راﺑﻄﻪ ﺳﻼﻣﺖ روان و ﻋﺰت ﻧﻔﺲ ﺑﺎ ارزﯾﺎﺑﯽ ﻓﺮاﺷﻨﺎﺧﺘﯽ ﺑﺪﺷﮑﻠﯽ ﺑﺪن در زﻧﺎن ﻣﺘﻘﺎﺿﯽ رﯾﻨﻮﭘﻼﺳﺘﯽ ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ دو ﻣﺮﮐﺰ ﺟﺮاﺣﯽ زﯾﺒﺎﯾﯽ ﮐﺮﻣﺎﻧﺸﺎه در ﺳﺎل 1397-1396

The Relationship between Mental Health and Self-Esteem with meta-cognitive assessment of body deformity for Females Requesting Rhinoplasty at the Cosmetic Surgery Center of Kermanshah, 2017-2018

زﻣﯿﻨﻪ و ﻫﺪف: رﯾﻨﻮﭘﻼﺳﺘﯽ را ﻣﯽﺗﻮان ﺷﺎﯾﻊﺗﺮﯾﻦ ﻋﻤﻞ ﺟﺮاﺣﯽ زﯾﺒﺎﯾﯽ در اﯾﺮان ﻧﺎﻣﯿﺪ ﮐﻪ ﻫﺮ روزه ﺑﻪ ﺗﻌﺪاد آن اﻓﺰوده ﻣﯽﮔﺮدد. ﻣﻄﺎﻟ ﻌﺎت ﻧﺸﺎن دادهاﻧﺪ ﮐﻪ ﺳﻼﻣﺖ روان و ﻋﺰت ﻧﻔﺲ از ﺟﻤﻠﻪ ﻋﻮاﻣﻠﯽ ﻫﺴﺘﻨﺪﮐﻪ ﻣﯽﺗﻮاﻧﻨﺪ در ﮔﺮاﯾﺶ اﻓﺮاد ﺑﻪ رﯾﻨﻮ ﭘﻼﺳﺘﯽ ﺗﺄﺛﯿﺮ داﺷﺘﻪ ﺑﺎﺷﺪ. ﺑﺮد اﺷﺖ اﻓﺮاد از ﻇﺎﻫﺮ ﺧﻮد ﻧﯿﺰ ﻣﯽﺗﻮاﻧﺪ ﺑﺮ ﺳﻼﻣﺖ روان، ﻋﺰت ﻧﻔﺲ و ﮔﺮاﯾﺶ ﺑﻪ ﻋﻤﻞ رﯾﻨﻮ ﭘﻼﺳﺘﯽ ﻣﺆﺛﺮ ﺑﺎﺷﺪ. ﺑﻨﺎﺑﺮ آﻧﭽﻪ ﮔﻔﺘﻪ ﺷﺪ، ﻫﺪف از اﯾ ﻦ ﻣﻄﺎﻟﻌﻪ، ﺗﻌﯿﯿﻦ ارﺗﺒﺎط ﺳﻼﻣﺖ روان و ﻋﺰت ﻧﻔﺲ ﺑﺎ اﺑﻌﺎد ﻓﺮاﺷﻨﺎﺧﺘﯽ ﺑﺪﺷﮑﻠﯽ ﺑﺪن زﻧﺎن ﻣﺘﻘﺎﺿﯽ رﯾﻨﻮﭘﻼﺳﺘﯽ ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﻣﺮاﮐﺰ ﺟﺮاﺣﯽ زﯾ ﺒﺎﯾﯽ ﮐﺮﻣﺎﻧﺸﺎه در ﺳﺎل 1397-1396 اﺳﺖ. ﻣﻮاد و روش ﻫﺎ: ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﯾﮏ ﻣﻄﺎﻟﻌﻪ ﺗﻮﺻﯿﻔﯽ – ﺗﺤﻠﯿﻠﯽ - ﻣﻘﻄﻌﯽ اﺳﺖ ﮐﻪ در ﺳﺎل 1397 -1396 در ﻣﺮاﮐﺰ ﺟﺮاﺣﯽ زﯾﺒﺎﯾﯽ ﮐﺮﻣﺎﻧﺸﺎه ﺷﺎ ﻣﻞ ﯾﮏ ﻣﻄﺐ ﺧﺼﻮﺻﯽ و ﺑﯿﻤﺎرﺳﺘﺎن دوﻟﺘﯽ ﻃﺎﻟﻘﺎﻧﯽ ﺑﺮ روي ﯾﮏ ﻧﻤﻮﻧﻪ 150 ﻧﻔﺮي از زﻧﺎن ﻣﺘﻘﺎﺿﯽ رﯾﻨﻮﭘﻼﺳﺘﯽ ﺻﻮرت ﮔﺮﻓﺖ. اﻃﻼﻋﺎت از ﻃﺮ ﯾﻖ ﭘﺮﺳﺸﻨﺎﻣﻪﻫﺎي ارزﯾﺎﺑﯽ ﻓﺮاﺷﻨﺎﺧﺖ ﺑﺪﺷﮑﻠﯽ ﺑﺪن )BDMCQ(، ﭘﺮﺳﺸﻨﺎﻣﻪ ﻋﺰت ﻧﻔﺲ روزﻧﺒﺮگ )SES( و ﭘﺮﺳﺸﻨﺎﻣﻪ ﺳﻼﻣﺖ ﻋﻤﻮﻣﯽ )GHQ-28 ( ﺟﻤﻊآوري ﺷﺪﻧﺪ. ﺳﭙﺲ ﯾﺎﻓﺘﻪﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰار 16 SPSS و آﻣﺎرﻫﺎي ﺗﻮﺻﯿﻔﯽ و اﺳﺘﻨﺒﺎﻃﯽ و ﻫﻤﺒﺴﺘﮕﯽ ﭘﯿﺮﺳﻮن و آزﻣﻮن رﮔﺮﺳﯿﻮن ﺧﻄﯽ ﻣﻮرد ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ روي 150 زن ﺑﺎ ﻣﯿﺎﻧﮕﯿﻦ ﺳﻨﯽ 4/24 ± 24/04 اﻧﺠﺎم ﺷﺪ. از ﻧﻈﺮ وﺿﻌﯿﺖ ﺗﺄﻫﻞ 80 درﺻﺪ آزﻣﻮدﻧﯽﻫﺎ ﻣﺠﺮد ﺑﻮدﻧﺪ. ﻧﺘﺎﯾﺞ ﺗﺤﻠﯿﻞ دادهﻫﺎ ﻧﺸﺎن داد ﮐﻪ ﺑﯿﻦ ﺳﻼﻣﺖ روان )0/52=P < 0/001 ،r(، اﻓﺴﺮدﮔﯽ )0/48=P < 0/001 ،r(، اﺿﻄﺮاب )0/47=P < 0/001 ،r(، ﻋﻤﻠﮑـﺮد اﺟﺘﻤﺎﻋﯽ )0/32=P < 0/001 ،r(، ﻋﻼﺋﻢ ﺟﺴﻤﺎﻧﯽ )0/41=P < 0/001 ،r( و ارزﯾﺎﺑﯽ ﻓﺮاﺷﻨﺎﺧﺘﯽ ﺑﺪ ﺷﮑﻠﯽ ﺑﺪن راﺑﻄﻪ ﻣﺜﺒﺖ ﻣﻌﻨﺎداري دارد، و ﻋﺰت ﻧﻔﺲ ﺑﺎ ارزﯾﺎﺑﯽ ﻓﺮاﺷﻨﺎﺧﺘﯽ از ﺷﮑﻞ ﺑﺪن )0/39- =P < 0/001 ،r( راﺑﻄﻪ ﻣﻨﻔﯽ ﻣﻌﻨﺎدار دارد. ﻫﻤﭽﻨﯿﻦ ﺗﺤﻠﯿﻞ دادهﻫﺎ ﻧﺸﺎن داد ﮐﻪ ارﺗﺒﺎط ﻣﺜﺒﺖ ﻣﻌﻨﺎداري ﺑﯿﻦ زﯾﺮ ﻣﻘﯿﺎسﻫﺎي ﺳﻼﻣﺖ روان )ﻋﻼﺋﻢ ﺟﺴﻤﺎﻧﯽ، اﺿﻄﺮاﺑﯽ، ﻋﻤﻠﮑﺮد اﺟﺘﻤﺎﻋﯽ، اﻓﺴﺮدﮔﯽ( و زﯾﺮ ﻣﻘﯿﺎسﻫﺎي ارزﯾﺎﺑﯽ ﻓﺮاﺷﻨﺎﺧﺘﯽ از ﺑﺪﺷﮑﻠﯽ ﺑﺪن )راﻫﺒﺮدﻫﺎي ﮐﻨﺘﺮل ﻓﺮاﺷﻨﺎﺧﺘﯽ، اﺋﺘﻼف ﻓﮑﺮ - ﻋﻤﻞ، ﺑﺎورﻫﺎي ﻣﺜﺒﺖ و ﻣﻨﻔﯽ ﻓﺮا ﺷﻨﺎﺧﺘﯽ و رﻓﺘﺎرﻫﺎي اﯾﻤﻨﯽ( وﺟﻮد دارد )0/05<(P. ﺑﯿﻦ ﻋﺰت ﻧﻔﺲ و و زﯾﺮ ﻣﻘﯿﺎس ﭘﺮﺳﺸﻨﺎﻣﻪ ارزﯾﺎﺑﯽ ﻓﺮاﺷﻨﺎﺧﺘﯽ ﺑﺪرﯾﺨﺖ اﻧﮕﺎري راﺑﻄﻪ ﻣﻨﻔﯽ ﻣﻌﻨﺎداري وﺟﻮد داﺷﺖ )0/001 < P(. ﻫﻤﭽﻨﯿﻦ ﻋﺰت ﻧﻔﺲ و ﺳﻼﻣﺖ روان 30 درﺻﺪ ﺗﻐﯿﯿﺮات ارزﯾﺎﺑﯽ ﻓﺮاﺷﻨﺎﺧﺘﯽ از ﺑﺪﺷﮑﻠﯽ ﺑﺪن را ﺗﺒﯿﯿﻦ ﻣﯽﮐﻨﻨﺪ )0/30=R2adj(. ﻧﺘﯿﺠﻪ ﮔﯿـﺮي: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻧﺘﺎﯾﺞ اﯾﻦ ﻣﻄﺎﻟﻌﻪ اﻓﺰاﯾﺶ ﻋﺰت ﻧﻔﺲ و ﺳﻼﻣﺖ روان ﻣﻨﺠﺮ ﺑﻪ ﺑﻬﺒﻮد ارزﯾﺎﺑﯽ ﻓﺮاﺷﻨﺎﺧﺘﯽ از ﺷﮑﻞ ﺑﺪن ﻣﯽﺷﻮد ﮐﻪ اﯾﻦ ﺑﻬﺒﻮد ﻣﯽﺗﻮاﻧﺪ در ﮐﺎﻫﺶ ﻋﻤﻞﻫﺎي زﯾﺒﺎﯾﯽ ﮐﻤﮏ ﮐﻨﻨﺪه ﺑﺎﺷﺪ. از ﻃﺮف دﯾﮕﺮ ﺑﻬﺒﻮد ارزﯾﺎﺑﯽ از ﺑﺪن ﺧﻮد ﻣﯽﺗﻮاﻧﺪ ﻣﻨﺠﺮ ﺑﻪ ﺑﻬﺒﻮد ﺳﻼﻣﺖ روان و ﻋﺰت ﻧﻔﺲ ﮐﻪ اﯾﻦ ﻋﻮاﻣﻞ ﺧﻮد از ﻋﻠﻞ ﮔﺮاﯾﺶ اﻓﺮاد ﺑﻪ ﺳﻤﺖ ﻋﻤﻞﻫﺎي زﯾﺒﺎﯾﯽ ﻫﺴﺘﻨﺪ.

Introduction & Objective: Rhinoplasty can be called the most commonly used cosmetic surgery in Iran, which is increasing. Studies have shown that mental health and self-esteem are among the factors that can affect people's tendency to rhinoplasty. People's perceptions of their appearance can also affect mental health, self-esteem and tendency to rhinoplasty. Therefore, the aim of this study was to determine the relationship between meta-cognitive assessment of body shape with mental health and self-esteem of applicant women for rhinoplasty who referred to Kermanshah cosmetic surgery centers in 2017-2018. Materials & Methods: The present study is a descriptive-analytical-cross-sectional study that was carried out in Kermanshah cosmetic Surgery Centers in 2017-2018, including a private clinic and Taleghani State Hospital on a sample of 150 applicant women for rhinoplasty. Data were collected through questionnaires of meta-cognitive assessment of body deformity (BDMCQ), Rosenberg Self-Esteem Questionnaire (SES), and General Health Questionnaire (GHQ-28). Then, the findings were analyzed using SPSS16 software, descriptive and inferential statistics and Pearson correlation and Linear regression. Results: This study was performed 0n 150 women with an average age 24.04 ± 4.24. In terms of marital status, 80% of subjects were single. The results of the data analysis showed that there was a significant positive correlation between mental health (P < 0.001, r = 0.52), depression (P < 0.001 r = 0.48), anxiety (P < 0.001, r = 0.47), social function (P < 0.001, r = 0.32), physical symptoms (P < 0.001, r = 0.41) and meta-cognitive assessment of body deformity. an‎d self-esteem had a negative correlation with meta-cognitive assessment of body shape (r = -0.39, P < 0.001). Also, analysis of the data showed that there was a significant positive correlation between mental health sub-scales (physical symptoms, anxiety, social function, depression) and sub meta-cognitive assessment of body deformity (metacognitive control strategies, thought-action coalitions, positive an‎d negative meta-cognitive beliefs and safety behaviors) (P < 0.05). There was a significant negative correlation between self-esteem and sub-scale meta-cognitive assessment of body malformation syndrome questionnaire (P > 0.001). Also Self-esteem and mental health explained 30% of the meta-cognitive assessment of body deformity (R2 adj = 0.30). Conclusions: According to the results of this study, increase of self-esteem and mental health lead to a better meta-cognitive assessment of the body shape, which can be helpful in reducing the cosmetic surgeries. On the other hand, improving the assessment of body can improve mental health and self-esteem, which these factors are the causes of people tendency to the cosmetic surgery.