Armaghane Danesh
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armaghanj
Medical Sciences
http://armaghanj.yums.ac.ir
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2017
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تأثیر مصاحبه انگیزشی بر پیروی از درمان در افراد چاق جراحی شده به روش اسلیو گاسترکتومی
The Effectiveness of Motivational Interviewing on Adherence in Obese Patients Undergoing Sleeve Gastrectomy Surgery
روانشناسی
Psychology
پژوهشي
Research
<strong><span style="font-size: 10pt;"><span style="font-family: yagut;">چکیده</span></span></strong><br>
<strong><span style="font-size: 10pt;"><span style="font-family: yagut;">زمینه و هدف:</span></span></strong> <span style="font-size: 10pt;"><span style="font-family: yagut;">منظور از پیروی، میزان موفقیت بیمار در اجرای توصیه­های درمانی ارایه شده از سوی متخصصان سلامت می­باشد. </span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">هدف این پژوهش</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;"> بررسی تأثیر مصاحبه انگیزشی بر پیروی از درمان در افراد چاق جراحی شده به روش اسلیو گاسترکتومی</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">بود.</span></span><br>
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<strong><span style="font-size: 10pt;"><span style="font-family: yagut;">روش بررسی:</span></span></strong><span style="font-size: 10pt;"><span style="font-family: yagut;"> طرح پژوهش حاضر به صورت نیمه تجربی و از نوع پیشآزمونـ پسآزمون با گروه کنترل بود. جامعه آماری را کلیه بیماران چاقی (35</span></span><span dir="LTR"><span style="font-size: 10pt;"><span style="font-family: times new roman,serif;"> ≥ </span></span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">نمایه توده بدنی</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">)</span></span> <span style="font-size: 10pt;"><span style="font-family: yagut;">تشکیل دادند که طی زمستان 1394 و بهار 1395 در بیمارستان فوق تخصصی مادر و کودک غدیر شیراز عمل جراحی لاپاروسکوپی اسلیوگاسترکتومیرا انجام دادند. از میان این جامعه آماری، با استفاده از روش نمونه­گیری در دسترس تعداد 30 نفر انتخاب شده و آن­ها به طور تصادفی در دو گروه 15 نفره، آزمایش و کنترل قرار گرفتند.</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;"> برای گردآوری داده­ها از پرسشنامه </span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">رفتارهای خودـ مدیریتی پس از عمل جراحی چاقی</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">، در دو مرحله پیش­آزمون و پس­آزمون استفاده شد. مصاحبه انگیزشی </span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">طی چهار هفته(هر هفته یک جلسه 5/1 ساعته)</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">، بر روی گروه آزمایش اعمال گردید. </span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">داده­های جمع­آوری شده با استفاده از روش تحلیل کوواریانس چند متغیره تحلیل شدند.</span></span><br>
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<strong><span style="font-size: 10pt;"><span style="font-family: yagut;">یافته­ها: </span></span></strong><span style="font-size: 10pt;"><span style="font-family: yagut;">مصاحبه انگیزشی منجر به تفاوت معنی­دار آماری بین مراحل پیش­آزمون و پس­آزمون در نمره کل پیروی از درمان (</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">0001/0></span></span><span dir="LTR"><span style="font-size: 10pt;"><span style="font-family: times new roman,serif;">p</span></span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">) و خرده مقیاس­های رفتارهای خوردن (</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">0001/0</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">></span></span><span dir="LTR"><span style="font-size: 10pt;"><span style="font-family: arial,sans-serif;">p</span></span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">)، مصرف مکمل­ها (</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">01/0></span></span><span dir="LTR"><span style="font-size: 10pt;"><span style="font-family: times new roman,serif;">p</span></span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">)، مصرف مایعات (</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">03/0</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">></span></span><span dir="LTR"><span style="font-size: 10pt;"><span style="font-family: arial,sans-serif;">p</span></span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">)، مصرف میوه­ها، سبزیجات، غلات و پروتئین (</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">01/0</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">></span></span><span dir="LTR"><span style="font-size: 10pt;"><span style="font-family: times new roman,serif;">p</span></span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">) و مدیریت سندرم دامپینگ (</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">002/0> </span></span><span dir="LTR"><span style="font-size: 10pt;"><span style="font-family: times new roman,serif;">p</span></span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">)، شده است. اما از لحاظ متغیر فعالیت فیزیکی معنی­دار نبوده است</span></span> <span style="font-size: 10pt;"><span style="font-family: yagut;">(</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">07/0</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;"><</span></span><span dir="LTR"><span style="font-size: 10pt;"><span style="font-family: times new roman,serif;">p</span></span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">). </span></span><br>
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<strong><span style="font-size: 10pt;"><span style="font-family: yagut;">نتیجه­گیری: </span></span></strong><span style="font-size: 10pt;"><span style="font-family: yagut;">اجرای مصاحبه انگیزشی به منظور </span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">افزایش پیروی از درمان و رفتارهای خودمدیریتی، </span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">رسیدن به کاهش وزن مطلوب</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;"> و کاهش عوارض بعد از عمل، در افراد چاق جراحی شده به روش اسلیو گاسترکتومی</span></span><span style="font-size: 10pt;"><span style="font-family: yagut;">اثربخش و مناسب می­باشد، اما به نظر میرسد که جهت افزایش میزان فعالیت فیزیکی در این افراد اجرای مداخلات بلندمدت­تری لازم است.</span></span><br>
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<p style="margin: 0cm 0cm 0pt; text-align: left; line-height: normal; unicode-bidi: embed; direction: ltr;"><b><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"><font color="#000000">Abstract</font></span></b></p>
<p style="margin: 0cm 0cm 0pt; text-align: left; line-height: normal; unicode-bidi: embed; direction: ltr;"><b><span style="font-family: "Arial","sans-serif"; font-size: 12pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"><font color="#000000"> </font></span></b></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"><font color="#000000"><b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">Background & aim:</span></b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;"> </span></font><span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><font color="#000000">Adherence is the degree of patient's success to do the health</font><font color="#000000"> </font><span><font color="#000000">experts</font></span><font color="#000000"> </font><font color="#000000">recommendations. </font></span><font color="#000000"><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">The aim of present research was to study</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> the effects of motivational interviewing on adherence to in obese patients undergoing sleeve gastrectomy surgery.</span></font></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"><b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"><font color="#000000"> </font></span></b></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"><font color="#000000"><b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">Methods:</span></b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> The design of present semi-</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;"> experimental</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> study was pre-test, post-test with control group.</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;"> The statistical population included all obese patients (BMI≥35) that undergone laparoscopic sleeve gastrectomy surgery in Shiraz Ghadir Mother & Child Hospital during the winter of 2015 and the spring of 2016.</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">30 of them were selected by using available sampling method</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> and they</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;"> randomly were asssigned to experimental (n=15) and control groups (n=15). The post bariatic surgery self-management behaviors questionnaire was used to collect data in two</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> steps (pre-test and post-test). Motivational </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">interviewing was implemented for the experimental group in four weeks (each week a 1.5 hour session). Data were analysed by using multivariate covariance analysis (MANCOVA).</span></font></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"><b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"><font color="#000000"> </font></span></b></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"><font color="#000000"><b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">Results:</span></b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">MANCOVA</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> results show that </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">motivational interviewing led to a statistically significant difference </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">between pre-test and post-test BSSQ total scores (P<0.0001) and subscales</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;"> eating behaviors</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> (P<0.0001)</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">, fluid intake </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">(P<0.03)</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">, vitamin and mineral supplement intake</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> (P<0.01)</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">, fruit, vegitable, whole grain intake and protein</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> (P<0/01)</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;"> & dumping syndrome management</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> (P<0.002)</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">. But there was no significant difference in the </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">score</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;"> of physical activity </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">(P>0.07)</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">.</span></font></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"><b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"><font color="#000000"> </font></span></b></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"><font color="#000000"><b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">Conclusion:</span></b><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">According to the results of the present study, implementation of motivational interviewing in order to enhance adherence and self-management behaviors, achieve favorable weight loss and reduce postoperative complications</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"> in obese patients undergoing sleeve gastrectomy surgery</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">, but it appears that longer</span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;"> </span><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">interventions are necessary to increase the rate of physical activity.</span></font></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"><span style="font-family: "Arial","sans-serif"; font-size: 10pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"><font color="#000000"> </font></span></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"></p>
<p style="margin: 0cm 0cm 0pt; text-align: justify; line-height: normal; unicode-bidi: embed; direction: ltr;"><b><span style="font-family: "Arial","sans-serif"; font-size: 12pt; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"><font color="#000000"> </font></span></b></p>
مصاحبه انگیزشی, پیروی, افراد چاق, جراحی اسلیوگاسترکتومی
Motivational Interviewing, Adherence, Obese Patients, Sleeve Gastrectomy Surgery
1218
1235
http://armaghanj.yums.ac.ir/browse.php?a_code=A-10-869-1&slc_lang=fa&sid=1
Z
Sobhani
زهرا
سبحانی
: zahrasobhani120@yahoo.com
100319475328460012661
100319475328460012661
No
Department of Health Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran,
گروه روانشناسی سلامت، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران،
H
Ahadi
حسن
احدی
drhahadi5@gmail.com
100319475328460012662
100319475328460012662
Yes
Department of Health Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran,
گروه روانشناسی سلامت، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران،
S
Khosravi
صدراله
خسروی
hamraz_khosravi@yahoo.com
100319475328460012663
100319475328460012663
No
Department of Clinical Psychology, Firoozabad Branch, Islamic Azad University, Firoozabad, Iran
گروه روانشناسی، واحد فیروزآباد، دانشگاه آزاد اسلامی، فیروزآباد، ایران،
H
Pourshrifi
حمید
پورشریفی
poursharifih@gmail.com
100319475328460012664
100319475328460012664
No
Department of Health Psychology, Tabriz University, Tabriz, Iran
گروه روانشناسی، دانشگاه تبریز، تبریز، ایران
M
Seirafi
محمدرضا
صیرفی
msf_3@yahoo.com
100319475328460012665
100319475328460012665
No
Department of Health Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran,
گروه روانشناسی سلامت، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران،