofset; 2009. 257-267.

31)Stephens MA, Crowther JH,
Koss PG & et. al. Effects of Daily Activities and Social Behavior on Blood-Pressure Elevation.
Journal of Behavioral Medicine 1988; 11(6):
553-563.

32)Şahin
TK, Demir LS, Koruk İ. Bir Tıp Fakültesi Hastanesinde Görevli Hemşirelerin Kan
Basıncı Ölçüm Bilgilerinin Değerlendirilmesi. TSK Koruyucu Hekimlik Bülteni
2006; 5(1): 8-18.

33)Williams
JS, Brown SM, Conlin PR. Blood-Pressure
Measurement. The New England
Journal of Medicine 2009;
360(5): e6.

34)Zaybak A, Güneş Ü. Hemşirelerin İndirekt
Arterial Kan Basıncını Ölçme Yöntemleri ile ilgili Gözlemsel Bir Çalışma. C.Ü.
Hemşirelik Yüksekokulu Dergisi 2007; 11(3): 23-28.

35)Zheng D, Giovannini R,
Murray A. Effect of Talking on Mean Arterial Blood Pressure: Agreement Between
Manual Auscultatory and Automatic Oscillometric Techniques. Computing in
Cardiology 2011; 38: 841-844.

36)Zheng D,
Giovannini R, Murray A. Effect of Respiration, Talking and Small Body Movements
on Blood Pressure Measurement. Journal of Human Hypertension 2012; 26: 458-462.

37)Zheng D, Pan F, Murray A. Effect of
Pre-Measurement Relaxation Time on Manual Blood Pressure Measurement. Computing
in Cardiology 2013; 40: 883-886.

38)Zheng D, Liu C, Amoore J & et. al. Need
for Re-validation of Automated Blood Pressure Devices for Use in Unstable
Conditions. Computing in Cardiology 2015; 42: 17-20.

 

Anahtar Kelimeler

kan basıncı, sfigmomanometre, konuşma

Kaynakça

• 1)Albertson B. Hemşirelik Esasları İnsan Sağlığı ve Fonksiyonları. Çevirenler: Gürol Arslan G. Ankara: Palme Yayıncılık; 2015.
• 2)Armstrong RS. Nurses’ Knowledge of Error in Blood Pressure Measurement Technique. International Journal of Nursing Practice 2002; 8: 118-126.
• 3)Berman A, Snyder S, Kozier B. Fundamentals of Nursing. Concepts, Process and Practice. 8th ed. St. Louis; 2008. 551-558.
• 4)Bilo G, Sala O, Perego C & et. al. Impact of Cuff Positioning on Blood Pressure Measurement Accuracy: May a Specially Designed Cuff Make a Difference? Hypertension Research 2017; 1-8.
• 5)Bryan S, Saint-Pierre Larose M, Campbell N & et. al. Resting Blood Pressure and Heart Rate Measurement in The Canadian Health Measures Survey, Cycle 1. Statistics Canada. Health Reports 2010; 21(1): 71-78.
• 6)Choudhary B, Rao V, Suneetha S. Cardiovascular Reactivity During Teaching: An Emerging Occupational Stress in School Teachers. Indian Journal of Occupational and Environmental Medicine 2004; 8(1): 22-24.
• 7)Denizli N, Yılmaz B, Gücün M ve ark. Hemodiyaliz Hastalarında Hipertansiyon. Yeni Tıp Dergisi 2011; 28(3): 169-172.
• 8)Dickson BK, Hajjar I. Blood Pressure Measurement Education and Evaluation Program İmproves Measurement Accuracy in Community-Based Nurses: A Pilot Study. Journal of The American Academy of Nurse Practitioners 2007; 19(2): 93-102.
• 9)Dieterle T. Blood Pressure Measurement-An Overview. Swiss Medical Weekly 2012; 142: 1-9.
• 10)Di Marco LY, Zheng D, Murray A. Effects of Deep Breathing on Blood Pressure Measurement in Healthy Subjects. Computing in Cardiology 2012; 39: 745-748.
• 11)Eşer İ, Khorshid L, Güneş Yapucu Ü & et. al. The Effect of Different Body Positions on Blood Pressure. Journal of Clinical Nursing 2007; 16: 137-140.
• 12)Friedmann E, Thomas SA, Kulick Ciuffo D & et. al. The Effect of Normal and Rapid Speech on Blood Pressure. Psychosomatic Medicine 1982; 44(6): 545-553.
• 13)Gürol Arslan G. Taylor Klinik Hemşirelik Becerileri Bir Hemşirelik Süreci Yaklaşımı. Ed: Bektaş H, Editör. Yaşamsal Bulgular. Ankara: Nobel Yayıncılık; 2015.
• 14)Holland M, Lewis PS. An Audit and Suggested Guidelines for İn-patient Blood Pressure Measurement. Journal of Hypertension 2014; 32(11): 2166-2170.
• 15)Hsiao JK, Lynch JJ, Foreman PJ & et. al. Cardiovascular Response to Speaking in Schizophrenics. Psychiatry Research 1987; 22(1): 69-79.
• 16)Karadakovan A, Eti Aslan F. Dahili ve Cerrahi Hastalıklarda Bakım. 1. Baskı. Adana: Nobel Tıp Kitabevleri; 2010. 613-616.
• 17)Le Pailleur C, Montgermont P, Feder JM & et. al. Talking Effect and “White Coat” Effect in Hypertensive Patients: Physical Effort or Emotional Content? Behavioral Medicine 2001; 26: 149-157.
• 18)Liebl ME, Holzgreve H, Schulz M & et. al. The Effect of Clother on Sphygmomanometric and Oscillometric Blood Pressure Measurement. Blood Pressure 2004; 13: 279-282.
• 19)Long JM, Lynch JJ, Machiran NM & et. al. The Effect of Status on Blood Pressure During Verbal Communication. J Behav Med 1982; 5(2): 165-172.
• 20)Lynch JJ, Thomas SA, Long JM & et. al. Human Speech and Blood Pressure. The Journal of Nervous and Mental Disease 1980; 168(9): 526-534.
• 21)Lynch JJ, Long JM, Thomas SA & et. al. The Effects of Talking on The Blood Pressure of Hypertensive and Normotensive İndividuals. Psychosomatic Medicine 1981; 43(1): 25-33.
• 22)Lynch JJ, Thomas SA, Paskewitz DA & et. al. Interpersonal Aspects of Blood Pressure Control. Journal of Nervous and Mental Disease 1982; 170(3): 143-153.
• 23)Malinow KL, Lynch JJ, Thomas SA & et. al. Automated Blood Pressure Recording: The Phenomenon of Blood Pressure Elevations During Speech. Angiology 1982; 33(7): 474-479.
• 24)Malinow KL, Lynch JJ, Foreman PJ & et. al. Blood Pressure İncreases while Signing in a Deaf Population. Psychosomatic Medicine 1986; 48(1/2): 95-101.
• 25)Netea RT, Lenders JWM, Smits P & et. al. Both Body and Arm Position Significantly İnfluence Blood Pressure Measurement. Journal of Human Hypertension 2003; 17: 459-462.
• 26)Netea RT, Thien TH. Blood Pressure Measurement: We should All Do İt Better! Netherland Journal of Medicine 2004; 62(8): 297-303.
• 27)Özcan N, Arpacı F. Arteryel Kan Basıncını (Tansiyon) Doğru Ölçüyor Muyuz? Türkiye Klinikleri Tıp Bilimleri 1991; 11: 264-271.
• 28)Pan F, Zheng D, He P & et. al. Does The Position or Contact Pressure of The Stethoscope Make any Difference to Clinical Blood Pressure Measurements. An Observational Study. Medicine 2014; 93(29): 1-5.
• 29)Potter PA, Perry AG. Fundamentals of Nursing. 6th ed. St Louis; 2005. 657-661.
• 30)Sabuncu N, Özhan F. Hemşirelik Bakımında İlke ve Uygulamalar. 2. Baskı. Ankara: Çetin Ofset; 2009. 257-267.
• 31)Stephens MA, Crowther JH, Koss PG & et. al. Effects of Daily Activities and Social Behavior on Blood-Pressure Elevation. Journal of Behavioral Medicine 1988; 11(6): 553-563.
• 32)Şahin TK, Demir LS, Koruk İ. Bir Tıp Fakültesi Hastanesinde Görevli Hemşirelerin Kan Basıncı Ölçüm Bilgilerinin Değerlendirilmesi. TSK Koruyucu Hekimlik Bülteni 2006; 5(1): 8-18.
• 33)Williams JS, Brown SM, Conlin PR. Blood-Pressure Measurement. The New England Journal of Medicine 2009; 360(5): e6.
• 34)Zaybak A, Güneş Ü. Hemşirelerin İndirekt Arterial Kan Basıncını Ölçme Yöntemleri ile ilgili Gözlemsel Bir Çalışma. C.Ü. Hemşirelik Yüksekokulu Dergisi 2007; 11(3): 23-28.
• 35)Zheng D, Giovannini R, Murray A. Effect of Talking on Mean Arterial Blood Pressure: Agreement Between Manual Auscultatory and Automatic Oscillometric Techniques. Computing in Cardiology 2011; 38: 841-844.
• 36)Zheng D, Giovannini R, Murray A. Effect of Respiration, Talking and Small Body Movements on Blood Pressure Measurement. Journal of Human Hypertension 2012; 26: 458-462.
• 37)Zheng D, Pan F, Murray A. Effect of Pre-Measurement Relaxation Time on Manual Blood Pressure Measurement. Computing in Cardiology 2013; 40: 883-886.
• 38)Zheng D, Liu C, Amoore J & et. al. Need for Re-validation of Automated Blood Pressure Devices for Use in Unstable Conditions. Computing in Cardiology 2015; 42: 17-20.