Razi Journal of Medical Sciences

fa اثربخشی روان‌پویشی فشرده و کوتاه مدت بر کیفیت زندگی، قدرت ایگو در زنان مبتلا به سردرد تنشی Effectiveness of Intensive and Short-Term Psychodynamic Therapy on Quality of Life, Ego Strength in Women with Tension Headaches روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: پژوهش حاضر با هدف تعیین اثربخشی درمان پویشی فشرده و کوتاه‌مدت بر کیفیت زندگی، قدرت ایگو در زنان مبتلا به سردرد تنشی انجام شد. روش کار: این مطالعه به روش نیمهتجربی با طرح پیش‌آزمون، پس‌آزمون و پیگیری دو‌ماهه با گروه کنترل بود. جامعه مورد نظر تمامی بیماران مبتلا به سردرد تنشی مراجعه کننده به کلینیک تخصصی اعصاب و روان شهر تهران در سال 1401 بود. حجم نمونه مورد بررسی با مراجعه به جدول Cohen تعیین شد. به این طریق که در سطح اطمینان 95 درصد، اندازه اثر 30/0 و توان آماری 83/0، برای هر گروه 12 نفر تعیین شد. اما از آنجایی که احتمال ریزش برخی نمونهها وجود داشت و همچنین در جهت تعمیم‌پذیری بیشتر نتایج، حجم نمونه در هر گروه 15 نفر تعیین شد. در مرحله اول به شیوه نمونهگیری در دسترس 30 نفر انتخاب و این 30 نفر در گام دوم به صورت تصادفی ساده (به شیوه قرعه کشی) در یک گروه آزمایش (15 نفر) و یک گروه کنترل (15 نفر) جایگزین شدند. یافته‌ها: میانگین و انحراف معیار سنی گروه آزمایش و کنترل به ترتیب 92/3 ± 40/43 و 49/4 ± 07/44 سال بود (669/0=P). نتایج آزمون t دو نمونه مستقل در مورد سن و آزمون دقیق فیشر در خصوص جنسیت، سطح تحصیلات و وضعیت تأهل نشان داد که بین گروه آزمایش و کنترل تفاوت آماری معنیداری وجود ندارد. میانگین نمرات کیفیت زندگی و قدرت ایگو قبل از مداخله به ترتیب در گروه درمان 25/72، 08/24 و در گروه کنترل 12/72، 52/23 بود، اما پس از مداخله، میانگین نمرات قدرت ایگو و کیفیت زندگی در گروه درمان به صورت معنی داری نسبت به گروه کنترل افزایش نشان داد. نتیجه‌گیری: نتایج مطالعه حاضر بیانگر آن بود که استفاده از درمان پویشی فشرده و کوتاه‌مدت بر روانپویشی فشرده و کوتاه مدت بر کیفیت زندگی، قدرت ایگو در زنان مبتلا به سردرد تنشی مؤثر است. از درمان روانپویشی فشرده و کوتاه مدت در کاهش افزایش کیفیت زندگی و افزایش قدرت ایگو در افراد مبتلا به سردردتنشی استفاده شود.</div> <div style="text-align: justify;">Background & Aims: Psychosomatic diseases are physical diseases that are caused by psychological factors, the most important of which are chronic colitis, high blood pressure, heart and coronary artery diseases, and finally tension headaches. Headache is one of the most common medical complaints and a debilitating neurological disorder in neurological clinics that affects the quality of life of patients. Severe headache can affect people's way of doing work and personal and social life and leave a negative impact on the quality of life in the long term, and intensive and short-term dynamic treatment can play an effective role in improving psychological symptoms; Therefore, the present study was conducted with the aim of determining the effectiveness of intensive and short-term dynamic therapy on intensive and short-term psychodynamic therapy on quality of life and ego strength in women with tension headaches. Methods: This study was a semi-experimental method with a pre-test, post-test and two-month follow-up plan with a control group. The target population was all patients with tension headaches who referred to the specialized neurology clinic in Tehran in 1402. The sample size was determined by referring to Cohen's table. In this way, at the confidence level of 95%, the effect size was 0.30 and the statistical power was 0.83 for each group of 12 people. However, since there was a possibility of some samples falling and also in order to generalize the results more, the sample size was determined to be 15 people in each group. In the first step, 30 people were selected by available sampling method, and in the second step, these 30 people were replaced by simple random (by lottery) in an experimental group (15 people) and a control group (15 people). Results: The mean and standard deviation of the age of the experimental and control groups were 43.40 ± 3.92 and 44.07 ± 4.49 years, respectively (P=0.669). The results of the t-test of two independent samples regarding age and Fisher's exact test regarding gender, education level and marital status showed that there is no statistically significant difference between the experimental and control groups (P<0.05). The average quality of life scores And ego strength before the intervention was 72.25, 24.08 in the treatment group and 72.12, 23.52 in the control group respectively (p<0.05), but after the intervention, the average scores of ego strength and quality of life in The treatment group showed a significant increase compared to the control group (p<0.01). Mauchly's sphericity showed that the assumption of sphericity was maintained in the data for all three components of quality of life (P=0.358, χ=3.56), ego strength (P=0.055, χ=16.05). Therefore, the assumed sphericity test was used. Box's M test was used to evaluate the equality of covariance matrices, according to the results for quality of life variables (Box's M=3.051, F=1.572, P=0.514), and ego strength (Box's M=4.179) , F=3.260, P=0.508) was established. The results of the intergroup test indicated that the difference between the experimental and control groups was significant in terms of average quality of life (P=0.008) and ego strength (P=0.024). The results of intragroup test (period) indicate that the difference between the average quality of life (P<0.001) and ego strength (P<0.001) is significant. In other words, the difference between the average scores of the dimensions of quality of life and ego strength in the three stages of pre-test, post-test and follow-up in the entire research sample is 67%, 78%, respectively, and is significant. Also, the results of Table 4 show that the interactive effect of group and time on quality of life and ego strength variables is significant (P<0.001), which indicates the effect of the intervention on increasing the average scores of quality of life variables and Ego strength in the post-test and follow-up stages in the experimental group is higher than the control group. The findings of the research showed that intensive and short-term dynamic therapy has led to the improvement of tension headache patients in the ego strength index. In the treatment to experience emotions, we "build the capacity of the ego" so that they do not use defense mechanisms in order not to experience negative emotions through defending. In fact, by building my capacity for the patient, we help him improve and we do this by bringing the patient closer to his feelings without using defense mechanisms. In fact, creating a feeling of mastery over emotions by challenging defenses in the treatment process improves the patient's condition and consequently improves his quality of life. The inability to regulate emotions is rooted in the early years of life and failure in the internalization process has the characteristic of "self-care" of parents. The ability of self-care is a psychological capacity and one of the functions of the ego. This capacity protects the person from harm and leads to the guarantee of survival. Self-care capacity includes the ability to measure reality, judge, control, the existence of anxiety with the function of warning the person and the ability to make logical conclusions and inferences. Self-care capacity is created through parent-child interaction and parental support and affection in the early years of childhood. Since people with tension headaches lack these internalizations, they have problems in the ability to take care of themselves, maintain self-esteem, and regulate communication. In fact, failure in self-care and self-regulation causes painful and confusing feelings in the person and brings heavy psychological suffering to the person. Conclusion: The results of the present study indicated that the use of intensive and short-term psychodynamic therapy is effective on quality of life and ego strength in women with tension headaches. Based on this, it is recommended to use intensive and short-term psychodynamic therapy to reduce the increase in the quality of life and increase the strength of the ego in people with tension headaches, and along with other treatment methods, this intervention can be used in psychiatric clinics. </div> درمان پویشی فشرده و کوتاه مدت, قدرت ایگو, سردردتنشی, کیفیت زندگی Intensive and Short-Term Dynamic Therapy, Ego Strength, Tension Headache, Quality of Life 384 393 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7619-1&slc_lang=fa&sid=1 Shide Amiri شیده امیری 3900319475328460082478 0009-0004-3023-2328 No Master's degree, Department of Psychology, Islamshahr Branch, Islamic Azad University, Tehran, Iran کارشناسی ارشد، گروه روانشناسی، واحد اسلامشهر، دانشگاه آزاد اسلامی، تهران، ایران. Azadeh Tehrani-Sersht آزاده تهرانی سرشت 3900319475328460082479 0009-0005-1021-7515 No Master's degree, Department of Psychology, Islamshahr Branch, Islamic Azad University, Tehran, Iran. . کارشناسی ارشد، گروه روانشناسی، واحد اسلامشهر، دانشگاه آزاد اسلامی، تهران، ایران. Amin Haji Bagheri امین حاجی باقری amin.taha444@gmail.com 3900319475328460082480 3900319475328460082480 Yes Master's degree, Department of Psychology, Science and Research Branch, Islamic Azad University, Tehran, Iran. کارشناسی ارشد، گروه روانشناسی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران Narges Diyani نرگس دیانی 3900319475328460082481 3900319475328460082481 No Master's degree, Department of Psychology, Science and Research Branch, Islamic Azad University, Tehran, Iran. کارشناسی ارشد، گروه روانشناسی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران Manzar Malekian منظر ملکیان 3900319475328460082482 3900319475328460082482 No Master's degree, Consulting Department, Science and Research Branch, Islamic Azad University, Kerman, Iran. کارشناسی ارشد، گروه مشاوره، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، کرمان، ایران.