ﻣﻘﺎﯾﺴﻪ اﺛﺮﺑﺨﺸﯽ ﮔﺮوﻫﯽ ﻗﺼﻪ درﻣﺎﻧﯽ و ﻫﻨﺮ ـ ﺑﺎزي درﻣﺎﻧﯽ ﺑﺮ اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن: ﺑﺎ ﺗﮑﯿﻪ ﺑﺮ ﭼﻬﺎرﭼﻮب، اﺻﻮل و ﻗﻮاﻋﺪ روﯾﮑﺮد ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري

Comparing the Effectiveness of Group Story Therapy and the Art-Play Therapy on Anxiety and Depression in Children with Cancer: Based on the Framework, Principles and Rules of Cognitive-Behavioral Approach

ﭼﮑﯿﺪه ﻣﻘﺪﻣﻪ: اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ از ﺟﻤﻠﻪ ﻣﺘﻐﯿﺮﻫﺎﯾﯽ ﻫﺴﺘﻨﺪ ﮐﻪ ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﻧﯿﺎزﻣﻨﺪ درﻣﺎنﻫﺎي روانﺷﻨﺎﺧﺘﯽ ﺑﺮاي آنﻫﺎ ﻫﺴﺘﻨﺪ. اﯾﻦ ﭘﮋوﻫﺶ ﺑﺎ ﻫﺪف ﻣﻘﺎﯾﺴﻪ اﺛﺮﺑﺨﺸﯽ ﮔﺮوﻫﯽ ﻗﺼﻪ درﻣﺎﻧﯽ و ﻫﻨﺮ ـ ﺑﺎزي درﻣﺎﻧﯽ ﺑﺮ اﺿﻄﺮاب و اﻓﺴﺮدﮔﯽ ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺑﺎ ﺗﮑﯿﻪ ﺑﺮ ﭼﻬﺎرﭼﻮب، اﺻﻮل و ﻗﻮاﻋﺪ روﯾﮑﺮد ﺷﻨﺎﺧﺘﯽ ـ رﻓﺘﺎري اﺟﺮا ﺷﺪ. روش ﮐﺎر: ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﻣﻄﺎﻟﻌﻪاي ﮐﺎرﺑﺮدي از ﻧﻮع ﺷﺒﻪ آزﻣﺎﯾﺸﯽ و ﻃﺮح ﭘﮋوﻫﺶ ﺳﻪ ﮔﺮوﻫﯽ ﺑﺎ ﺳﻪ ﻣﺮﺣﻠﻪ ﭘﯿﺶآزﻣﻮن، ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي ﺑﻮد. ﺑﻪ ﻣﻨﻈﻮر اﻧﺠﺎم ﭘﮋوﻫﺶ از ﻣﯿﺎن ﮐﻮدﮐﺎن 8 ﺗﺎ 12 ﺳﺎل ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن در ﺑﯿﻤﺎرﺳﺘﺎن اﻣﯿﺮ ﺷﻬﺮ ﺷﯿﺮاز در ﺗﺎﺑﺴﺘﺎن ﺳﺎل 36 ،1397 ﮐﻮدك ﺑﻪﺻﻮرت ﻫﺪﻓﻤﻨﺪ اﻧﺘﺨﺎب و ﺑﻪ ﺳﻪ ﮔﺮوه )دو ﮔﺮوه آزﻣﺎﯾﺶ و ﯾﮏ ﮔﺮوه ﮐﻨﺘﺮل ﻫﺮ ﮔﺮوه 12 ﻧﻔﺮ( ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. از ﻣﻘﯿﺎس اﺿﻄﺮاب اﺳﭙﻨﺲ )SCAS اﺳﭙﻨﺲ، 1998( و ﻣﻘﯿﺎس اﻓﺴﺮدﮔﯽ ﮐﻮدﮐﺎن )CDS ﺗﯿﺸﺮ و ﻻﻧﮓ، 1978( ﺑﺮاي ﺳﻨﺠﺶ در ﻣﺮاﺣﻞ ﭘﯿﺶآزﻣﻮن، ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي اﺳﺘﻔﺎده ﺷﺪ. ﮔﺮوه ﻗﺼﻪ درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري و ﻫﻨﺮ-ﺑﺎزي درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري ﻫﺮ ﯾﮏ ﺑﻪ ﻣﺪت 12 ﺟﻠﺴﻪ، ﺗﺤﺖ درﻣﺎن ﻗﺮار ﮔﺮﻓﺘﻨﺪ. دادهﻫﺎ از ﻃﺮﯾﻖ ﺗﺤﻠﯿﻞ وارﯾﺎﻧﺲ اﻧﺪازهﻫﺎي ﻣﮑﺮر ﺗﺤﻠﯿﻞ ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﮐﻪ ﺑﯿﻦ ﻗﺼﻪ درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري و ﻫﻨﺮ-ﺑﺎزي درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل در اﺿﻄﺮاب )0/001

Introduction: Anxiety and depression are among the variables that children with cancer need psychological treatment for them. This study aimed to determine the comparing the effectiveness of group story therapy and the art-play therapy on anxiety and depression in children with cancer based on the framework, principles and rules of the cognitive-behavioral approach. Methods: The research method was semi-experimental, and the research design was three groups with three stages (pre-test, post-test and follow up design). To carry out the research, from 8-12 years old children with cancer in Amir Hospital, in Shiraz city in the Summer of 2018, 36 children were purposefully selected and randomly assigned to three groups (two experimental and one control group, each group was 12 children). Children Anxiety Scale (SCAS- Spence, 1998) and Children Depression Scale (CDS- Tisher & Lang, 1978) was used to measuring the dependent variable in the pretest, post-test and follow up. The group of cognitive-behavioral story therapy and cognitive-behavioral art-play therapy received 12 sessions of treatment. The data were analyzed with the use of repeated-measures analysis of variance. Results: The results showed that there is a significant difference between cognitive-behavioral story therapy and cognitive-behavioral art-play therapy with the control group in anxiety (F=29.98, P<0.001) and depression (F=28.62, P<0.001). Also, cognitive-behavioral art-play therapy had stronger effects than cognitive-behavioral story therapy in reducing anxiety and depression (P<0.001). Conclusions: Based on the results of this study, it can be said that cognitive-behavioral story therapy and cognitive-behavioral art-play therapy can be used as a treatment to reduce the anxiety and depression of children with cancer in educational and therapeutic settings.