Razi Journal of Medical Sciences

fa مدل‌یابی ساختاری رابطه‌ استیگمای بیماری با اضطراب اجتماعی با توجه به نقش واسطه‌ای عملکرد خانوادگی در بیماران مبتلا به صرع Structural Modeling of Relationship Between Disease Stigma and Social Anxiety by Considering the Mediating Role of Family Function in Patients with Epilepsy روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: صرع به‌شدت بر زندگی افراد مبتلا به آن تأثیر می‌گذارد و با کاهش سلامت جسمی و روانی آنان موجب بروز اختلالات روان‌پزشکی می‌شود. صرع یکی از بیماری‌های شایع و مزمن نورولوژیکی است که در عینحال می‌تواند مشکلات روانشناختی زیادی برای افراد مبتلا به این بیماری ایجاد کند. هدف پژوهش حاضر بررسی رابطه استیگمای بیماری با اضطراب اجتماعی در بیماران مبتلا به صرع با توجه به نقش واسطهای مولفههای عملکرد خانوادگی بوده است. روش کار: طرح پژوهش حاضر از نوع پژوهشهای توصیفی به شیوه معادلات ساختاری بوده است. 117 بیمار مبتلا به صرع-بر اساس تشخیص پزشک متخصص- به شیوه نمونه‌گیری در دسترس انتخاب شده و به وسیله پرسشنامه‌های مقیاس استیگمای صرع، پرسشنامه هراس اجتماعی و پرسشنامه ابزار سنجش خانواده مورد ارزیابی قرار گرفتند. نمونه‌گیری ذکر شده از اوایل اردیبهشت ماه 1397 آغاز و تا آخر تیرماه به مدت 3 ماه ادامه داشت. دادهها با استفاده از روش مدلیابی ساختاری تجزیه و تحلیل شدند. یافته‌ها: شاخص‌های برازندگی اکثر مدل‌های مفروض بالاتر از مقدار مطلوب و در سطح خوبی قرار دارند که این مقدار حاکی از برازش خوب مدل است. نتایج حاکی از تایید نقش واسطهای تعدادی از مولفه‌های عملکرد خانوادگی شامل حل مسئله، نقش‌ها، پاسخگویی عاطفی و کنترل رفتاری در رابطه استیگمای بیماری با اضطراب اجتماعی در بین بیماران مصروع بود (05/0>p). اما نقش میانجی مولفه‌های ارتباط، آمیزش عاطفی و عملکرد کلی خانواده در رابطه استیگمای بیماری با اضطراب اجتماعی در بین بیماران مصروع معنادار به دست نیامد. نتیجه‌گیری: بر اساس نتایج به دست آمده، استیگمای بیماری میتواند اضطراب اجتماعی بیماران مبتلا به صرع را افزایش دهد ولی برخی از مولفههای عملکرد خانوادگی می توانند این تاثیر را تعدیل کنند. <div style="text-align: justify;">Background & Aims: Epilepsy is one of the most common and chronic neurological diseases that can cause many psychological problems for people with this disease. Epilepsy is transient changes in brain function due to excessive and hyper-synchronous nervous activity that may lead to uncontrolled body movements or changes in the level of consciousness. Social anxiety disorder is defined as an extreme or unreasonable fear of being in social situations. The presence of comorbid mental disorders, especially social anxiety disorder in people with epilepsy, along with the patient's dysfunctional beliefs and attitudes about epilepsy, affect adaptation skills and the ability to cope with the problems of this chronic disease. General characteristics of epilepsy cause maladaptive coping strategies, high levels of anxiety, fear of being in public, and increased vulnerability of the epileptic person to social anxiety disorder.  Family function denotes family ability to adapt to the changes made during life, solving contradictions and conflicts, solidarity between members and success in disciplinary patterns, observing the limits of individuals and the enforcement of the laws and regulations governing this institution with the aim of protecting the whole system. Family functioning refers to the family's ability to adapt to changes in life, Resolving contradictions and conflicts, Solidarity between members, and respect for boundaries. People with epilepsy receive the most treatment in the community from the family as the primary caregiver, which is the most important component of social support that is an important protective effect in the relationship between illness and health. Although there have been researches aimed at investigating the anxiety of patients with epilepsy or research aimed at investigating the stigma of epilepsy, the relationship between epilepsy and the stigma of the disease and social anxiety has not been investigated, considering the important role of the family, especially in the form of structural equations. The purpose of this study was to investigate the relationship between disease stigma and social anxiety considering the mediating role of family function in patients with epilepsy.</div> Methods: The study design was descriptive-correlation and the study population include all epileptic patients were referred to clinics and hospitals of Isfahan in 2018. After obtaining a code of ethics and coordinating with the education and protection departments of hospitals, 117 patients with epilepsy- based on specialist physician's diagnosis- selected by convenient sampling which evaluated by the questionnaires of Stigma Scale for, Social Phobia Inventory and Family Function Assessment. In selecting the research sample, the inclusion criteria were conscious satisfaction and the right to cancel the continuation of the research and the ability to read and write, and also the exclusion criteria was Failure to complete the questionnaire questions. The mentioned sampling started from the beginning of April 2018 and continued for 3 months. In selecting the research sample, the inclusion criteria were 1- informed consent and the right to withdraw from the research, 2- the ability to read and write, and the exit criteria of not completing the questionnaire questions were considered. The mentioned sampling started from the beginning of May 2017 and continued for 3 months until the end of July. The data were analyzed by using Structural Modeling in Smart PLS. 3.2.8. <pre style="text-align:justify"> Results: Path analysis has been used to investigate the mediating role of family functioning components in the relationship between disease stigma and social anxiety. Considering the non-significance of Shapiro-Wilk test values, it can be said that the distribution of the studied scales was normal. Path analysis has been used to investigate the mediating role of family </pre> <pre style="text-align:justify"> functioning components in the relationship between disease stigma and social anxiety. All fitness indicators of the most assumed models are above the desired value and are at a good level, which indicates a good fit of the model. The results confirmed the mediation role of the components of problem solving, roles, affective responsiveness and behavioral control among the epileptic patients (p<0.05), however the mediating role of the components of communication, affective involvement and general family functioning not significant in the relationship between disease stigma and social anxiety in patients with epilepsy (p>0.05). But in general, the mediating role of family functioning variable was not approved (p>0.05).</pre> <pre style="text-align:justify"> Conclusion: Based on the results of this study, it can be said that the stigma of epilepsy as a chronic disease can cause anxiety and social isolation in these patients, which can lead to a wide range of disorders and problems such as depression, inability to make friends and academic and professional failure. However, family functioning can reduce the negative emotional burden of the disease and the social problems that result from it, especially in areas such as emotional support and problem solving. Research in this area can also have therapeutic implications and clarify the need for specific treatment plans for this group of patients and their families for mental health policy makers and it can be effective in reducing the problems caused by the disease and their other negative consequences, which allocates a large part of human and financial resources. According to results, the disease stigma increase social anxiety in patients with epilepsy, but family function could be mediate this effect. Due to the fact that the research method was descriptive correlational, as a result, it is not possible to infer causal relationships from the findings of this study; Also, due to the limited sample population and from the place where sampling was available, therefore, he acted more cautiously in generalizing the findings. It is suggested that future researches investigate this model using random sampling to increase the internal validity of the research. It can be effective to prepare a psychological profile and identify and screen people who are exposed to family problems and psychological injuries and prioritize training and psychological interventions for them.It can be said that the stigma of epilepsy as a chronic disease can cause anxiety and social isolation of these patients, which itself can create a wide range of disorders and problems such as depression, problems in making friends. Finding and failing academically and professionally; however, family functioning, especially in areas such as emotional support and problem solving, can reduce the negative emotional burden of this disease and the resulting social problems.</pre> عملکرد خانوادگی, استیگما, اضطراب اجتماعی, صرع Family functioning, Stigma, Social anxiety, Epilepsy 1 15 http://rjms.iums.ac.ir/browse.php?a_code=A-10-4961-3&slc_lang=fa&sid=1 Elahe Rezaii الهه رضایی 3900319475328460066228 3900319475328460066228 No MSc Student of Clinical Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran دانشجوی کارشناسی ارشد روان شناسی بالینی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران Sayed Abbas Haghayegh سید عباس حقایق abbas_haghayegh@yahoo.com 3900319475328460066229 3900319475328460066229 Yes Assistant Professor of Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran استادیار، گروه روان شناسی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران