Journal of Rafsanjan University of Medical Sciences
مجله دانشگاه علوم پزشکی رفسنجان
JRUMS
Medical Sciences
http://journal.rums.ac.ir
69
journal69
1735-3165
2008-7268
10.66224/jrums
fa
jalali
1399
2
1
gregorian
2020
5
1
19
2
online
1
fulltext
fa
تأثیر بازی درمانی شناختی رفتاری و تلفیق آن با آموزش مدیریت والدین بر علائم نارسایی توجه-بیشفعالی کودکان بیشفعال 11-7 سال: یک مطالعه نیمه آزمایشی
The Effect of Cognitive Behavioral Play Therapy and Its Integration with Parental Management Training on Symptoms of ADHD in 7-11 Year Old Children: A Quasi-Experimental Study
روانپزشكي
Psychiatry
پژوهشي
Research
<strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">چکیده</span></span></strong><br>
<strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">زمینه و هدف: </span></span></strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">اختلال نارسایی توجه-بیشفعالی یکی از شایع</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">ترین اختلالات روان</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">پزشکی دوران کودکی است. پژوهش حاضر با هدف تعیین و مقایسه تأثیر بازی درمانی شناختی رفتاری و تلفیق آن با آموزش مدیریت والدین بر علائم نارسایی توجه-بیشفعالی کودکان 11-7 سال انجام شد. </span></span><br>
<strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">مواد و روش</span></span></strong><strong><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span></strong><strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">ها</span></span></strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">: طرح مطالعه، نیمه</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">آزمایشی به شکل پیش</span></span><span dir="LTR"><span style="font-size:9.0pt;"></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">آزمون- پس</span></span><span dir="LTR"><span style="font-size:9.0pt;"></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">آزمون با گروه گواه بود</span></span><span dir="LTR"><span style="font-size:9.0pt;">.</span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;"> جامعه پژوهش، شامل کودکان دارای اختلال نارسایی توجه-بیش</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">فعالی 11-7 سال شهر کرمانشاه در سال 1398 بودند که 48 نفر از آن</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">ها به روش نمونهگیری خوشهای تصادفی چندمرحلهای انتخاب و در گروه</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">های آزمایش 1 و 2 و گروه گواه به تعداد مساوی جایگزین شدند. در گروه آزمایش 1 بازی ‏درمانی شناختی رفتاری (10 جلسه</span></span><span dir="LTR"><span style="font-size:9.0pt;"></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;"> 90 دقیقه</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">ای) و درگروه آزمایش 2 بازی درمانی شناختی رفتاری و آموزش مدیریت والدین (10 جلسه</span></span><span dir="LTR"><span style="font-size:9.0pt;"></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;"> 90 دقیقه</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">ای) اجرا شد. گروه گواه (گروه 3) تحت مداخله قرار نگرفت. اطلاعات از طریق تکمیل پرسش</span></span><span dir="LTR"><span style="font-size:9.0pt;"></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">نامه تشخیص علائم نارسایی توجه-بیشفعالی </span></span><span dir="LTR"><span style="font-size:9.0pt;">Swanson</span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;"> قبل از مداخله و بعد از آن جمع</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">آوری شد. </span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">داده­ها با استفاده از تحلیل کوواریانس چند</span></span> <span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">متغیری تجزیه و تحلیل شدند. </span></span><br>
<strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">یافته‏ها</span></span></strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">: پس از مداخله</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">ها، بین نمرات</span></span> <span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">میانگین شدت</span></span> <span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">علائم نارسایی توجه-بیشفعالی در گروه آزمایش 1 (86/1</span></span><span style="font-size:11.0pt;">±</span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">24/34) و گروه گواه (23/3</span></span><span style="font-size:11.0pt;">±</span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">80/37) و هم</span></span><span dir="LTR"><span style="font-size:9.0pt;"></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">چنین گروه آزمایش 2 (07/2</span></span><span style="font-size:11.0pt;">±</span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">18/31) و گروه گواه (23/3</span></span><span style="font-size:11.0pt;">±</span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">80/37) تفاوت معنیدار مشاهده شد (001/0</span></span><span dir="LTR"><span style="font-size:9.0pt;">P<</span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">). هم</span></span><span dir="LTR"><span style="font-size:9.0pt;"></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">چنین بین مقدار تأثیر دو مداخله بازی </span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">درمانی شناختی رفتاری و تلفیق بازی </span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">درمانی شناختی رفتاری و آموزش مدیریت والدین تفاوت معنی</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">دار دیده شد (05/0</span></span><span dir="LTR"><span style="font-size:9.0pt;">P<</span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">)</span></span><span dir="LTR"><span style="font-size:9.0pt;">.</span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;"> در مقایسه میانگین دو رویکرد، مداخله تلفیقی مؤثرتر بود.</span></span><br>
<strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">نتیجهگیری</span></span></strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">: به نظر می</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">رسد تلفیق بازی درمانی و آموزش مدیریت والدین در کاهش علائم نارسایی توجه-بیشفعالی مؤثر باشد.</span></span><br>
<strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">واژه</span></span></strong><strong><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span></strong><strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">های کلیدی</span></span></strong><strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">:</span></span></strong><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;"> بازی درمانی شناختی رفتاری، آموزش مدیریت والدین، اختلال نارسایی توجه-بیش</span></span><span dir="LTR"><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">‎</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:11.0pt;">فعالی</span></span><span dir="LTR"><span style="font-size:1.0pt;"></span></span><br>
<br>
<br>
<div>
<div>
<div id="_com_2" uage="JavaScript"><span dir="LTR"></span></div>
</div>
</div>
<strong>Background and Objectives:</strong> Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood. The purpose of this study was to determine and compare the effects of cognitive behavioral play therapy (CBPT) and its integration with parental management training (PMT) on the symptoms of ADHD in children aged 7-11 years.<br>
<strong>Materials and Methods:</strong> The present study was a quasi-experimental study with pre-test and post-test with the control group. The study population included children with ADHD in Kermanshah city in 2019, of whom 48 were selected by multistage random cluster sampling and they were randomly allocated in experimental groups 1 and 2 and one control group in equal numbers. In the experimental group 1, CBPT was performed in 10 sessions of 10 -90-minute and in the experimental group 2, CBPT and its integration with PMT was performed in 10 sessions of 10 -90-minute. The control group (group 3) did not receive any intervention. Data were collected before and after the intervention through completing Swanson attention deficit hyperactivity disorder questionnaire. Data were analyzed using multivariate analysis of covariance (MANCOVA).<br>
<strong>Results:</strong> After the treatment, there was found a statistically significant difference between the average score of the symptoms of ADHD in the experimental group 1 (34.24±1.86) and the control group (37.80±3.23) and the experimental group 2 (31.18±2.07) and the control group (37.80±3.23) (p<0.001). Also, there was a significant difference between the effect of CBPT and the integration of CBPT and PMT (p<0.05). Comparing the mean of two approaches, the integrated intervention was more effective.<br>
<strong>Conclusion</strong>: CBPT, PMT and their integration might be effective in reducing symptoms of ADHD. The aforementioned approaches is suggested to be used in psychological counseling centers.<br>
<strong>Key words:</strong> Cognitive-behavioral play therapy (CBPT), Parent management training (PMT), Attention deficit hyperactivity disorder (ADHD)<br>
<br>
<strong>Funding: </strong>This study did not have any funds.<br>
<strong>Conflict of interest: </strong>None declared.<br>
<strong>Ethical approval</strong>: The Ethics Committee of Kermanshah University of Medical Sciences approved the study (IR.KUMS.REC.1398.42).<span dir="RTL"></span><br>
<br>
<strong>How to cite this article</strong>: Feizollahi J, Sadeghi M, Rezaei F. The Effect of Cognitive Behavioral Play Therapy and Its Integration with Parental Management Training on Symptoms of ADHD in 7-11 Year Old Children: A Quasi-Experimental Study.<em> J Rafsanjan</em> <em>Univ Med Sci</em> 2020; 19 (2): 155-72. [Farsi]
بازی درمانی شناختی رفتاری, آموزش مدیریت والدین, اختلال نارسایی توجه-بیشفعالی
Cognitive-behavioral play therapy (CBPT), Parent management training (PMT), Attention deficit hyperactivity disorder (ADHD)
155
172
http://journal.rums.ac.ir/browse.php?a_code=A-10-4464-1&slc_lang=fa&sid=1
J.
Feizollahi
جلال
فیض اللهی
jalal.feiz@ymail.com
6900319475328460037899
6900319475328460037899
No
دانشگاه لرستان
M.
Sadeghi
مسعود
صادقی
sadeghi.m@lu.ac.ir
6900319475328460037900
6900319475328460037900
Yes
دانشگاه لرستان
F.
Rezaei
فاطمه
رضایی
rezaei.f@lu.ac.ir
6900319475328460037901
6900319475328460037901
No
lorestan university
دانشگاه لرستان