Razi Journal of Medical Sciences

fa تجربه زیسته‌ی مبتلایان به اختلال دوقطبی در محیط کار: مطالعه‌ی پدیدار شناختی Lived experienced of patients with bipolar disorder in the workplace: A phenomenological روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: پژوهش حاضر با هدف واکاوی پدیدار شناختی تجربه زیسته‌ی مشکلات شغلی بیماران مبتلا به اختلال خلقی دوقطبی انجام شد. روش کار: مطالعه‌ی حاضر به روش کیفی و از نوع پدیدار شناختی توصیفی تجربه زیسته انجام گرفت. 48 بیمار دوقطبی با استفاده از روش نمونه‌گیری در دسترس انتخاب شدند. جهت گردآوری داده‌ها از مصاحبه‌ی عمیق نیمه ساختاریافته و برای تحلیل داده‌ها از روش تحلیل موضوعی کلایزی استفاده شد. نتایج تحلیل موضوعی در زمینه‌ی تجربه زیسته‌ی بیماران دوقطبی در محیط کار منجر به شناسایی 554 کد اولیه یا گزاره مفهومی شد که این کدها بر اساس شباهت‌ها و تفاوت‌هایشان مورد ارزیابی قرار گرفتند و نهایتاً در 14 مقوله فرعی و 3 مقوله اصلی طبقه‌بندی شدند. یافته‌ها: مشکلات شغلی بیماران دوقطبی در برگیرنده‌ی 14 مقوله فرعی بود که در قالب 3 مقوله اصلی مشکلات شغلی در سایه‌ی علائم اختلال دوقطبی (قهر از محیط کار، نیاز به استقلال، مشکل‌زایی، مشکلات مالی، ولنگاری شغلی، بی‌قیدی در ارتباط با جنس مخالف، افشای رازهای شغلی، عدم حفظ حریم و دخالت در کار دیگران، مشکل با صاحبان قدرت)، مشکلات شغلی مرتبط با محیط کاری (احساس ناامنی در محیط کار،  عدم درک علائم بیماری در محیط کار، دریافت انگ بیماری، استخدام نشدن و کار پاره وقت) و مشکلات شغلی مرتبط با ماهیت کار (چالشی نبودن کار) طبقه‌بندی شدند. نتیجه‌گیری: بررسی تجربه زیسته‌ی مشکلات شغلی بیماران دوقطبی حاکی از آن است که به علت خاصیت ناتوان کننده‌ی این اختلال در کار، بیش تشخیصی و یا کم تشخیصی این اختلال و ناکافی بودن درمان‌های روانپزشکی و روان‌شناختی و اثربخشی ضعیف آن‌ها بر مشکلات شغلی تاکنون، بهتر است که سمت و سوی بهبودی و مدیریت این اختلال به سمت رویکردهای توانبخشی شغلی حرکت کند.   <gdiv></gdiv><gdiv></gdiv> Background & Aims: Bipolar disorder is one of the types of mood disorders that due to its fluctuating symptoms and properties, has adverse effects on the work performance of people with it. In fact, work problems are more common among people with bipolar disorder than other people with other mental disorders, and these people are more likely than other people with other mental disorders to quit their works, change works, or quit their works. They lose their work and are often unemployed. Despite the many work problems of bipolar patients and the losses caused by the impact of this disorder on their work, researches are needed to examine these problems in depth; However, no study has been found in Iran that has studied the occupational problems of bipolar patients in depth. Also researches conducted in this field abroad are mainly related to the subject and content of health insurance reports or reports of costs and economic and sociological losses of bipolar disorder and reporting statistics in this field or meta-analysis of researches and no research has not examined the lived experience of these patients in the workplace. Accordingly, the aim of the present study was to analyze the lived experience of people with bipolar disorder in the workplace and to address the question of  what is the work problems of patients with bipolar disorder in the workplace.The aim of this study was to phenomenologically analyze the lived experience of wok problems of patients with bipolar disorder. Methods: In order to investigate the experiences and mental perceptions of patients with bipolar disorder type 2 and type 3 of their work problems, the phenomenological method of lived experience was selected from various qualitative research approaches. 48 bipolar patients participating in the study were selected using the available sampling method. Thus, from people with this disorder who received a diagnosis of type 2 or type 3 bipolar disorder from a psychiatrist and counselor and referred to a counseling clinic for psychological treatment, people who wished to participate in the study were selected. Sampling and interviewing continued until saturation and repetition in the work problems discovered from the content of the interviews were achieved. To collect data from in-depth semi-structured interviews (with questions such as: What are the work problems you have faced in the past or now? What are the factors and issues have been most effective in creating your work problems? What do others think of your work problems? Which of your work problems has been most annoying to you? Which of your work problems has not been solved and persisted? And...) was used. Interviews were conducted at a counseling center. The text of the interview was carefully rewritten and in the next session, the accuracy of the written text of the interview with the patient was examined. Kolaizi thematic analysis method was used to analyze the data. The results of the thematic analysis of the lived experience of bipolar patients in the workplace led to the identification of 554 primary codes or conceptual propositions that were evaluated based on their similarities and differences and finally classified into 14 sub-categories and 3 main categories. Results: Work problems of bipolar patients included 14 sub-categories which are classified into 3 main categories (work problems due to the symptoms of bipolar disorder, work problems related to the workplace and work problems related to the nature of work). Work problems in the shadow of the symptoms of bipolar disorder, ie problems that cause work problems for a person under the influence of clinical signs and symptoms of the disorder, whose sub-categories are: (sulks from the workplace, independence, creating problem, financial problems, poor work performance, problems with the opposite sex, disclosure of job secrets, lack of privacy and interference in the work of others, problems with those in power), work problems related to the workplace, in fact problems that a bipolar patient has due to This disorder is encountered in the workplace and these problems will exacerbate the symptoms of the disorder and its recurrence. Subcategories of work problems related to the workplace in bipolar patients include: (feeling insecure in the workplace, lack of understanding the symptoms of the disorder in the workplace, get stigmatized disorder, not being employed and part-time job opportunity) and work problems related to the nature of work. Work problems related to the nature of work mean that sometimes the characteristics of the job and its quality become problematic for the patient and create consequences that the sub-category of this problem is classified as (not challenging work). Conclusion: The lived experience of people with bipolar disorder showed that the work problems of these patients in the workplace fall into three main categories of work problems in the shadow of symptoms of bipolar disorder, work problems related to the workplace and work problems related to the nature of work. Therefore, it seems that in the first step of the intervention, the symptoms of the disorder should be managed by prescribing medication and psychological strategies and the patient should be taught to overcome the symptoms. Naturally, because this disorder is not definitely curable, use rehabilitation counseling approaches to manage the symptoms of the disorder. Also, after managing the symptoms of the disorder, it seems necessary to use career rehabilitation counseling approaches to prevent and correct work-related problems, as well as career planning to solve work problems related to the nature of the selected work. In general, due to the debilitating nature of this work disorder, overdiagnosis or underdiagnosis of this disorder and the inadequacy of psychiatric and psychological therapies and their poor effectiveness on work problems among these patients so far, it is better to improve and manage this disorder towards rehabilitation approaches. <gdiv></gdiv><gdiv></gdiv> اختلال دوقطبی, مشکلات شغلی, تجربه زیسته Moral code, Mental health, Environment, Coaches 29 45 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5349-1&slc_lang=fa&sid=1 Zeinab Rostami زینب رستمی roz_zeinabrostami@yahoo.com 3900319475328460055566 3900319475328460055566 No University of Isfahan, Isfahan, Iran دانشگاه اصفهان، اصفهان، ایران Mohammad Reza Abedi محمدرضا عابدی m.r.abedi@edu.ui.ac.ir 3900319475328460055567 3900319475328460055567 Yes University of Isfahan, Isfahan, Iran دانشگاه اصفهان، اصفهان، ایران Parisa Nilforooshan پریسا نیلفروشان p.nilforooshan@edu.ui.ac.ir 3900319475328460055568 3900319475328460055568 No University of Isfahan, Isfahan, Iran دانشگاه اصفهان، اصفهان، ایران