اثربخشی توان‌بخشی شناختی بر کیفیت زندگی و اصلاح شناختی مادران دارای فرزند فلج مغزی و اثربخشی آن بر روند بهبود درمان فرزندانشان
محورهای موضوعی : سلامتزهرا السادات فهندژ سعدی 1 , حمیدرضا نوربخش 2 , نازنین هنرپروران 3 *
1 - دانشجوی دکتری مشاوره، دانشگاه تهران، تهران ایران
2 - دانشجوی دکتری روانشناسی بالینی دانشگاه شیراز، شیراز، ایران
3 - - نویسنده مسئول، دکتری مشاوره، استادیار گروه مشاوره واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران nazanin48@gmail.com
کلید واژه: اصلاح شناختی, بهبود درمان, توان‌بخشی شناختی, کیفیت زندگی, فلج مغزی,
چکیده مقاله :
چکیده مقدمه: فلج مغزی یک نابهنجاری غیرپیشرونده است که در مغز در حال رشد رخ می‌دهد که باعث ایجاد نواقص نرولوژیکی، حرکتی و پوسچرال در کودکان در حال رشد می‌شود. پژوهش حاضر به بررسی اثربخشی توان‌بخشی شناختی بر کیفیت زندگی و اصلاح شناختی مادران دارای فرزند فلج مغزی و نیز اثربخشی آن بر روند بهبود درمان فرزندانشان می‌پردازد. روش پژوهش: این پژوهش از نوع آزمایشی با طرح پیش آزمون-پس‌آزمون با گروه کنترل بود. جامعه آماری پژوهش حاضر، شامل مادران دارای فرزند فلج مغزی در شهر شیراز است و نمونه آماری شامل 30 نفر از مادرانی بود که به‌صورت تصادفی در دو گروه 15 نفره ی مداخله و کنترل تقسیم شدند. "آزمون کوتاه وضعیت ذهنی" جهت سنجش وضعیت روانی مادران بعنوان شرط ورود به پژوهش انجام گرفت. سپس دو آزمون «کیفیت زندگی سازمان بهداشت جهانی» و «آزمون کن تب» به‌عنوان پیش‌آزمون و پس‌آزمون جهت سنجش بین این دو گروه، پیش و پس از مداخله انجام شد. مداخله درمانی مادران، به‌وسیله پروتکل‌های توان‌بخشی شناختی توسط نرم‌افزار توان‌بخشی شناختی کاپیتان لاگ در 20 جلسه یک‌ساعته انجام پذیرفت. همچنین کودک فلج مغزی آن‌ها نیز با انجام تست ليست ارزشيابي ناتواني کودکان، به‌صورت پیش‌آزمون و پس‌آزمون توسط کار درمانگر ارزیابی‌شده و تحت درمان وی قرار گرفتند. داده‌های خام پرسشنامه‌ها بعد از جمع‌آوری در دو سطح توصیفی و استنباطی به‌وسیله‌ی نرم‌افزار اس پی اس اس مورد تجزیه و تحلیل قرار گرفتند. یافته ها: نتایج نشان داد که توان‌بخشی شناختی بر کیفیت زندگی و اصلاح شناختی مادران دارای فرزند فلج مغزی، اثربخشی مثبت و معناداری دارد. همچنین توان‌بخشی شناختی مادران دارای کودک فلج مغزی توانست اثربخشی خود را بر روند بهبود کودکان که تحت درمان کاردرمانی قرارگرفته بودند، نشان دهد که این امر اثر مثبت و معناداری بر روند بهبود درمان فرزندان دچار فلج مغزی داشته است. نتیجه گیری: پیشنهاد می‌شود در آموزش بالینی و نظری دانشجویان و پرسنل پرستاری از مقوله سلامت معنوی به‌عنوان یکی از ابعاد مهم سلامت روانی جهت توانمند کردن بیشتر بیماران به‌خصوص بیماران مزمن استفاده بیشتر گردد.
Abstract Introduction: Cerebral palsy is a non-progressive abnormality that occurs in the developing brain, which causes motor and postural neurological deficits in growing children. The present study is to investigate the effectiveness of cognitive rehabilitation on the quality of life and cognitive improvement of mothers with children with cerebral palsy, as well as its effectiveness on the improvement process of their children's treatment. Research method: This research was an experimental type with a pre-test-post-test design with a control group. The statistical population of the current study includes mothers with children with cerebral palsy in Shiraz and the statistical sample includes.There were 30 mothers who were randomly divided into two groups of 15 intervention and control. A short mental state test was conducted to measure the mental state of mothers as a condition for entering the research. Then two World Health Organization quality of life tests and "Fever Test" were performed as pre-test and post-test to measure between these two groups before and after the intervention. The therapeutic intervention of mothers was carried out through cognitive rehabilitation protocols by Captain Log cognitive rehabilitation software in 20 one-hour sessions. Also, their children with cerebral palsy were evaluated by the therapist by performing the children's disability evaluation list test as a pre-test and post-test and were treated by him. The raw data of the questionnaires were collected in two descriptive levels Inferences were analyzed by SPSS software. Findings: The results showed that cognitive rehabilitation has a positive and significant effect on the quality of life and cognitive improvement of mothers with children with cerebral palsy. Also, the cognitive rehabilitation of mothers with children with cerebral palsy was able to show its effect on the recovery process of children who were treated with occupational therapy, which had a positive and significant effect on the process of improving the treatment of children with cerebral palsy. Conclusion: It is suggested that in the clinical and theoretical education of nursing students and personnel, the category of spiritual health is one of the important dimensions of mental health to empower more patients, especially chronic patients should be used more.
References:
1. Nejat S. Quality of life and its measurement. Iran epidemiology. 2009;4(2):57 -62. [Persian]
2. Liu L. Quality of life as a social representation in China: A qualitative study. Social Indicators Research. 2006;75(2):217 -40.
3. Rahimi, M., Khayyer, M. Relationship between family communication patterns and the quality of life of high school students in Shiraz. Studies in Education and Psychology. 2010; 10(1): 5 -25. [Persian]
4. Susniene, D., & Jurkauskas, A. The Concepts of Quality of Life and Happiness - Correlation and Differences. The Engineering Economics,2009. 63.
5. Khayatzadeh Mahani M. A comparative Study about quality of life in Mothers of children with cerebral palsy, mental retardation and mothers of normal children. Daneshvar.2009;16(83):49 -58. [Persian].
6. Yuen Shan Leung, Cecilia Wai Ping Li-Tsang. Quality of Life of Parents who have Children With Disabilities, Hong Kong Journal of Occupational Therapy, 2003;13(1): 19-24.
7. Ahmadizadeh, Z., Rassafiani, M., Ehsani, F., Hosseini, A. Comparing the quality of life of mothers with cerebral palsy children based on walking ability. Journal of Research in Rehabilitation Sciences, 2014; 10(1): 88-98. 10.22122/jrrs.v10i1.1147
8. Mugno D, Ruta L, D'Arrigo V, Mazzone L. Impairment of quality of life in parents of children and adolescent with pervasive developmental disorder. Health and quality of life outcomes, 2007; 5- 22. 10.1186/1477-7525-5-22.
9. Sajedi F, Vameghi R, Ali-Zad V, Malek-Khosravi G, Karimlou M, Ravarian A et al . Is Anxiety More Common in Mothers of Children with Cerebral Palsy?. jrehab 2011; 11: 15-20 http://rehabilitationj.uswr.ac.ir/article-1-679-fa.html
10. Wilson B.A. Cognitive Rehabilitation in the 21st Century, OBE, First Published June 1; 2002.
11. Ma H., Trombly K. A. Effects of task complexity on reaction time and movement kinematics in elderly people. Am. J. Occup. Ther. 2004; 58: 150–158.
12. Fakharynia F., Rassafiani M., Sourtiji H., Jalili N., Bakhshi E. Comparison of the Effectiveness of Group-based Handling Training and Individualized Handling Training on the Quality of Life in Mothers of 1-6-Year-Old Children with Cerebral Palsy. The Scientific Journal of Rehabilitation Medicine, 2017; 6(2): 91-101. https://doi.org/10.22037/jrm.2017.1100313
13. Nazari M.A, Jafarpoor S. Impact of working memory capacity on temporal processing in preschool children. JCP 2015; 2(4): 31-40.URL: http://jcp.khu.ac.ir/article-1-2454-fa.html
14.Shariat A., Ghamarani A., Abedi A., Sharif T. Meta-analysis of the Effectiveness of Couple Therapy on Increasing Marriage Satisfaction (Iran 2006-2012). Journal of Woman and Family Studies, 2015; 3(1): 93-109. https://doi.org/10.22051/jwfs.2015.2197
15. SHaker dolagh A., Narimani M., Afrouz G., Hasani F., Baghdasarias, A. The Effectiveness Cognitive-Behavioral Couple Therapy on Improvement Function Family in Divorce Applicant Clients. Quarterly Journal of Health Breeze, 2014; 2(1): 53-60. https://jfh.sari.iau.ir/article_639706.html?lang=fa
16. Jalili N., Godarzi M., Rassafiani M, Haghgou H., Dalvand H., Farzi M.. The influenced factors on quality of life mothers of children with severe cerebral aplasia: a survey study. J Modern rehabilitation Internet]. 2013;7(3): 40-47.
17. Paster A, Brandwein D, Walsh J. A comparison of coping strategies used by parents of children with disabilities and parents of children without disabilities. Res Dev Disabil,2009; 30(6): 1337-1342.4
18. Wang M, Turnbull AP, Summers JA, Little TD, Poston DJ, Mannan H. Severity of disability and income as predictors of parents' satisfaction with their family quality of life during early childhood years. Research and Practice for Persons with Severe Disabilities, 2004; 29(2): 82-94.
19. Pruthi G, Singh T. Psychosocial burden and quatlity of life in parents of children with thalassemia and CP. Journal of Psychological Research, 2010; 2(1): 46-57.
20. Novak I., Honan I. Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review. Australian Occupational Therapy Journal; 2019. doi:10.1111/1440-1630.12573.
21. Kruijsen-Terpstra A.J.A., Ketelaar M., Boeije H., Jongmans M.J., Gorter J.W., Verheijden J., Verschuren O. Parents’ experiences with physical and occupational therapy for their young child with cerebral palsy: a mixed studies review. Child: Care, Health and Development, 2013; 40(6): 787–796.