Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
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2022
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تاثیر آموزش خودمراقبتی مبتنی بر پذیرش و تعهد بر داغ ننگ درکشده و بار مراقبتی در مراقبین بیماران اسکیزوفرنی (کارآزمایی بالینی تصادفی)
Effect of Self-care Training based on Acceptance and Commitment Therapy on Perceived Stigma and Burden of Care in Caregivers of Patients with Schizophrenia: A Randomized Controlled Trial
پرستاری
nursing
پژوهشي-کامل
Research(Original)
<strong> </strong><span style="font-size:12pt"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="letter-spacing:-.1pt">سابقه</span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="letter-spacing:-.1pt"> و هدف:</span></span></span> <span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">داغ ننگ و بارمراقبتی در مراقبین بیماران اسکیزوفرن اثرات منفی بر بیمار و خانوادههای آنان دارد. این مطالعه با هدف تعیین تاثیر آموزش خودمراقبتی مبتنی بر پذیرش و تعهد بر داغ ننگ درکشده و بار مراقبتی مراقبین بیماران اسکیزوفرن طراحی و انجام شد</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%">.</span></span><span style="font-family:"B Zar"" lang="FA"></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="letter-spacing:-.1pt">مواد و روش</span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt"></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="letter-spacing:-.1pt">ها:</span></span></span> <span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">این مطالعه کارآزمایی بالینی بر روی 80 نفر از مراقبین بیماران اسکیزوفرنی درمرکز آموزشی درمانی</span></span> <span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">روانپزشکی زارع شهر ساری انجام شد. مراقبین در گروه مداخله،آموزش خودمراقبتی مبتنی بر پذیرش و تعهد را برای 8 جلسه و هفتهای 2 بار دریافت نمودند. نمره داغ ننگ و بار مراقبتی دو گروه قبل و بعد از مداخله با استفاده از پرسشنامه داغ <span style="letter-spacing:-.1pt">ننگ شمسایی و بار مراقبتی زاریت (</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="letter-spacing:-.1pt">Zarit</span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">) اندازهگیری شد. دادهها با آزمون تی مستقل، تی زوجی و روشهای آمار توصیفی</span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""> آنالیز شدند</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%">.</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="letter-spacing:-.2pt">یافته</span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt"></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="letter-spacing:-.2pt">ها:</span></span></span> <span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">بر طبق نتایج، بین میانگین تغییرات </span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">نمره کل داغ ننگ درک شده قبل و بعد از مداخله بین گروه مداخله (</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">6/79 </span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:92%">±</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""> 65/45) و کنترل (10/34 </span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:92%">±</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""> 80/25) اختلاف معنی</span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">داری وجود داشت(0/05</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><</span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%">P</span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">). </span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">همچنین </span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">در مقایسه بین گروهی نتایج نشان داد</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">، بین میانگین تغییرات </span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">نمره کل بار مراقبتی قبل و بعد از مداخله بین گروه مداخله (</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">6/37 </span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:92%">±</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""> 44/35) و کنترل (10/29 </span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:92%">±</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""> 55/05) اختلاف معنی</span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">داری وجود داشت (0/05</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><</span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%">P</span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">).</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="letter-spacing:-.2pt">استنتاج:</span></span></span> <span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">آموزش خودمراقبتی مبتنی بر پذیرش و تعهد، در مراقبین بیماران مبتلا به اسکیزوفرنی، داغ ننگ و بار مراقبتی را کاهش داده و بهبود میبخشد، بر این اساس انجام چنین مداخلات غیرتهاجمی توصیه میشود.</span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span dir="LTR" style="font-size:5.0pt"><span style="line-height:92%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="font-size:10.0pt"><span style="line-height:92%"><span style="font-family:"B Zar"">شماره ثبت کارآزمایی بالینی : 6</span></span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:92%">N</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:92%"><span style="font-family:"B Zar"">20171203037723</span></span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:92%">IRCT</span></span><b><i><span lang="FA" style="font-size:10.0pt"><span style="line-height:92%"><span style="font-family:"2 Davat""></span></span></span></i></b></span></span></span></span></span><br>
<strong> </strong><span style="font-size:12pt"><span style="line-height:125%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:125%"><span style="font-family:"Arial","sans-serif""><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:125%">Stigma and burden of care in caregivers of patients with schizophrenia have negative effects on the patient and their families. This research aimed to determine the effect of self-care training based on Acceptance and Commitment Therapy (ACT) on perceived stigma and caregiver burden of schizophrenic patients.</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:125%"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:125%"><span style="font-family:"Arial","sans-serif"">Materials and methods:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:125%">This randomized clinical trial included 80 caregivers of schizophrenia patients in Sari Zare Hospital. Participants in intervention group received self-care training based on ACT in 8 sessions twice a week, while the control group received only routine care. The scores for stigma and care burden were measured in both groups before and after the intervention using Shamsaei stigma questionnaire and Zarit Burden Interview (ZBI, 22-item)</span></span><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span style="line-height:125%"><span style="font-family:"B Nazanin"">.</span></span></span><span style="font-size:10.0pt"><span style="line-height:125%"> T-test and paired t-test and descriptive statistical methods were used to analyze the data.</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:125%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:125%"><span style="font-family:"Arial","sans-serif"">Results:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:125%">The mean changes of the total score for perceived stigma before and after the intervention were found to be significantly different between the intervention group (65.45</span></span><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="line-height:125%"><span style="font-family:"Cambria","serif"">±</span></span></span><span style="font-size:10.0pt"><span style="line-height:125%">6.79) and the <span style="letter-spacing:-.1pt">control group (80.25</span></span></span><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="line-height:125%"><span style="font-family:"Cambria","serif""><span style="letter-spacing:-.1pt">±</span></span></span></span><span style="font-size:10.0pt"><span style="line-height:125%"><span style="letter-spacing:-.1pt">10.34</span></span></span><span style="font-size:10.0pt"><span style="line-height:125%"><span style="letter-spacing:-.1pt">)(P<0.05). Also, intergroup comparison showed a significant</span></span></span><span style="font-size:10.0pt"><span style="line-height:125%"> difference in mean changes of the total scores for burden of care before and after the intervention between the intervention group (44.35 </span></span><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="line-height:125%"><span style="font-family:"Cambria","serif"">±</span></span></span><span style="font-size:10.0pt"><span style="line-height:125%"> 6.37) and the control group (55.05 </span></span><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="line-height:125%"><span style="font-family:"Cambria","serif"">±</span></span></span><span style="font-size:10.0pt"><span style="line-height:125%">10.29) (P <0.05).</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:125%"><span style="vertical-align:top"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:125%"><span style="font-family:"Arial","sans-serif"">Conclusion:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:125%"> According to current study, s</span></span><span style="font-size:10.0pt"><span style="line-height:125%">elf-care training based on Acceptance and Commitment Therapy will improve perceived stigma and reduce burden of care in caregivers of patients with schizophrenia and such non-invasive interventions are recommended.</span></span><i><span style="font-size:10.0pt"><span style="line-height:125%"></span></span></i></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:7.0pt"><span style="line-height:150%"><span style="letter-spacing:-.1pt"></span></span></span></b></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman","serif""><span style="font-size:8.0pt"><span style="line-height:150%"><span style="letter-spacing:-.1pt">(Clinical Trials Registry Number: </span></span></span><span style="font-size:8.0pt"><span style="line-height:150%"><span style="letter-spacing:-.1pt">IRCT20171203037723N6</span></span></span><span style="font-size:8.0pt"><span style="line-height:150%"><span style="letter-spacing:-.1pt">)</span></span></span><b><i><span style="font-size:8.0pt"><span style="line-height:150%"><span style="letter-spacing:-.1pt"></span></span></span></i></b></span></span></span><br>
<br>
<strong> </strong>
اسکیزوفرنی, بار مراقبتی, داغ ننگ, خودمراقبتی مبتنی بر پذیرش و تعهد
schizophrenia, caregiver, burden, stigma, acceptance and commitment therapy
39
51
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-14824-1&slc_lang=fa&sid=1
Neda
Rahmatnejad
ندا
رحمت نژاد
rn.neda@gmail.com
1003194753284600144124
1003194753284600144124
No
Master Student in Psychiatric Nursing, Student Research Committee, Nasibeh Faculty of Nursing and Midwifery, Sari, Iran
دانشجوی کارشناس ارشد روان پرستاری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی نسیبه، دانشگاه علوم پزشکی مازندران، ساری، ایران
Yadollah
Jannati
یدا...
جنتی
annati.yadollah@gmail.com )
1003194753284600144122
1003194753284600144122
No
Assistant Professor, Department of Community Health Nursing, Behshahr Faculty of Nursing, Mazandaran University of Medical Sciences, Sari, Iran
استادیار، دکتری پرستاری، مرکز پرستاری سلامت جامعه، دانشکده پرستاری و مامایی بهشهر، دانشگاه علوم پزشکی مازندران، ساری، ایران
Reza Ali
Mohammad Pour
رضاعلی
محمدپورتهمتن
Mohammadpour2002@yahoo.com
1003194753284600144123
1003194753284600144123
No
Professor, Department of Biostatistics and Epidemiology, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
استاد، مرکز آمار زیستی، گروه آمار و اپیدمیولوژی، دانشکده بهداشت، دانشگاه مازندران، ساری، ایران
Hamideh
Azimi Lolaty
حمیده
عظیمی لولتی
azimihamideh@gmail.com
1003194753284600144121
1003194753284600144121
Yes
Associate Professor, Department of Psychiatric Nursing, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
دانشیار، گروه روانپرستاری، مرکز تحقیقات روانپزشکی و علوم رفتاری، پژوهشکده اعتیاد، دانشگاه علوم پزشکی مازندران، ساری، ایران