Razi Journal of Medical Sciences

fa کارآزمایی بالینی بستۀ آموزشی-مداخله‌ای راه‌حل محور اضطراب فراگیر بر فرانگرانی زوجین مراجعه‌کننده به مراکز درمانی Clinical Trial of an Educational-Interventional Package Focused on The Solution of Pervasive Anxiety on the Over-Anxiety of Couples Referring to Medical Centers روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: یﮑﯽ از تازه‌ترین مؤلفه‌ها در حیطه اﺧﺘﻼﻻت اﺿـﻄﺮاﺑﯽ ﻣﻔﻬـﻮم ﻓﺮاﻧﮕﺮاﻧـﯽ اﺳﺖ ﮐﻪ ﺑﻪ ﻧﮕﺮاﻧﯽ در ﻣﻮرد ﻧﮕﺮاﻧﯽ اشاره دارد. ﻫﺪف این ﭘﮋوﻫﺶ کارآزمایی بالینی بستۀ آموزشی-مداخله‌ای راه‌حل محور اضطراب فراگیر بر فرانگرانی زوجین مراجعه‌کننده به مراکز درمانی بود. روش کار: ﭘﮋوﻫﺶ ﺣﺎﺿﺮ به‌صورت ﺗﺮﮐﯿﺒـﯽ در دو بخش ﮐﯿﻔـﯽ و کمی می‌انجام ﺷـﺪ. زیر مطالعه اول: ﺗﺪویﻦ ﺑﺴﺘﻪ مداخله‌ای، آموزشی اضطراب فراگیر مبتنی بر رویکرد راه‌حل محور از طریق مرور، بررسی نظر متخصصین به روش دلفی و تعیین روایی محتوایی بسته آموزشی طراحی‌شده و زیر مطالعه دوم: کار آزمایی بالینی ﺑﺴﺘﻪ آموزشی، مداخله ای  ﺑﺮ فرانگرانی. بخش کمی ﭘﮋوﻫﺶ ﻧﯿﻤﻪ آزﻣﺎیﺸﯽ ﺑﺎ ﻃﺮح ﭘﯿﺶ آزﻣﻮن - ﭘﺲ آزﻣﻮن ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل بود. بسته درمانی در 8 جلسه 45 دقیقه ای تدوین گردید. این بسته بر روی 30 زوج که حداقل یکی از آن ها دارای اختلال اضطراب فراگیر بود، اجرا شد . نمونه گیری به صورت در دسترس هدفمند بود که در دو گروه آزمایش (15 زوج) و گروه کنترل (15 زوج) به صورت تصادفی جایگزین شدند. نهایتاً اطلاعات 27 زوج وارد تجزیه و تحلیل آماری گشت. ابزارهای پژوهش، ﭘﺮﺳﺸ ﻨﺎمه مقیاس اختلال اضطراب فراگیر ۷ سؤالی اسپیتزر و همکاران (Generalized Anxiety Disorder Scale-GAD-7)، و پرسش نامه فرانگرانی ولز (MWQ Metaworry Questionnaire-) بودند ﮐﻪ در اﺑﺘﺪا و اﻧﺘﻬﺎی ﻣﺪاﺧﻠﻪ ﺗﻮﺳﻂ ﻫﺮ دو ﮔﺮوه ﺗﮑﻤﯿﻞ ﮔﺮدیﺪ. دادهﻫﺎی ﺟﻤﻊآوریﺷﺪه ﺑﺎ ﻧﺮم اﻓﺰارSPSS26 و آﻣﺎر اﺳﺘﻨﺒﺎﻃﯽ ﺗﺤﻠﯿﻞ ﮐﻮاریﺎﻧﺲچند متغییره ﻣﻮرد ﺗﺠﺰیﻪ و ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺖ. یافته ها: نتایج نشان داد ﺑﺎ ﺣﺬف اﺛﺮ نمره‌های فرانگرانی پیش‌آزمون به‌عنوان ﻣﺘﻐﯿﺮ هم پراش اﺛﺮ اﺻﻠﯽ بسته آموزشی- مداخله‌ای اضطراب فراگیر مبتنی بر رویکرد راه‌حل محور ﺑﺮ نمره‌های فرانگرانی در پس‌آزمون معنی‌دار اﺳﺖ. نتیجه گیری: با توجه به نتایج پژوهش، می‌توان نتیجه گرفت که بسته آموزشی-مداخله‌ای راه‌حل محور اضطراب فراگیر، تأثیر مثبت و معناداری بر کاهش فرانگرانی زوجین مراجعه‌کننده به مراکز درمانی دارد. </div> <div style="text-align: justify;">Background & Aims: One of the newest components in the field of anxiety disorders is the concept of anxiety, which refers to anxiety about anxiety. Nowadays, anxiety (pathological anxiety) is considered the main feature of anxiety disorders; so in many researches, pathological worry is equated with anxiety disorders. Most people may worry in different situations and their worry can be controlled; but if they are constantly worried and their worry covers a wide range of different issues, the thinking style of such people is characterized by excessive worry and uncontrollable anxiety, and this is a pathological process, and in fact these people suffer from anxiety disorder. When normal anxiety turns into pathological anxiety, anxiety occurs. Wells suggests that the distinction between the two types of worry stated above will be useful in the process of conceptualizing the pathology of worry, and this distinction will become a model of generalized anxiety disorder. The aim of this research was the clinical trial of an educational-interventional package for the solution of pervasive anxiety the over-anxiety of couples referring to medical centers. Methods: The current research was conducted in qualitative and quantitative. The first sub-study: is a compilation of an interventional, educational package for pervasive anxiety based on a solution-oriented approach through review, a review of experts' opinions using the Delphi method and determining the content validity of the designed educational package, and the second sub-study: clinical trial of the educational package, an intervention on meta-anxiety. The quantitative part of the research was semi-experimental with a pre-test-post-test design with a control group. The treatment package was developed in 8 sessions of 45 minutes. This package was implemented on 30 couples, at least one of whom had generalized anxiety disorder. Sampling was available in a purposeful way, which was randomly replaced in two experimental groups (15 couples) and a control group (15 couples). Finally, the data of 27 couples entered the statistical analysis. The research tools were Spitzer et al.'s 7-item Generalized Anxiety Disorder Scale (GAD-7) and Wells' Metaworry Questionnaire (MWQ Metaworry Questionnaire), which were completed by both groups at the beginning and end of the intervention. The collected data were analyzed and analyzed with SPSS26 software and inferential statistics of multivariate analysis. Results: The results showed that by removing the effect of pre-test meta-anxiety scores as a covariate, the main effect of the comprehensive anxiety educational intervention package based on the solution-oriented approach on post-test meta-anxiety scores is significant. According to the information mentioned in Table 1, the average pre-test score of Wells anxiety in the experimental group is 17.54 with a standard deviation of 2.60, and the average pre-test score in the control group is 18.07 with a standard deviation of 2.78. Similarly, the average post-test score in the experimental group is 11.92 with a standard deviation of 2.98, and the average post-test score in the control group is 17.50 with a standard deviation of 2.59. The results of the covariance analysis show that by removing the effect of the pre-test meta-anxiety scores as a covariate, the main effect of the general anxiety education intervention package based on the solution-oriented approach on the post-test meta-anxiety scores is significant. In other words, the statistics in Table 2 show that the observed difference between the mean anxiety scores of the experimental-control group participants according to the group membership in the post-test stage is significant with 95 percent confidence (P<0.05). The effect of this intervention on anxiety was 0.722. In this sense, the presence in the solution-oriented group counseling has explained 72 percent of the variance of the post-test scores. Conclusion: Psychological pressures with different intensities and weaknesses almost exist in human life. This may be doubly so for couples who themselves or their spouses suffer from widespread anxiety. A solution-focused approach is a form of brief therapy that emphasizes people's resources and abilities to create solutions. The results of the research show that the educational-interventional package for the solution of generalized anxiety is an effective and efficient method to reduce anxiety in couples who refer to medical centers. This method can help couples deal with problems and challenges in their lives more effectively and enjoy their relationship more. For this reason, people who take these courses naturally suffer less anxiety. This model reduces anxiety by increasing the quality of problem-solving and reducing negative evaluations, and finally, people learn to experience their thoughts and feelings positively by examining different solutions. Solution-oriented therapy uses the resources and abilities of the clients in the process of changing communication patterns, and this work creates an image of hope in the clients. Therefore, the solution-oriented therapist strengthens the sense of self-control relationship management, and emotion control in clients. They do this by empowering clients to create solutions and structure these solutions. Solution-oriented therapists believe that a couple's problems remain and get worse because of the method that the couple uses to solve them. Couples therapy reminds couples of solution-oriented problem-solving skills when needed, enables them to destroy the vicious cycle of problems and ineffective communication patterns, and develop long-term solutions; in such a way that the change of one of the couples causes the change of other people in the system. In addition to that, identifying, determining, extracting, and strengthening exceptions by clients about problems is one of the important factors of change in solution-oriented couple therapy. In the solution-oriented approach, the identification of exceptions keeps the referrals in a positive direction until the end of the treatment process; In order to improve the situation, any kind of change will be useful, and the only thing that a person can be sure of is himself. Therefore, in the sessions of this research, each of the couples realizes that they are the source of change in their current situation, and each of the spouses should start by changing their thoughts, emotions, and behavior in order to improve their married life we should not expect corrective actions from their spouses.. </div> رویکرد راه‌حل محور, اضطراب فراگیر, فرانگرانی Solution-Oriented Approach, Pervasive Anxiety, Meta-Anxiety 1 11 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7752-2&slc_lang=fa&sid=1 Aziz Lachini عزیز لاچینی 3900319475328460090310 0009-0009-4753-5137 No PhD Student, Clinical Psychology, Department of Psychology, Roudhen Branch, Islamic Azad University, Roudhen, Iran دانشجوی دکتری روانشناسی بالینی، گروه روانشناسی،واحد رودهن، دانشگاه آزاد اسلامی، رودهن، ایران Mina Mojtabaie مینا مجتبایی Mojtabaie_in@yahoo.com 3900319475328460090311 3900319475328460090311 Yes Associate Professor, Department of Psychology, Roudhen Branch, Islamic Azad University, Roudhen, Iran دانشیار، گروه روانشناسی، واحد رودهن، دانشگاه آزاد اسلامی، رودهن، ایران Malek Mirhashemi مالک میرهاشمی 3900319475328460090312 3900319475328460090312 No Associate Professor, Department of Psychology, Roudhen Branch, Islamic Azad University, Roudhen, Iran دانشیار، گروه روانشناسی، واحد رودهن، دانشگاه آزاد اسلامی، رودهن، ایران