مقايسهٔ كاركردهاي خانوادگي بيماران اختلال خورد و خوراك با افراد سالم بر اساس مدل مك‌مستر

Comparison of the Family Functions of Patients Feeding and Eating Disorders with Healthy Individuals Based on the McMaster Model

هدف: نابساماني‌هاي ساختار و كاركرد خانواده از عوامل اصلي تقويت انگاره‌هاي اختلال خورد و خوراك است. هدف مطالعهٔ حاضر بررسي كاركرد خانوادهٔ بيماران مبتلا به اختلال خوردوخوراك بر اساس نظريهٔ مدل خانوادگي مك‌مستر و مقايسهٔ آن با كاركرد خانوادهٔ افراد سالم بود. روش‌بررسي: پژوهش از نوع توصيفي و علي‌مقايسه‌اي انجام شد. جامعهٔ آماري پژوهش حاضر را بيماران داراي اختلال پرخوري عصبي و كم‌اشتهايي عصبي مراجعه‌كننده در تاريخ اول اسفند 1394تا اول ارديبهشت 1395 به كلينيك روان‌پزشكي بيمارستان ابن‌سيناي مشهد تشكيل ‌دادند. بدين‌منظور 40 نفر از اين بيماران به‌صورت نمونه‌گيري در دسترس انتخاب شدند. 20 نفر گروه گواه نيز از بين دانشجويان كارشناسي دانشگاه فردوسي مشهد به‌صورت نمونه‌گيري تصادفي طبقه‌اي انتخاب گرديد. از مقياس تشخيصي اختلالات خوردن (استيك و همكاران، 2001) و آزمون سنجش خانواده (اپستين و همكاران، 1983) در اين پژوهش استفاده شد. داده‌ها با استفاده از آمار توصيفي و آزمون تفاوت ميانگين براي گروه‌هاي مستقل و نرم‌افزار آماري SPSS نسخهٔ 20 تجزيه‌ و تحليل شد. در اين مطالعه مقدار P كمتر از 0٫05 ازلحاظ آماري معنادار تلقي گرديد. يافته‌ها: نتايج آزمون نشان داد كه در بُعد عملكرد عمومي و كنترل رفتاري گروه سالم بهتر از كم‌اشتهايي عصبي و گروه كم‌اشتهايي عصبي بهتر از بيماران پرخوري عصبي عمل كرده‌اند (0٫001> p). در بُعد ارتباط، گروه بيماران كاركرد خانوادگي ضعيف‌تري درمقايسه با گروه سالم داشتند (0٫001> p). در بُعد درگيري عاطفي، گروه كم‌اشتهايي عصبي از هر دو گروه سالم و پرخوري عصبي ضعيف‌تر عمل كرده بودند (0٫001> p). در بُعد پاسخ‌گويي عاطفي، تنها بين دو گروه كم‌اشتهايي عصبي و سالم تفاوت معناداري وجود داشت (0٫001> p). نتيجه‌گيري: نتايج پژوهش نشان داد كه عملكرد افراد گروه اختلال خورد و خوراك ضعيف‌تر از افراد بهنجار است.

Background & Objective: According to the World Health Organization, eating disorder is one of the most challenging diseases in adolescence. Eating disorders include two distinct signs, anorexia and bulimia. Anorexia characterized by refraining from preserving the body's least normal body weight. Bulimia characterized by craving, followed by inappropriate compensatory behaviors such as intentional vomiting, misuse of laxatives, fasting, or excessive exercise. Disturbance in understanding the shape and weight of the body is a significant attribute of anorexia and bulimia. Types of eating disorders reported in 4% of teenagers and student youth. The relationship between environment and family background with mental illness has long been of interest to scholars and researchers. On the other hand, the ravages of the structure and function of the family, including conflict of roles, clutter borders, alliances, emotional involvement and Lack of emotional responsiveness is the critical factor strengthening the notion of feeding and eating disorders. One of the essential models of the family function is the McMaster Model of Family Function (MMFF). To understand the structure and organization and the family-interactive model, this model evaluates and evaluates the sixth dimension of family life (problem-solving, communication, roles, affective Responsiveness, affective Involvement, general functioning). The eating disorder hurts family functioning and relationships, but since most research has been done in Western societies, and given that the structure of the family in Western nations is different from that of the eastern and Iranian communities, it seems better. To do similar research in our country. This study aimed to examine the functioning of families of patients with feeding and eating disorders based on the theory of the McMaster model and compare it with the function of the family is healthy subjects. Methods: The type of study in this research is descriptive and causal-comparative. For this purpose, 40 patients with feeding and eating disorders from a psychiatric clinic Ebne Sina Hospital in Mashhad selected by convenience sampling. The main criteria for entering this project were the following: Detection of Anorexia or bulimia disorder based on a clinical interview conducted by DSM-V Otmmer and the Eating Disorder Diagnosis Scale. The control group was selected through a stratified random sampling method from among undergraduate students of the Ferdowsi University of Mashhad by matching them with the eating disorder group in variables such as sex, age, economic status, and education level. The eating disorder diagnostic scale (EDDS) and the Family Assessment Device (FAD) used. This scale well comprised of psychiatric interviews, such as structured clinical interviews (SCID), and Kappa's test-re-test for eating disorder is 0.80-0.90. Family Assessment Device determines the structural, occupational and interactive characteristics of the family, and identifies six dimensions the performance of the household. On this scale, in addition to the six dimensions, there is also a subscale that measures the overall performance of the family. The data analyzed by descriptive statistics (frequency, percentage, mean and standard deviation), and the mean difference test for independent groups. Statistical analysis performed by SPSS-20 software. Results: Findings showed that in general functioning and behavioral control, the healthy group better than Anorexia Nervosa and anorexia nervosa had done better Bulimia nervosa patients (p<0.001). In communication, patients group had a poorer family functioning than the healthy group (p<0.001). In the emotional involvement, anorexia group, both bulimia and healthy had been weaker (p<0.001). In the emotional response, only between the two groups Anorexia Nervosa and healthy, there was a significant difference (p<0.001). Conclusion: The results of the study showed that the performance of the subjects in the feeding and eating disorders was weaker than the normal group. Therefore, in addition to treating a patient with the eating disorder, the family members of the patient should be encouraged to participate in relevant educational and therapeutic programs. In this research, all ethical considerations such as informed consent, preservation of anonymity and secrecy, voluntary participation in the interview and assessment observed.