اثربخشی برنامه آموزش روانشناختی خانواده در کاهش هیجان ابراز شده مراقبین بیماران اسکیزوفرن
محورهای موضوعی : تکتونواستراتیگرافیصمد فریدونی 1 , امیر هوشنگ مهریار 2 , حجت اله جاویدی 3 , رامین افشاری 4
1 - دانشجوی دکترای روانشناسی. گروه روانشناسی. دانشکده روانشناسی و علوم تربیتی. واحد مرودشت. دانشگاه آزاد اسلامی. مرودشت. ایران
2 - استاد دانشگاه آزاد. گروه روانشناسی. دانشکده روانشناسی و علوم تربیتی. واحد مرودشت. دانشگاه آزاد اسلامی، مرودشت، ایران.
3 - استادیار دانشگاه آزاد. گروه روانشناسی. دانشکده روانشناسی و علوم تربیتی. واحد مرودشت. دانشگاه آزاد اسلامی، مرودشت، ایران.
4 - روانپزشک- بیمارستان اعصاب و روان استاد محرری شیراز. جانشین تام الاختیار رییس دانشگاه علوم پزشکی شیراز در امور اعتیاد و رییس دفتر پیشگیری
کلید واژه: اسکیزوفرنیا, آموزش روانشناختی خانواده, هیجان ابراز شده,
چکیده مقاله :
پژوهش حاضر در قالب یک کارآزمایی بالینی (IRCT2016081729402N1) با هدف بررسی اثربخشی مداخله مبتنی بر آموزش روانشناختی خانواده در کاهش سطح هیجان ابراز شده مراقبین بیماران مبتلا به اسکیزوفرنیا انجام شد. گروه نمونه شامل خانوادههای 49 نفر از بیماران اسکیزوفرن بستری در بیمارستان اعصاب و روان استاد محرری شیراز بود، که به صورت نمونهگیری در دسترس انتخاب و در دو گروه مداخله (24n=) و کنترل (25n=) قرار گرفتند و به پرسشنامه هیجان ابراز شده خانواده در شروع مداخله، پس از مداخله و دو ماه بعد از اتمام مداخله پاسخ دادند. برنامه آموزش خانواده برای گروه آزمایشی اجرا گردید، اما گروه کنترل هیچ مداخله خاصی دریافت نکرد. نتایج تحلیل واریانس یک راهه با اندازهگیریهای مکرر نشان داد آموزش روانشناختی خانواده در کاهش هیجان ابراز شده خانواده موثر بوده است (031/. = لامبدای ویلکز، 895/339=F، 0001/.=P، 969/.= مجذور اتای تفکیکی چند متغیره). تحلیل واریانس یک راهه بین گروهها نیز حاکی از تفاوت معنادار میان گروه مداخله با گروه کنترل (785/38=F، 0001/.=P، 45/.= اندازه اثر) بود. یافتههای پژوهش نشان میدهد که آموزش روانشناختی خانواده از اثر بالایی در کاهش هیجان ابراز شده خانواده برخوردار است. نتایج پیگیری دو ماهه نیز نشان از پایداری بهبود هیجان ابراز شده خانواده داشته است.
Objective: The aim of this clinical trial study (IRCT2016081729402N1) is explored the effectiveness of familial psycho-educational program in inpatients suffering from schizophrenia in reducing caregivers’ expressed emotion.
Methods: In this clinical trial, we included 49 people from the family of schizophrenic inpatients, who were admitted to Shiraz Psychiatric Hospital. They were randomly divided into intervention (n=24) and control (n=25) groups. Only, in the experimental group, a psycho-educational program was arranged for their caregivers. At baseline, immediately, post-intervention and two month later, all participants completed Family Questionnaire (FQ).
Results: According to the results of the analysis of variance for repeated measures by SPSS software V.20: both groups showed decrease in post-test in FQ (Wilks' Lambda=.031; F=339.859; p=0.0001; Partial Eta Squared=.969). Also, there was a significant difference among groups (F=38.785; p=0.0001; Effect Size=0.45).
Conclusion: Our research findings indicate that using the family psycho-educational program, can decrease the expressed emotion on schizophrenic inpatients' caregivers.
- Asadollah, GH., Abbas Alizadeh, A. (1993). Guide for the families of schizophrenic patients. Isfahan: IUMS.
- Asen, K., Berkowitz, R., Cooklin, A., Leff, J., Loader, P., Piper, R., Rein, L. (1991). Family therapy outcome research: a trial for families, therapists, and researchers. Family Process; 30: 3–20.
- Bertrando, P., Cecchin, G., Clerici, M., Beltz, J., Milesi, A., Cazzullo, C. (2006). Expressed emotion and Millan systemic intervention: A pilot study on families of people with a diagnosis of schizophrenia. Journal of Family Therapy; 28, 81-102.
- Boland, D.L., Sims, S. L. (1996). Family care giving at home as a solitary journey. Image: The Journal of Nursing Scholarship; 28(1):55-58.
- Brady, N. (2004). A portrait of families with a member Labeled schizophrenia. (Unpublished doctoral dissertation, Case Western Reserve University , Cleveland, Ohio).
- Chan, S, Wai, Ch. (2011). Global Perspective of Burden of Family Caregivers for Persons With Schizophrenia. Archives of Psychiatric Nursing; 25, 5, 339–349.
- Chien, W. T., Chan, S., Morrissey, J. (2007). The perceived burden among Chinese family caregivers of people with schizophrenia. Journal of Clinical Nursing; 16: 1151–1161.
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hilsdale. NJ: Lawrence Earlbaum Associates, 2.
- Dixon, L., Adams, C. Lucksted, A. (2000). Update on family psycho-education for schizophrenia. Schizophrenia Bulletin; 26: 5–20.
- Doornbos, M. (1996). The strengths of families coping with serious mental illness. Archives of Psychiatric Nursing; 10(4):214-220.
- Edwards, ME., Steinglass, P. (1995). Family therapy outcomes for alcoholism. Journal of Marital and Family Therapy; 21: 475–509.
- Eisler, I., Dare, C., Russell, GF., Szmukler, G., Le Grange, D., Dodge, E. (1997). Family and individual therapy in anorexia nervosa. Archives of General Psychiatry; 54: 1025–1030.
- Eizedi, V.A., Shegefti Sohrabi, N., Khayer, M. (2014). Family Psychological Characteristics of the Popular and Unpopular Children. Journal of Psychological models and methods; Volume 4, Issue 16, Page 101-114. [In Persian]
- Falloon, I. R. H. (2003). Family interventions for mental disorders: Efficacy and effectiveness. World Psychiatry; 2, 20-28.
- Friedrich, R. M., Lively, S., Buck Walter, K. C. (1999). Well siblings living with schizophrenia. Implication associated behaviors. Journal of Psychological Nursing and Mental health; 37: 11-19.
- Gmitrowicz, A., Kaszynxka, B. (1996). Psychoeducation of families adolescent patients. Psychiatry, Pol; 30(6): 919-79.
- Hansell, J., Damour, L. (2005). Abnormal Psychology. New York: John Wiley & Sons.
- Hazelrigg, M. D., Cooper, H. M. Borduin, C. M. (1987). Evaluating the effectiveness of family therapies: an integrative review and analysis. Psychological Bulletin; 101: 428–442.
- Jenkins, H., Marvin, K. (1992). The meaning of Expressed Emotion: Theoretical Issues Raised by Cross – Cultural Research. Am. J. Psychiatry; 149: (1), 9-21.
- Karamlo, S., Mazaheri, E., Mottaghipoor, Y. (2010). Effectiveness of family psycho-education program on family environment improvement of severe mental disorder patients. Journal of Behavioral Sciences; 4 (2), 123-128. [In Persian]
- Kavanagh, D. J. (1992). Recent developments in expressed emotion and schizophrenia. The British Journal of Psychiatry; 160(5), 601-620.
- Leff, J., Alexander, B., Asen, E., Brewin Chris R., Dayson, D., Vearnals, S., Wolff, G. (2003). Modes of action of family interventions in depression and schizophrenia: the same or different?. Journal of Family Therapy; 25: 357–370.
- Leff, J., Vearnals, S., Brewin, C. R., Wolff, G., Alexander, B., Asen, K., Dayson, D., Jones, E., Chisholm, D. Everitt, B. (2000). The London Depression Intervention Trial. Randomised controlled trial of antidepressants v. couple therapy in the treatment and maintenance of people with depression living with a critical partner: clinical outcome and costs. British Journal of Psychiatry; 177: 95–100.
- Malekoti, K., Nori Ghasemabadi, R., Naghavi, M., Ahmadi Abhari, M., Nasr Esfahani, M., Afghah, S., Salehi, P., Hemmati, M., Moghadamnia, M. (2003). The burden caregivers of choronic mental patients and their needs to care and therapeutic services. Hakim Research Journal; 6 (2), 1-10. [In Persian]
- Markus, E., Lange, A., Pettigrew, T. F. (1990). Effectiveness of family therapy: a meta-analysis. Journal of Family Therapy;12: 205–221.
- McDonagh, LA. (2004). Expressed emotion as a precipitant of relapse in psychological disorders. www.personalityresearch.org/papers/mcdonagh.html.
- Meisel, M. (1999). Psychosocial implication in care of the critically ill patient and family Philadelphia: Daris company; 20-24.
- Mottaghipoor, Y. (2005). Family Psychological Education Program. Tehran: SBUMS [Not printed]
- Mueser, K. T. (2004). Family services for mental health illness. Dartmouth Psychiatric Research Center.
- Ohaeri, J. (2003). The burden of caregiving in families with a mental illness: a review of 2002. Current Opinions in Psychiatry; 16: 457-465.
- Pratibha, J SPK., Bhatia, MS. (2012). Expressed Emotion Research in Severe Mental Illness. Delhi Psychiatry Journal; 15, 1: 32-40.
- Rahmani, F., Ranjbar, F., Ebrahimi, H., Hosseinzadeh, M. (2015). The Effects of Group Psychoeducational Programme on Attitude toward Mental Illness in Families of Patients with Schizophrenia, 2014. Journal of Caring Sciences; 4 (3): 245-253.
- Reid, J., Lloyd, C., De Groot, L. (2005). The psychoeducation need of parents who have an adult son or daughter with a mental illness. Australian e-Journal for The Advancement of Mental Health; 4: 15-21.
- Reinhard, S. (1994). Perspectives on the family’s caregiving experience in mental illness. Image; 26 (1): 70-74.
- Samani, F., Hossein Chari, M. (2013). Investigating the Mediating Role of Cognitive Emotion Regulation in Relationship Between Parenting and Academic Adjustment in Students. Journal Of Psychological models and methods; 3, 11: 83-98. [In Persian]
- Seyedi Saroei, M., Farhand, S., Amini, M., Hosseini, M. (2013). Relationship between Family Communication Patterns and Personality Characteristics with Psychological Well-Being with Mediating Relativism in MS Patients. Journal Of Psychological models and methods; 3, 11, 17-38. [In Persian]
- Simoneau, T. L., Miklowitz, D. J., Richards, J. A., Saleem, S. George, E. L. (1999). Bipolar disorder and family communication: effects of a psychoeducational treatment program. Journal of Abnormal Psychology; 108: 588–597.
- Skelton, J. (1994). Association of Relatives and Friends of the Mentally Ill. ARAFMI Newsletter (NSW); 53:2.
- Vostanis, P., Burnham, J., Harris, Q. (1992). Changes of expressed emotion in systemic family therapy. Journal of Family Therapy; 14: 15–27.
- Wearden, A.J., Tarrier, N., Barrowclough, C., Zastowny, T.R., Rahill, A.A. (2000). A review of expressed emotion research in health care. Clin Psychol Rev; 20(5): 633-666.
- Wiedemann, G., Rayki, O., Feinstein, E., Hahlweg, K. (2002). The family questionnaire: Development and validation of a new self-report scale for assessing expressed emotion. Psychiatry Research; 109: 265-279.
- World Federation of Mental Health (WFMH). (2010). Caring for the caregiver: Why your mental health matters when you are caring for others. Woodbridge VA: WFMH.
- World Health Organization. (2010). Schizophrenia. Retrieved on 10 January 2010. http://www.who.int/mental_health/ management/schizophrenia/en/.
- Yamaguchi, H., Takahashi, A., Takano, A., & Kojima, T. (2006). Direct effects of short term psycho-educational intervention for relatives of patients with schizophrenia in Japan. Psychiatry & Clinical Neuroscience; 60, 590-597.
- Yang, Y. K., Hsieh, H. H., Wu, A. C., Yeh, T. L., Chen, C. C. (1999). Help-seeking behaviors in relatives of schizophrenics in Taiwan. General Hospital Psychiatry; 21: 303-309.
- Yip, K. S. (2000). Have psychiatric services in Hong Kong been impacted by the deinstitutionalization and community care movements?. Administration and Policy of Mental Health; 27: 443–449.
- Zubin, J., Spring, B. (1977). Vulnerability--a new view of schizophrenia. Journal of Abnormal Psychology; 86: 103-126.
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