Razi Journal of Medical Sciences

fa بررسی اثربخشی درمان مبتنی بر پذیرش و تعهد بر کیفیت زندگی مادران دارای کودکان مبتلا به اوتیسم Investigating the Effectiveness of Treatment Based on Acceptance and Commitment Therpy on the Quality of Life of Mothers with Children with Autism روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: مادران دارای کودکان مبتلا به اوتیسم با مشکلات اجتماعی و روانشناختی متعددی روبرو هستند که می‌تواند بر رضایت زندگی آنها اثر داشته باشد. پژوهش حاضر با هدف بررسی اثربخشی درمان مبتنی بر پذیرش و تعهد بر کیفیت زندگی مادران درای کودک مبتلا به اختلال اوتیسم شهرستان تبریز انجام شد. روش کار: این مطالعه از نوع نیمه آزمایشی با طرح پیش آزمون-پس آزمون با گروه کنترل بود. جامعه آماری پژوهش، شامل کلیه مادران دارای کودک مبتلا به اوتیسم تحت پوشش بهزیستی شهرستان تبریز در سال 1401 بودند. از این جامعه 30 نفر به روش نمونه گیری هدفمند انتخاب و در دو گروه آزمایش و کنترل (هر گروه 15 نفر) جایگزین شدند. گروه آزمایش در 8 جلسه 90 دقیقه ای درمان مبتنی بر پذیرش و تعهد را دریافت کردند. ابزار اندازه گیری در این تحقیق شامل پرسشنامه کیفیت زندگی سازمان بهداشت جهانی، بود. به منظور تجزیه و تحلیل داده ها از آزمون کوواریانس تک متغیره با کمک نرم افزار SPSS-25 استفاده شد. یافته ها: نتایج نشان داد که درمان مبتنی بر پذیرش و تعهد توانسته به صورت معناداری نمرات کیفیت زندگی گروه آزمایش در پس آزمون در مقایسه با پیش آزمون را افزایش دهد (005/0P<). نتیجه گیری: به نظر می‌رسد درمان مبتنی بر پذیرش و تعهد، رویکرد مناسبی برای بهبود کیفیت زندگی مادران دارای کودک مبتلا به اختلال اوتیسم باشد. بنابراین به درمانگران و روانشناسان حیطه کودکان مبتلا به اوتیسم پیشنهاد می‌شود که از درمان  مبتنی بر پذیرش و تعهد جهت بهبود بهداشت روانی این مادران بهره ببرند.</div> <div style="text-align: justify;">Background & Aims: Autism spectrum disorder is a type of pervasive developmental disorder whose sufferers have three main characteristics: impairment in socialization, impairment in verbal and non-verbal communication, and limited and repetitive patterns of behavior (2). The prevalence of this disease in America has been reported as one in 68 people (6), although in Iran, this statistic is one in every 150 people, but unfortunately, this statistic seems to be increasing (9). Also, this disorder is related to gender, so that the ratio of girls to boys in autism spectrum disorders is about one to three (11). Despite the appearance of autism symptoms in the first year of a child's life; Patients are usually not diagnosed until they are 2-3 years old, and after diagnosis, the parents' initial reaction to this problem can be very different, but most of these reactions are influenced by the different beliefs of parents and the surrounding environment, and have a wide range of general denial of the problem. And not coping with it or intense follow-up for treatment (12). In autism spectrum disorders, like other children's diseases, the greatest tension and pressure will be on the child's caregivers. After a long process of diagnosis, in most cases, all the wishes and hopes of the parents turn into despair due to the awareness of their child's disability and anxiety about the child's future, and the parents' problems begin (14). In addition, the long treatment process and behavioral and communication problems of these children cause parents to suffer from fatigue, high stress, mental pressure and despair, depression and anxiety while raising their autistic child. Meanwhile, mothers seem to have more psychological vulnerability due to the main responsibility of taking care of the child and having more conflict with the affected child (17). Methods: The research method was semi-experimental with a pre-test-post-test design with a control group, and the statistical population included all the mothers of children with autism spectrum disorder covered by the welfare of Tabriz city in 1401. From among the statistical population, 30 mothers of children with autism spectrum disorder were selected by purposive sampling method and randomly replaced in two experimental groups of 15 people, test and control. Among the criteria for entering the study are having a child with autism disorder, between the ages of 25 and 50 years, at least a cycle education degree, no parental divorce, no history of psychiatric disorders leading to hospitalization, and completing the consent form for treatment and residence in Tabriz city. Cited. Also, absence of more than two sessions during therapy sessions, failure to answer the questionnaire questions accurately and completely, losing any of the criteria for entering the study and refusing to continue cooperation at any stage were among the criteria for exiting the study. To collect data, the quality-of-life questionnaire of the World Health Organization (WHOQOL-BREF) was used. To analyze the data, univariate analysis of covariance was used. Resluts: In this study, the average age of the mothers was 37.6, all of them were married, and none of them were heads of households. More than half of the mothers had a university education, so that 17 of the subjects (56%) had an associate's degree or higher, 8 mothers (26%) had a diploma degree, and only 5 mothers had a bachelor's or bachelor's degree. . Also, 11 mothers (36%) had only one child, while 14 mothers (46%) had two children and only 5 mothers had three or more children. The results of univariate covariance analysis in Table (3) show that the treatment based on acceptance and commitment had a significant effect on the quality of life of mothers of children with autism spectrum disorder (P<0.01); So that treatment based on acceptance and commitment has led to an increase in the quality of life of mothers of children with autism spectrum disorder in the experimental group; Therefore, the answer to the first question is positive. The results of univariate covariance analysis in Table (4) show that treatment based on acceptance and commitment had a significant effect on all four dimensions of quality of life (physical health, psychological health, social relations and environmental health) of mothers of children with autism spectrum disorder. P < 0.01); So that the treatment based on acceptance and commitment has led to an increase in the dimensions of the quality of life of mothers of children with autism spectrum disorder in the experimental group. Conclusion: The results of the research showed that there is a significant difference between the experimental and control groups in terms of the quality-of-life dimensions after the therapeutic intervention based on acceptance and commitment. Therefore, it can be said that this treatment has been effective in improving the quality of life of mothers with children with enema disorder. These results are in line with the findings of Byrne et al. (2021), who showed that treatment based on commitment and acceptance is effective in reducing depression in mothers with children with autism (19). Also, in similar results, Marino et al. (2022) also showed that this treatment was able to significantly improve the psychological well-being of mothers with children with autism (20). Internal studies also indicate the effectiveness of treatment based on commitment and acceptance on mothers with children with autism, so the study by Tabatabai et al. (1401) showed that treatment based on acceptance and commitment improves perceived social support, cognitive flexibility and emotional exchange in mothers with children with autism has helped (21). In the explanation of these evidences, it can be said that the scientific evidence shows that the change in acceptance and failure and not the change in the cognitive or emotional content is the mediator of therapeutic outcomes in the therapeutic approach of acceptance and commitment (22). In fact, treatment based on commitment and acceptance reduces negative emotions through factors such as being in the present moment, coping with internal experiences without avoidance, acceptance without judgment, suppression or trying to change them (23). Mothers of children with autism need strategies to be able to maintain their ability to cope and adapt. Also, treatment based on commitment and acceptance helps mothers with a child with autism not to think of themselves as failures and without hope, and their lives have value and meaning (24).</div> اوتیسم, درمان مبتنی بر پذیرش و تعهد, کیفیت زندگی Acceptance and commitment therapy, Autism, Quality of life 1 10 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7549-1&slc_lang=fa&sid=1 Seyyedeh Haniyeh Sajadishahri سیده هانیه سجادی شهری 3900319475328460089904 0009-0000-1219-4269 No Master of General Psychology, Science and Research Branch, Islamic Azad University, Tehran, Iran کارشناسی ارشد روانشناسی عمومی، واحد علوم تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران Fereshteh Rezazadeh khalkhali فرشته رضا زاده خلخالی 3900319475328460089905 0009-0001-0329-8290 No Master of Clinical Psychology, Alzahra University, Tehran, Iran کارشناسی ارشد روانشناسی بالینی، دانشگاه الزهرا، تهران، ایران Zeinab Adel زینب عادل 3900319475328460089906 0009-0000-2953-6448 No Master of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran کارشناسی ارشد روانشناسی بالینی، واحد رودهن، دانشگاه آزاد اسلامی، رودهن، ایران Sanaz Pourhedayati ساناز پورهدایتی 3900319475328460089907 3900319475328460089907 No Master of Clinical Child and Adolescent Psychology, Tabriz University, Tabriz, Iran کارشناسی ارشد روانشناسی بالینی کودک و نوجوان، دانشگاه تبریز، تبریز، ایران Yalda Biabani یلدا بیابانی s.safari2022@yahoo.com 3900319475328460089908 3900319475328460089908 Yes PhD Student in General Psychology, Urmia Branch, Islamic Azad University, Urmia, Iran دانشجوی دکتری روانشناسی عمومی، واحد ارومیه، دانشگاه آزاد اسلامی، ارومیه، ایران