Journal of Arak University of Medical Sciences
مجله دانشگاه علوم پزشكي اراك
J Arak Uni Med Sci
Medical Sciences
http://jams.arakmu.ac.ir
46
journal46
1735-5338
2008-644X
10.61882/jams
fa
jalali
1402
8
1
gregorian
2023
11
1
26
4
online
1
fulltext
fa
اثربخشی درمان شناختی-رفتاری بر خودتنظیمی زناشویی و عدم تحمل بلاتکلیفی در زنان نابارور
Efficacy of Cognitive-Behavioral Therapy on Marital self-regulation and Intolerance of uncertainty in Infertile women
روانپزشکی
psychology
پژوهشي اصیل
Original Atricle
<span style="font-size:12pt"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black">سابقه و هدف:</span></span></span></span></b> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">امروزه ناباروری یک نگرانی عمده برای سلامت عمومی و یکی از مهمترین بحرانهای دوران زندگی به شمار میرود که به مشکلات روانشناختی زیادی منجر میشود. از آنجایی که درمان شناختی-رفتاری بر توانمندسازی و آموزش به بیمار برای حل مشکلات تاکید دارد، لذا این مطالعه به منظور بررسی اثربخشی درمان شناختی- رفتاری بر خودتنظیمی زناشویی و عدم تحمل بلاتکلیفی در زنان نابارور انجام شد.</span></span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:#0e101a"></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:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">روش کار:</span></span></span></span></span></b><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"> این مطالعه کارآزمایی بالینی بر روی 30 نفر از زنان نابارور مراجعه کننده به مرکز نازایی شهرستان ساری در دو گروه 15 نفری آزمایش و کنترل انجام گرفت. درمان شناختی-رفتاری در 12جلسه 45دقیقه</span></span></span><span dir="LTR" lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">‎</span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">ای، هفتهای یک بار برای گروه آزمایش اجرا شد، در حالیکه گروه کنترل، درمان روتین را دریافت کردند. پس از دوره پیگیری، گروه کنترل هم تحت روان درمانی قرار گرفتند. هر دو گروه پرسشنامههای </span></span></span><strong><span lang="AR-SA" style="border:none windowtext 1.0pt; font-size:11.0pt; padding:0cm"><span style="background:white"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">خودتنظیمی زناشویی </span></span></span></span></strong><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">ویلسون و همکاران (2005) و </span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black">عدم تحمل بلاتکلیفی </span></span></span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">فریستون و همکاران (1994) </span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">را در پیش</span></span></span><span dir="LTR" lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">‎</span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">آزمون، پسآزمون و پیگیری (45 روز بعد از پسآزمون) تکمیل کردند و مقایسه شدند.</span></span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span style="font-family:"B Nazanin""></span></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:95%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:11.0pt"><span style="line-height:95%"><span b="" nazanin="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></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:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black">یافته</span></span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></b><b><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black">ها:</span></span></span></span></b> <span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">یافته‎ها نشان داد </span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">میانگین نمرات به ترتیب در سه مرحله پیشآزمون، پسآزمون و پیگیری</span></span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"> دو زیرمقیاس خودتنظیمی زناشویی</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">درگروه آزمایش، برای زیر مقیاس خودنظمبخشی ارتباطی<span style="letter-spacing:-.1pt"> (</span><span style="letter-spacing:-.2pt">273/6 </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span cambria="" style="font-family:"><span style="letter-spacing:-.2pt">±</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> 266/24</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">)، (</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">207/3 </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span cambria="" style="font-family:"><span style="letter-spacing:-.2pt">±</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> 000/41</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">) و (</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">899/3 </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span cambria="" style="font-family:"><span style="letter-spacing:-.2pt">±</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> 266/35</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">) </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">افزایش معناداری در پسآزمون و پیگیری نسبت به پیش‏آزمون داشت (05/0></span></span></span><span dir="LTR" style="font-size:11.0pt"><span style="line-height:90%">P</span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">)</span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">و زیر مقیاس تکاپوی ارتباطی (</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">094/5 </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span cambria="" style="font-family:"><span style="letter-spacing:-.2pt">±</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> 333/19</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">)، </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">(<span style="letter-spacing:-.2pt">914/1 </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span cambria="" style="font-family:"><span style="letter-spacing:-.2pt">±</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> 666/8</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">) و (<span style="letter-spacing:-.2pt">449/2 </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span cambria="" style="font-family:"><span style="letter-spacing:-.2pt">±</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> 000/12</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">) و همچنین عدم تحمل بلاتکلیفی <span style="letter-spacing:-.1pt">(</span><span style="letter-spacing:-.2pt">302/9 </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span cambria="" style="font-family:"><span style="letter-spacing:-.2pt">±</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> 600/92</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">)، (</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">585/7 </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span cambria="" style="font-family:"><span style="letter-spacing:-.2pt">±</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> 400/67</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">) و (</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">975/10 </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span cambria="" style="font-family:"><span style="letter-spacing:-.2pt">±</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> 200/75</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">) </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">کاهش معنیداری در پسآزمون و پیگیری نسبت به پیش‏آزمون داشتند. (05/0></span></span></span><span dir="LTR" style="font-size:11.0pt"><span style="line-height:90%">P</span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">). <span style="color:black"></span></span></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:95%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:11.0pt"><span style="line-height:95%"><span b="" nazanin="" style="font-family:"><span style="color:black"></span></span></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:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">نتیجه گیری:</span></span></span></span></span></b><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black"> .نتایج مطالعه نشان داد که </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">درمان شناختی-رفتاری </span></span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black">می تواند یک مداخله اثربخش در بهبود خودتنظیمی زناشویی</span></span></span></span> <span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black">کاهش </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">و عدم تحمل بلاتکلیفی</span></span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:">در زنان نابارور </span></span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:90%"><span b="" nazanin="" style="font-family:"><span style="color:black">باشد. </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:90%"><span style="font-family:"B Nazanin""></span></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:95%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:11.0pt"><span style="line-height:95%"><span style="color:black"></span></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="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"><span style="color:black"></span></span></span></span></span></span></span></span></span><br>
<br>
<pre style="text-align:justify">
<span style="font-size:10pt"><span courier="" new="" style="font-family:"><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.2pt">Background:</span></span></span></b> <span lang="EN" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">Today, infertility is a major concern for public health and one of the most important crises in life, which leads to many psychological problems. Since cognitive-behavioral therapy emphasizes empowering and educating the patient to solve problems, this study was conducted to investigate the effectiveness of cognitive-behavioral therapy on marital self-regulation and uncertainty intolerance in infertile women.</span></span><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:#202124"></span></span></span></span></span></pre>
<span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span dir="RTL" lang="FA" style="font-size:11.0pt"><span style="line-height:150%"></span></span></span></span></span><br>
<span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Methods</span></b><span style="font-size:11.0pt">: </span><span lang="EN" style="font-size:11.0pt">This clinical trial study was performed on 30 infertile women referring to the infertility center of Sari city in two groups of case and control (15 patients in each group). Cognitive-behavioral therapy was performed in 12 sessions of 45 minutes, once a week for the experimental group, while the control group received the routine treatment. After the follow-up period, the control group also underwent psychotherapy. Both groups completed the questionnaires of marital self-regulation by Wilson et al. (2005) and uncertainty intolerance by Friston et al. (1994) in the pre-test, post-test and follow-up (45 days after the post-test) and were compared.</span><span lang="AR-SA" dir="RTL" style="font-size:11.0pt"></span></span></span><br>
<span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><span style="font-size:11.0pt"></span></span></span><br>
<span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Finding:</span></b> <span lang="EN" style="font-size:11.0pt">The results showed that in the two subscales of marital self-regulation in the experimental group, the average scores in the three stages of pre-test, post-test and follow-up respectively for the subscale of communication self-regulation</span><span style="font-size:11.0pt"> (24.266 ± 6.273), (41.000 ± 3.207) and (35.266 ± 3.899) </span><span lang="EN" style="font-size:11.0pt">there was a significant increase in the post-test and follow-up compared to the pre-test stage</span><span style="font-size:11.0pt">(P<0.05).</span> <span lang="EN" style="font-size:11.0pt">And the sub-scale of communication effort</span><span style="font-size:11.0pt">(19.333 ± 5.094), (8.666 ± 1.914) and (12.000 ± 2.449),</span> <span lang="EN" style="font-size:11.0pt">and intolerance of uncertainty </span><span style="font-size:11.0pt">92.600 ± 9.302), (67.400 ± 7.585) and (75.200 ± 10.975),</span> <span lang="EN" style="font-size:11.0pt">had a significant decrease in the post-test and follow-up compared to the pre-test stage </span><span style="font-size:11.0pt">(P<0.05)</span><span lang="EN" style="font-size:11.0pt">.</span><span style="font-size:11.0pt"></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span dir="RTL" lang="FA" style="font-size:11.0pt"><span style="line-height:150%"></span></span></span></span></span><br>
<span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Conclusion:</span></b><span style="font-size:11.0pt"> The results of the study showed that cognitive-behavioral therapy can be an effective intervention in improving marital self-regulation and reducing intolerance of uncertainty in infertile women.</span></span></span><br>
<span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><span style="font-size:11.0pt"></span></span></span><br>
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واژه های کلیدی: درمان شناختی-رفتاری, خودتنظیمی زناشویی, عدم تحمل بلاتکلیفی, زنان نابارور
Cognitive-Behavioral Therapy, Marital self-regulation, Intolerance of uncertainty, Infertile women.
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http://jams.arakmu.ac.ir/browse.php?a_code=A-10-7406-1&slc_lang=fa&sid=1
Bahram
Mirzaeian
بهرام
میرزائیان
bahrammirzaian@gmail.com
4600319475328460087565
4600319475328460087565
Yes
Islamic Azad University
دانشگاه آزاد اسلامی واحد ساری
Fatemeh
Talebi
فاطمه
طالبی
yeganeh_talebi_1998@yahoo.com
4600319475328460087566
4600319475328460087566
No
Islamic Azad University
دانشگاه آزاد اسلامی واحد ساری