مقایسه اثربخشی درمان دارویی و تغییر سبک زندگی بر اساس مدل فرانظریه ای در سه شاخص بیماران سندروم متابولیک شهر تهران در سال 1396

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی سلامت دانشگاه عدالت تهران

2 استاد تمام ، دکترای روانشناسی ، استاد یار ، دانشگاه ازاد اسلامی ، تهران

3 دکترای روانشناسی ، دانشیار ، دانشگاه امام حسین ، تهران

4 دکترای روانشناسی ، استاد یار ، دانشگاه خوارزمی ، تهران

چکیده

چکیده :
مقدمه و هدف: :سندرم متابولیک مجموعه ای از عوامل خطر مرتبط با بیماری های قلبی عروقی و دیابت می باشد که هر روز بر شمار مبتلایان به آن افزوده می شود . این مطالعه با هدف تعیین اثر برنامه آموزشی مبتنی بر فرانظریه ای به منظور کنترل عوامل خطر ساز بیماری سندرم متابولیک صورت گرفت .
مواد و روش کار:روش پژوهشی شبه تجربی با طرح پیش آزمون –پس آزمون با در گروه کنترل دارویی و شاهد ، 75 افراد مبتلا به سندرم متابولیک به صورت تصادفی ساده در سه گروه 25 نفری قرار گرفتند . ابزار اندازه گیری مورد استفاده پ پرسشنامه فرانظریه ای مارکوس که به وسیله آن مراحل تغییر رفتار و فرایند رفتار (خودکارآمدی و موازنه تصمیم گیری ) مورد ارزیابی سپس مورد آموزش قرار گرفت همچنین یرگه ثبت اطلاعات برای جمع آوری داده های مربوط به دور کمر ، فشار خون سیستولی و دیاستولیک ، TG،HDL، و FBSمورد استفاده قرار گرفت .که وجود حداقل سه شاخص ملاک تعیین بیماری سندرم متابولیک بود . بعد از گردآوری داده ها مداخله آموزشی در چهار جلسه ای برای گروه آزمون و برای گروه دارویی ،داروهای مورد نیاز بدون مداخله آموزشی و گروه شاهد بدون مداخله به کار گرفته شد و نتایج پس از 4 ماه مداخله آموزشی جمع آوری شد.در نهایت داده ها توسط آزمونهای T مستقل و وابسته و کوواریانس و به وسیله نرم افزار SPSS مورد تجزیه و تحلیل قرار گرفت .
یافته های پژوهش :اندازه گیری سازه مراحل تغییر قبل مداخله نشان داد که درصد بالایی از بیماران،در مرحله مقدماتی (پیش تفکر،تفکر و آمادگی ) قرار داشتند که بعد از مداخله بیش از4/76% افراد گروه آزمون در مرحله عمل و نگهداشت قرار گرفتند
نتیجه گیری :سندرم متابولیک یک بحران جهانی است، . شواهد علمی نشان می دهد بخش عمده ای از بیماری سندرم متابولیک از طریق تغییر رفتارهای واسطه ای بویژه اصلاح رژیم غذایی و شیوه زندگی قابل پیشگیری و حتی درمان است .حتی در بعضی از شاخص های سندرم متابولیک (قند ناشتا و دور کمر )عملکرد بهتری نسبت به درمان دارویی دارد.

کلیدواژه‌ها

عنوان مقاله [English]

comparison of the effectiveness of drug treatment and lifestyle change based on a meta-theoretical model in three indicators of patients with metabolic syndrome in Tehran in 1396

نویسندگان [English]

  • Parviz Moradian zand 1
  • Hasan Ahadi 2
  • Hamidreza Rahmani 3
  • Gholamreza Sarami 4
1 PHD student in Health Psychology Tehran university of justice
2 Professor and holder of PhD Degree in the field of Psychology, Assistant Professor at Islamic Azad University, Tehran
3 holder of PhD Degree in the field of Psychology, Associate Professor at University of Imam Hossein, Tehran
4 holder of PhD Degree in the field of Psychology, Assistant Professor at University of Kharazmi, Tehran
چکیده [English]

Abstract:
Introduction:Metabolic syndrome is a collection of the risk factors relevant to the cardiovascular diseases & diabetes and the number of patients who suffer the said syndrome increases every day. This study was performed with the aim of determining the effect of one educational plan based on the model-trans-theory(TTM) and in order to control the risk factors (Especially the Nutrition).
Materials and Methods: This study applies the quasi-experimental research method and with the pre-exam & post-exam plan in the medicine control group and testifier so that a number of 75 individuals who were ill with the metabolic syndrome were included in a simple accidental form and in three groups of 25 individuals. The measuring tool applicable for a 24 hours questionnaire with the food mode and the meta-theory questionnaire of Marcus by which the behavior change stages and behavior process (Self-Efficiency & Decision Making Balance) were first assessed and then taught. Also the data registration sheet was used for gathering the data relevant to the waist size and circumference, systolic and diastolic blood pressure (Hypertension), TG, HDL and FBS and the existence of at least three indexes was taken into consideration as a criterion for determining the metabolic syndrome. Educational intervention was performed in four sessions and for the test group and some required medicines were applied for the medical & testifier groups but without the educational intervention and after collecting the data and the results were obtained after 4 months of educational intervention. Ultimately the said data were analyzed by the independent, dependent T tests, co-variance and SPSS software.
Results: Measuring the change stages structure and prior to the intervention showed that a high percentage of patients were in the preliminary stage (Pre-Contemplation, Contemplation and Readiness) that more than %76/4 of test group individuals remained in the act and retention after the intervention stage.
Conclusion:Metabolic syndrome is one global crisis which threatens the health and economy of the most nations. Scientific evidence shows that a major part of the metabolic syndrome can be preventable and even curable (Treatable) through a change in mediating behaviors especially modifying diet and lifestyle.

کلیدواژه‌ها [English]

  • Trans-Theory Model
  • Metabolic Syndrome
  • Mediating Behavior
  • Stages of Change and Change Process

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 63، شماره 3
مرداد و شهریور 1399
صفحه 2370-2379

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