ﺑﺮرﺳﯽ ﺗﺎﺛﯿﺮ آﻣﻮزش ﺑﺮﻧﺎﻣﻪ ﺧﻮد ﻣﺪﯾﺮﯾﺘﯽ ﭘﻨﺞ آ ﺑﺮ آﭘﮕﺎر ﺧﺎﻧﻮاده ﻫﺎي داراي ﮐﻮدﮐﺎن ﻓﻠﺞ ﻣﻐﺰي

The Effects of “Self-Management 5 A's Program” on Family Apgar of Children with Cerebral Palsy

ﻣﻘﺪﻣﻪ: ﻓﻠﺞ ﻣﻐﺰي ﯾﮏ اﺧﺘﻼل ﻣﺰﻣﻦ اﺳﺖ ﮐﻪ ﻣﯽ ﺗﻮاﻧﺪ ﺗﺎﺛﯿﺮي ﻣﻨﻔﯽ ﺑﺮ واﺣﺪ ﺧﺎﻧﻮاده داﺷﺘﻪ ﺑﺎﺷﺪ. ﺧﺎﻧﻮاده ﻫﺎي داراي ﮐﻮدﮐﺎن ﻓﻠﺞ ﻣﻐﺰي ﻣﺸﮑﻼت ﺑﺴﯿﺎري در راﺑﻄﻪ ﺑﺎ ﻣﻌﯿﺎرﻫﺎي آﭘﮕﺎر ﺧﺎﻧﻮاده ﺳﺎزﮔﺎري، ﻣﺸﺎرﮐﺖ، رﺷﺪ، ﻋﺎﻃﻔﻪ و ﺣﻞ و ﻓﺼﻞ ﻣﺸﮑﻼت زﻧﺪﮔﯽ" دارﻧﺪ ﮐﻪ ﻧﯿﺎزﻣﻨﺪ اﺟﺮاي ﻣﺪاﺧﻼت ﻣﻨﺎﺳﺐ اﺳﺖ. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ ﺗﺎﺛﯿﺮ آﻣﻮزش ﺑﺮﻧﺎﻣﻪ ﺧﻮد ﻣﺪﯾﺮﯾﺘﯽ ﭘﻨﺞ آ ﺑﺮ آﭘﮕﺎر ﺧﺎﻧﻮاده ﻫﺎي داراي ﮐﻮدﮐﺎن ﻓﻠﺞ ﻣﻐﺰي اﻧﺠﺎم ﺷﺪ. روش ﮐﺎر: در اﯾــﻦ ﻣﻄﺎﻟﻌــﻪ ﻧﯿﻤﻪ ﺗﺠﺮﺑــﯽ ﮐﻪ در ﺳــﺎل 94-95 اﻧﺠــﺎم ﺷــﺪ، 47 واﻟﺪ داراي ﮐــﻮدك ﻓﻠــﺞ ﻣﻐــﺰي 4 ﺗــﺎ 12 ﺳــﺎﻟﻪ ﺳــﺎﮐﻦ اﺳــﺘﺎن ﮐﺮدﺳــﺘﺎن، ﺑــﻪ ﺷــﯿﻮه ﺗﻤــﺎم ﺷــﻤﺎري اﻧﺘﺨــﺎب ﺷــﺪﻧﺪ. در ﻣﺮﺣﻠـﻪ ﺑﻌـﺪ از ﻣﺪاﺧﻠـﻪ ﺑﻪ ﻋﻠﺖ رﯾﺰش ﻧﻤﻮﻧﻪ ﻫﺎي ﭘﮋوﻫﺶ، 23 ﺧﺎﻧﻮاده در ﮔـﺮوه ﻣﺪاﺧﻠـﻪ و 16 ﺧﺎﻧﻮاده در ﮔـﺮوه ﮐﻨﺘـﺮل ﻗـﺮار ﮔﺮﻓﺘﻨـﺪ. داده ﻫـﺎ ﺑـﺎ ﭘﺮﺳﺸـﻨﺎﻣﻪ اﻃﻼﻋـﺎت ﺟﻤﻌﯿـﺖ ﺷـﻨﺎﺧﺘﯽ واﻟﺪ و ﮐـﻮدك و ﭘﺮﺳﺸﻨﺎﻣﻪ ﺑﺮرﺳﯽ آﭘﮕﺎر ﺧﺎﻧﻮاده "smilkstein family apgar" ﺑﺎ رواﯾــﯽ و ﭘﺎﯾﺎﯾــﯽ، ﺗﻮﺳــﻂ ﻫﺮ دو واﻟﺪ ﺑﻪ ﺻﻮرت ﻣﺸﺎرﮐﺘﯽ در دو ﻣﺮﺣﻠـﻪ ﻗﺒـﻞ و ﺑﻌـﺪ از آﻣـﻮزش ﺑﺮﻧﺎﻣـﻪ ﺧـﻮد ﻣﺪﯾﺮﯾﺘـﯽ ﭘﻨـﺞ–آ" ﮐﺎﻣـﻞ ﺷـﺪ. داده ﻫـﺎ ﺑـﺎ اﺳـﺘﻔﺎده از ﻧـﺮم اﻓـﺰار اس ﭘـﯽ اس اس ﻧﺴـﺨﻪ 22 ﻣـﻮرد ﺗﺤﻠﯿـﻞ ﻗـﺮار ﮔﺮﻓـﺖ. ﯾﺎﻓﺘﻪﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ آﭘﮕﺎر ﺧﺎﻧﻮاده در ﮔﺮوه ﻣﺪاﺧﻠﻪ از 6/46 ﺑﻪ 7/82 و در ﮔﺮوه ﮐﻨﺘﺮل از 6/83 ﺑﻪ 6/31 رﺳﯿﺪ. ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﮐﻪ آﭘﮕﺎر ﺧﺎﻧﻮاده در ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﮐﻨﺘﺮل ﻗﺒﻞ از اﻧﺠﺎم ﻣﺪاﺧﻠﻪ ﺗﻔﺎوت ﻣﻌﻨﯽ داري ﻧﺪارد ) )0/381 = P( اﻣﺎ در ﻣﺮﺣﻠﻪ ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ ﺗﻔﺎوت ﻣﻌﻨﯽ داري ﺑﯿﻦ دو ﮔﺮوه از ﻧﻈﺮ آﭘﮕﺎر ﺧﺎﻧﻮاده ﻣﺸﺎﻫﺪه ﺷﺪ. آﻣﻮزش ﺑﻪ روش ﺑﺮﻧﺎﻣﻪ ﺧﻮد ﻣﺪﯾﺮﯾﺘﯽ ﭘﻨﺞ آ ﺑﺮ آﭘﮕﺎر ﺧﺎﻧﻮاده ﻣﻮﺛﺮ ﺑﻮد و ﺳﺒﺐ ارﺗﻘﺎ آن از ﺳﻄﺢ ﺧﺎﻧﻮاده ﻣﺘﻮﺳﻂ ﻧﺎﮐﺎرآﻣﺪ ﺑﻪ ﺳﻄﺢ ﺧﺎﻧﻮاده ﮐﺎرآﻣﺪ ﺷﺪ )0/022 = P(. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: آﭘﮕﺎر ﺧﺎﻧﻮاده ﻫﺎي داراي ﮐﻮدﮐﺎن ﻓﻠﺞ ﻣﻐﺰي در ﺳﻄﺢ ﻣﺘﻮﺳﻄﯽ اﺳﺖ و آﻣﻮزش ﺑﻪ روش ﺑﺮﻧﺎﻣﻪ ﺧﻮد ﻣﺪﯾﺮﯾﺘﯽ ﭘﻨﺞ-آ" ﺳﺒﺐ ارﺗﻘﺎ آن ﺷﺪ. در ﻫﻤﯿﻦ راﺳﺘﺎ ﺿﺮوري اﺳﺖ ﮐﻪ ارﮔﺎن ﻫﺎي ﺣﻤﺎﯾﺖ ﮐﻨﻨﺪه از اﯾﻦ ﺧﺎﻧﻮاده ﻫﺎ ﻋﻼوه ﺑﺮ رﺳﯿﺪﮔﯽ ﺑﻪ وﺿﻌﯿﺖ ﮐﻮدﮐﺎن، ﺑﻪ ﺧﺎﻧﻮاده ﻫﺎ ﻧﯿﺰ ﺗﻮﺟﻪ ﺑﯿﺸﺘﺮي داﺷﺘﻪ ﺑﺎﺷﻨﺪ.

Introduction: Cerebral palsy is a chronic condition that can have a negative impact on the family unit. Families of children with cerebral palsy have numerous difficulties with the family's Apgar Criteria, including "adaptation, participation, growth, affection, and ability to solve problems in life" that necessitate proper interventions. This study aimed to determine the effect of self-management training program on Apgar scores of families of children with cerebral palsy. Methods: In this quasi-experimental study, conducted in 2015-2016, 47 parents of children with cerebral palsy ranging from 2 to 5 years of age were selected through the Census. In the post-intervention phase, due to the decline of the study samples, 23 families were included in the intervention group and 16 families in the control group. After the assessment of reliability and validity, data were analyzed using the parent and child cognitive demographic questionnaire and the "smilkstein family Apgar" questionnaire by both parents in a two-step pre-test and post-test self-management program. Data were analyzed using the SPSS version 22 software. Results: The mean Apgar score in the intervention group reduced from 6.46 to 7.82 and in the control group from 6.83 to 6.31. The results showed that there was no significant difference in family Apgar scores in the intervention and control groups before the intervention (p = 0.381); nonetheless, in the post-intervention phase, there was a significant difference between the two groups in terms of family Apgar scores. “Self-management program based on the 5 A's model” affected families' Apgar score and improved it from the average inefficient to the practical level (P=0.022). Conclusions: Apgar scores of families of children with cerebral palsy are moderate, and education through a “self-management program based on the 5 A's model” improved it. In this regard, it is vital that the supporting authorities, in addition to addressing the condition of children, pay more attention to their families.