fa بررسی تأثیر آموزش فعال سازی رفتاری بر نشخوار فکری در بیماران با اقدام به خودکشی مراجعه کننده به بخش اورژانس بیمارستان منتخب شهر تهران روان شناسی Psychology پژوهشي Research <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">مقدمه:</span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> اقدام به خودکشی یکی از بیشترین علل مراجعه به اورژانس‌های بیمارستان‌های روانپزشکی است. کاهش نشخوار فکری در این افراد از جمله مواردی است که باید مورد توجه قرار گیرد.</span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">هدف:</span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> این مطالعه با هدف تعیین تأثیر آموزش فعال سازی رفتاری بر نشخوار فکری بیماران با اقدام به خودکشی مراجعه کننده به بخش اورژانس بیمارستان منتخب شهر تهران انجام شد.</span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">مواد و روش‌ها:</span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> این کارآزمایی بالینی تصادفی شده بر روی 72 مددجوی مراجعه کننده به اورژانس بیمارستان منتخب شهر تهران در سال 1403 انجام شد. بیماران به روش هدفمند وارد مطالعه شدند و به روش تصادفی ساده با پرتاب سکه به دو گروه آزمون و کنترل تخصیص یافتند. در گروه آزمون علاوه بر مراقبت‌های متداول، فعال سازی رفتاری به روش حل مسئله اجتماعی دزوریلا و گولدفرید </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">(</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="background:white"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">D&#39;Zurilla & Goldfried</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">) </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">شامل یک برنامه‌ی آموزشی 4 هفته‌ای که هر هفته شامل دو جلسه 60 دقیقه‌ای بود اجرا شد. میزان نشخوار فکری بیماران قبل و بعد از مداخله با استفاده از پرسشنامه نشخوار فکری نالن هاکسما- مارو </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">(</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="background:white"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">Nolen-hoeksema and morrow</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">) </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">سنجیده شد. داده‌ها با نرم‌افزار </span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">SPSS</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> نسخه 21 تحلیل شدند.</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">یافته‌ها:</span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> قبل از مداخله میانگین نمره کل نشخوار فکری بیماران گروه آزمون (8/36&nbsp;</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%">&plusmn;</span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">52/90) و گروه کنترل (7/61</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%">&plusmn;</span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">55/44) تفاوت معنی‌داری نداشت (0/202=</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">P</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">). در حالی که بعد از مداخله میانگین نمره کل نشخوار فکری </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">در</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> گروه آزمون (9/58</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%">&plusmn;</span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">42/90) پایین‌تر از گروه کنترل (9/47</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%">&plusmn;</span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">53/70) بود (0/001</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">P<</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">). میانگین نمره نشخوار فکری بیماران گروه آزمون بعد از مداخله کاهش معنی‌دار یافت (0/001</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">P<</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">)، در حالی که تغییر معنی‌داری در گروه کنترل ایجاد نشد (0/311=</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">P</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">).</span></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">نتیجه‌گیری</span></span></span></b><i><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">:</span></span></span></i><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> آموزش فعال سازی رفتاری به روش حل مسئله اجتماعی منجر به کاهش نشخوار فکری در بیماران مراجعه کننده به بخش اورژانس</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">شد</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">. لذا، پیشنهاد می‌شود </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">پرستاران شاغل در بخش اورژانس و </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">روان پرستاران از این روش بیشتر بهره ببرند.</span></span></span></span></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:115%"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Introduction:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> Suicide attempts represent one of the most common reasons for referrals to psychiatric hospital emergency departments. Reducing rumination in these individuals is a critical issue that warrants attention.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:115%"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Objective:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> This study aimed to determine the effect of behavioral activation training on rumination among patients with suicide attempts presenting to the emergency department of a selected hospital in Tehran.</span></span></span><br> <b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Material and Methods:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> This randomized clinical trial was conducted on 72 patients referred to the emergency department of a selected&nbsp; hospital in Tehran in 2024. Patients were purposively enrolled in the study and randomly allocated to the intervention or control group using a simple coin-toss method. In addition to routine care, the intervention group received behavioral activation based on the social problem-solving approach of D&#39;Zurilla and Goldfried, consisting of a 4-week educational program with two 60-minute sessions per week. Rumination was assessed before and after the intervention using the Nolen-Hoeksema and Morrow Ruminative Thought Style Questionnaire. Data were analyzed using SPSS version 21.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:115%"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Results:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> Prior to the intervention, there was no significant difference in the mean total rumination scores between the intervention group (52.90&plusmn;8.36) and the control group (55.44&plusmn;7.61) (P=0.202). However, post-intervention, the mean total rumination score in the intervention group (42.90&plusmn;9.58) was significantly lower than in the control group (53.70&plusmn;9.47) (P<0.001). The mean rumination score in the intervention group showed a significant decrease after the intervention (P<0.001), whereas no significant change was observed in the control group (P=0.311).</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:115%"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> Behavioral activation training using the social problem-solving method led to a reduction in rumination among patients presenting to the emergency department. Therefore, it is recommended that nurses working in emergency departments and psychiatric nurses make greater use of this approach.</span></span></span></span></span></span></div> آموزش, بخش اورژانس, بیمار, رفتاری, فعال سازی, نشخوار فکری Behavioral Activation, Emergency Department, Patient, Training, Rumination 228 237 http://mcs.ajaums.ac.ir/browse.php?a_code=A-10-718-1&slc_lang=fa&sid=1 Maryam Askari مریم عسکری maryamaskari999@gmail.com 100319475328460018689 100319475328460018689 No Nursing School, Aja University of Medical Sciences, Tehran, Iran دانشکده پرستاری، دانشگاه علوم پزشکی آجا، تهران ایران Seyedeh Azam Sajadi سیده اعظم سجادی 100319475328460018690 100319475328460018690 Yes Nursing Management Department, Nursing School, Aja University of Medical Sciences, Tehran, Iran گروه مدیریت پرستاری، دانشکده پرستاری، دانشگاه علوم پزشکی آجا، تهران، ایران Zahra Farsi زهرا فارسی z.farsi@ajaums.ac.ir 100319475328460018691 100319475328460018691 No Research and Ph.D. Nursing Departments, Nursing School, Aja University of Medical Sciences, Tehran, Iran گروه دکترای تخصصی پرستاری و معاون پژوهش، دانشکده پرستاری، دانشگاه علوم پزشکی آجا، تهران، ایران