اثربخشي تقويت رفتاري مثبت مبتني بر ذهن آگاهي بر استرس، اضطراب و افسردگي مادران كودكان مبتلا به اتيسم

Effectiveness of Mindfulness-Based Positive Behavior Support (MBPBS) on Stress. Depression and Anxiety of Mothers of Children with Autism Disorder

زﻣﯿﻨﻪ ﻣﺎدران ﮐﻮدﮐﺎن ﻣﺒﺘﻠﺎ ﺑﻪ اﺧﺘﻠﺎل ﻃﯿﻒ اﺗﯿﺴﻢ، از اﺳﺘﺮس، اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ رﻧﺞ ﻣﯽﺑﺮﻧﺪ. ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ ﺗﻘﻮﯾﺖ رﻓﺘﺎري ﻣﺜﺒﺖ ﻣﺒﺘﻨﯽ ﺑﺮ ذﻫﻦآﮔﺎﻫﯽ ﺑﺮ اﺳﺘﺮس، اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ اﯾﻦ ﻣﺎدران اﻧﺠﺎم ﺷﺪ. روش ﮐﺎر ﺳﯽ ﻧﻔﺮ از ﻣﺎدران داراي ﮐﻮدﮐﺎن 6-8 ﺳﺎﻟﻪ ﻣﺒﺘﻠﺎ ﺑﻪ اﺧﺘﻠﺎل ﻃﯿﻒ اﺗﯿﺴﻢ از ﻣﺪارس ﺷﻬﺮ ﮔﺮﮔﺎن ﺑﻪ ﺻﻮرت ﺗﺼﺎدﻓﯽ ﺑﻪ دو ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﮐﻨﺘﺮل ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ و در 8 ﺟﻠﺴﻪ 120 دﻗﯿﻘﻪاي ﺗﺤﺖ آﻣﻮزش ﯾﮏ رواﻧﺸﻨﺎس ﺑﺮاي ﺗﻘﻮﯾﺖ رﻓﺘﺎري ﻣﺜﺒﺖ ﻣﺒﺘﻨﯽ ﺑﺮ ذﻫﻦآﮔﺎﻫﯽ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. اﺑﺰارﻫﺎي ﻣﻮرد اﺳﺘﻔﺎده، ﺷﺎﻣﻞ ﭘﺮﺳﺸﻨﺎﻣﻪ اﺳﺘﺮس ادراك ﺷﺪه، ﭘﺮﺳﺸﻨﺎﻣﻪ اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ ﺑﮏ ﺑﻮده ﮐﻪ ﻫﻤﻪ ﻣﺎدران ﻗﺒﻞ، ﺑﻠﺎﻓﺎﺻﻠﻪ و ﯾﮏ ﻣﺎه ﭘﺲ از ﻣﺪاﺧﻠﻪ ﺗﮑﻤﯿﻞ ﮐﺮدﻧﺪ. ﻣﻘﺎﯾﺴﻪ ﺑﯿﻦ دو ﮔﺮوه ﺗﻮﺳﻂ آزﻣﻮن ﺗﯽ ﻣﺴﺘﻘﻞ اﻧﺠﺎم ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ ﻗﺒﻞ از ﻣﺪاﺧﻠﻪ، ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮات اﺳﺘﺮس، اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ در ﻣﺎدران ﮐﻮدك ﻣﺒﺘﻠﺎ ﺑﻪ اﺧﺘﻠﺎل ﻃﯿﻒ اﺗﯿﺴﻢ، ﺑﯿﻦ دو ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﮐﻨﺘﺮل، ﺗﻔﺎوت ﻣﻌﻨﺎداري ﻧﺪاﺷﺖ. اﻣﺎ ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮات دو ﮔﺮوه در زﻣﺎنﻫﺎي ﺑﻠﺎﻓﺎﺻﻠﻪ و ﯾﮏ ﻣﺎه ﭘﺲ از ﻣﺪاﺧﻠﻪ، ﺗﻔﺎوت ﻣﻌﻨﺎداري داﺷﺖ؛ ﺑﻪ ﻃﻮري ﮐﻪ ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮات اﺳﺘﺮس، اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ ﻣﺎدران ﮐﻮدﮐﺎن اﺗﯿﺴﺘﯿﮏ در ﮔﺮوه ﮐﻨﺘﺮل در ﻃﻮل زﻣﺎن، ﺗﻐﯿﯿﺮ ﻣﻌﻨﺎداري ﻧﺪاﺷﺖ اﻣﺎ در ﮔﺮوه ﻣﺪاﺧﻠﻪ در ﻃﻮل زﻣﺎن، ﮐﺎﻫﺶ ﻣﻌﻨﺎداري داﺷﺖ )001.P<0(. ﻧﺘﯿﺠﻪﮔﯿﺮي ﻣﺪاﺧﻠﻪ ﺗﻘﻮﯾﺖ رﻓﺘﺎري ﻣﺜﺒﺖ ﻣﺒﺘﻨﯽ ﺑﺮ ذﻫﻦآﮔﺎﻫﯽ ﺗﻮاﻧﺴﺘﻪ اﺳﺖ اﺳﺘﺮس، اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ ﻣﺎدران ﮐﻮدﮐﺎن ﻣﺒﺘﻠﺎ ﺑﻪ اﺧﺘﻠﺎل ﻃﯿﻒ اﺗﯿﺴﻢ را ﮐﺎﻫﺶ دﻫﺪ. اﺳﺘﻔﺎده از ﺗﻘﻮﯾﺖ رﻓﺘﺎري ﻣﺜﺒﺖ ﺑﺮاي ﮐﺎﻫﺶ اﺳﺘﺮس، اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ ﻣﺎدران ﮐﻮدﮐﺎن ﻣﺒﺘﻠﺎ ﺑﻪ ﻃﯿﻒ اﺗﯿﺴﻢ، ﭘﯿﺸﻨﻬﺎد ﻣﯽﮔﺮدد.

Introduction: Mothers of children with autism spectrum disorder suffer from stress, anxiety and depression. The aim of this study was to determine the Mindfulness-Based Positive Behavior Support on stress, depression and anxiety of these mothers. Materials and Methods: Thirty mothers with children aged 6-8 years old with autism spectrum disorder were selected randomly from Gorgan Special Schools and were randomly divided into 2 groups of intervention and control. An expert psychiatrist educated MBPBS to the intervention group in 8 sessions. The assessment tools included the Perceived Stress Scale, Beck Depression and Anxiety Inventory, completed by all mother before, immediately and one month after the intervention. Independent t-test was used to compare the two groups. Results: Before intervention, mean scores of depression, anxiety and stress in mothers of autistic children were not significantly different between the intervention and control groups, but the mean scores of the two groups were significantly different after intervention and one month after the intervention; mean scores of depression, anxiety and stress of mothers of autistic children did not change significantly in the control group over time, but decreased significantly in the intervention group (P<0.001). Conclusion: MBPBS was able to reduce depression, anxiety and stress in mothers of children with autism spectrum disorder. Using MBPBS is suggested to be used for decreasing depression, anxiety and stress in mothers of children with autism spectrum disorder.