Middle Eastern Journal of Disability Studies

fa طراحی و تدوین برنامهٔ جامع مداخلات خانواده‌محور و ارزیابی اثربخشی آن بر سلامت ‌روان والدین کودکان با اختلال‌‌های هیجانی‌‌ و رفتاری Developing a Comprehensive Family-Based Intervention and Assessing its Effects on the Mental Health of the Parents of Children With Emotional and Behavioral Disorders روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article زمینه و هدف: براساس بررسی‌ها، سلامت ‌روان والدین کودکان دارای اختلال هیجانی و رفتاری در خطر است. این والدین به‌منظور ارتقای سلامت ‌روان خویش نیاز به مهارت‌‌هایی دارند. یکی از راه‌های کسب این مهارت‌ها مداخلات خانواده‌محور است. هدف پژوهش حاضر طراحی برنامهٔ جامع مداخلات خانواده‌محور و ارزیابی اثربخشی آن بر سلامت ‌روان والدین کودکان با اختلال‌های هیجانی‌‌ و رفتاری بود. روش‌بررسی: پژوهش حاضر نیمه‌تجربی با پیش‌آزمون و پس‌آزمون با گروه گواه بود. جامعهٔ پژوهش را تمامی والدین دارای کودک با اختلال‌های هیجانی و رفتاری ساکن شهر تهران در سال ۹۷-۱۳۹۶ تشکیل ‌دادند. آزمودنی‌ها ۳۰ خانواده (۳۰ پدر و ۳۰ مادر) بودند که با روش نمونه‌گیری هدف‌مند از میان والدین مراجعه‌کننده و ارجاع‌شده به مرکز سلامت ‌روان جامعه‌نگر انتخاب شدند که دارای کودکان با اختلالات هیجانی و رفتاری بودند. سپس به‌شکل تصادفی در یک گروه مداخله (۳۰ پدر و مادر) و یک گواه (۳۰ پدر و مادر) قرار گرفتند. گردآوری داده‌ها ازطریق پرسشنامهٔ سلامت ‌روانی (گلدبرگ و هیلر، ۱۹۷۹) انجام پذیرفت. برای گروه آزمایشی، دوازده جلسه آموزش به‌مدت سه ماه و هر هفته ۹۰ دقیقه اجرا شد؛ درحالی‌که گروه گواه هیچ مداخلهٔ مشخصی دریافت نکرد. سپس نتایج پس‌آزمون با روش تحلیل کوواریانس چندمتغیری در محیط SPSS نسخهٔ ۲۳ در سطح معناداری ۰٫۰۱ بررسی شد. یافته‌ها: نتایج نشان داد که مداخلهٔ مذکور باعث تغییر معناداری در گروه آزمایش در میانگین نمرهٔ کل سلامت ‌روان می‌شود (۰٫۰۰۱>p) و نیز این تفاوت برای تمامی زیر‌مقیاس‌های سلامت‌ روان ازجمله نشانه‌های جسمانی (۰٫۰۰۸=p)، اضطراب و بی‌خوابی (۰٫۰۰۱=p)، نارساکنش‌وری اجتماعی (۰٫۰۰۱=p) و افسردگی (۰٫۰۰۱=p) معنادار است. نتیجه‌گیری: براساس یافته‌های پژوهش، مداخلات خانواده‌‌محور که توسط محققان این پژوهش تدوین شده است، بر بهبود سلامت ‌روان پدران و مادران کودکان با اختلالات هیجانی و رفتاری مؤثر است. <div style="text-align: justify;">Background & Objectives: Mental and behavioral disorders are crucial issues in each community. This is because individuals’ early–life experiences form the foundation of their future mental health status. Emotional and behavioral disorders usually stem from the inappropriate interaction of children with the surrounding environment. Studies have suggested that the mental health status of the parents of children with emotional and behavioral disorders is at risk and they require skills to improve those. One of the ways to gain these skills is using family–based interventions. The present study aimed to design a comprehensive family–based intervention program and evaluate its effects on the mental health status of the parents of children with emotional and behavioral disorders. Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The study population consisted of all the parents of children diagnosed with emotional and behavioral disorders living in Tehran City, Iran, in 2017–2018. The study sample consisted of 30 families (30 fathers & 30 mothers; N=60) referring to the Community Mental Health Center. They had children with emotional and behavioral disorders. They were selected by convenience sampling method; they were then randomly assigned to two intervention and control groups. The necessary data were collected by the General Health Questionnaire (GHQ) (Goldberg & Hillier, 1979). This 28–item questionnaire has 4 subscales of physical symptoms, anxiety and sleep disorders, social dysfunction, and depression. After sampling, the mental health questionnaire was distributed among all study participants, and under equal conditions, the pretest data were collected by an independent assessor. The control group received no intervention other than the pretest. The intervention group received a family–oriented treatment program. The intervention group received a family–based psychological intervention. The intervention was complementary and consisted of fifteen 90–minute weekly sessions of group consultations for 3 months. Next, the post–test results were analyzed by Multivariate Analysis of Covariance (MANCOVA) at a significance level of 0.01. In the present study, comprehensive family–centered interventions were educational and psychotherapeutic programs designed for parents in the form of individual and group counseling sessions. This program was developed based on a combination of family–centered intervention programs by Afrooz and Minoo (2015) and Mehri et al. (2016), as well as an intervention designed by McKay et al. (2017), as family–centered programs. Cognitive–Behavioral counseling methods were also used to modify the negative attitudes and beliefs of families, reduce stress, teach coping skills, and better adjustment of spouses in the intervention. Therefore, the presented program was an integrated protocol. To observe the ethical observations, after the completion of the study, the control group received the same treatment as well. Furthermore, the subjects of the two groups were tested by a posttest. Results: The MANCOVA results indicated that (considering pretest scores as a covariant variable), the difference between the treatment and control groups was significant concerning the total and all subscale scores of a mental health test. Thus, the provided family–based psychological intervention reduced the total score of mental health (p<0.001), physical disorders (p=0.008), anxiety and insomnia (p=0.001), social dysfunction (p=0.001), and depression (p=0.001) in the explored parents (p=0.05). Based on the Eta–Squared, 11%–86% of these differences were due to treatment. Conclusion: The present study data indicated that the presented family–based psychological intervention designed by the researchers was effective in improving the mental health status of the studied parents of children with emotional–behavioral disorders. Accordingly, it is recommended to employ the above–mentioned intervention program in different clinical populations, e.g., hyperactive children, children with special disorders or chronic physical complications, and so on.</div> اختلالات هیجانی و رفتاری, سلامت ‌روان, مداخلات خانواده‌محور, والدین. Emotional–Behavioral disorders, Mental health, Family–Based intervention, Parents. 184 184 http://jdisabilstud.org/browse.php?a_code=A-10-1492-1&slc_lang=fa&sid=1 Farideh Kolahi Heshmat فریده کلاهی حشمت farideh.kolahi.heshmat@gmail.com 100319475328460052119 100319475328460052119 No Department of Psychology, Islamic Azad University گروه روان‌شناسی، دانشگاه آزاد اسلامی، واحد تهران مرکز GHolamali Afrooz غلامعلی افروز Afrooz@ut.ac.ir 100319475328460052120 100319475328460052120 Yes Department of Psychology, Tehran University گروه روان‌شناسی ، دانشگاه تهران Mahnaz Estaki مهناز استکی mah.estaki@iauctb.ac.ir 100319475328460052121 100319475328460052121 No Department of Psychology, Islamic Azad University گروه روان‌شناسی، دانشگاه آزاد اسلامی، واحد تهران مرکز