مقايسه اثربخشي هنر بازي درماني شناختي رفتاري و قصه درماني شناختي رفتاري بر كيفيت زندگي وابسته به سلامت كودكان مبتلا به سرطان

Comparing the effectiveness of cognitive-behavioral art-play and cognitive-behavioral story therapy on health related quality of life among children with cancer

ﻫﺪف : ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳــﺮﻃﺎن ﺑﺮا ي اﻓﺰاﯾﺶ ﺳــﻄﺢ ﮐﯿﻔﯿ ﺖ زﻧﺪﮔ ﯽ ﺧﻮد در ﮐﻨﺎر درﻣﺎن ﻫﺎ ي ﭘﺰﺷــﮑﯽ، ﻧﯿ ﺎزﻣﻨﺪ درﻣﺎن ﻫﺎ ي روانﺷﻨﺎﺧﺘﯽ ﻫﺴﺘﻨﺪ. ﺑﺮ ﻫﻤﯿﻦ اﺳﺎس، اﯾﻦ ﭘﮋوﻫﺶ ﺑﺎ ﻫﺪف ﻣﻘﺎﯾﺴﻪ اﺛﺮﺑﺨﺸﯽ ﮔﺮوه ﻫﻨﺮ ـ ﺑﺎز ي درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ ـ رﻓﺘﺎر ي و ﻗﺼﻪ درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ ـ رﻓﺘﺎري ﺑﺮ ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ واﺑﺴﺘﻪ ﺑﻪ ﺳﻼﻣﺖ در ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن اﺟﺮا ﺷﺪ. ﻣﻮاد و روش ﻫﺎ: روش ﭘﮋوﻫﺶ ﻧﯿﻤﻪ آزﻣﺎ ﯾﺸــﯽ و ﻃﺮح ﭘﮋوﻫﺶ ﺳــﻪ ﮔﺮوﻫﯽ ﺑﺎ دو ﻣﺮﺣﻠﻪ ﭘﯿﺶآزﻣﻮن و ﭘﺲآزﻣﻮن ﺑﻮد. از ﻣﯿ ﺎن ﺟﺎﻣﻌﻪ آﻣﺎري ﮐﻮدﮐﺎن 8 ﺗﺎ 12 ﺳﺎل ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن در ﺑﯿﻤﺎر ﺳﺘﺎن اﻣﯿﺮ ﺷﻬﺮ ﺷ ﯿﺮاز در ﺗﺎﺑ ﺴﺘﺎن ﺳﺎل 36 ،1397 ﮐﻮدك ﺑﻪ ﺻﻮرت ﻫﺪﻓﻤﻨﺪ اﻧﺘﺨﺎب و ﺑﻪ ﻃﻮر ﺗﺼــﺎدﻓﯽ در دو ﮔﺮوه آزﻣﺎ ﯾﺶ )12 ﻧﻔﺮ ﺑﺮاي ﻫﺮ ﮔﺮوه( و ﮔﺮوه ﮐﻨﺘﺮل )12 ﻧﻔﺮ( ﮔﻤﺎرده ﺷــﺪﻧﺪ. از ﻣﻘ ﯿ ﺎس ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ واﺑ ﺴﺘﻪ ﺑﻪ ﺳﻼﻣﺖ ﮐﻮدﮐﺎن )KiD-KINDL- ﺑﻮﻟﯿﻨﮕﺮ و راوﻧﺰ ﺳﺎ ﯾﺒﺮر، 1998( ﺑﺮاي ﺳﻨﺠﺶ ﻣﺘﻐ ﯿﺮ واﺑ ﺴﺘﻪ در ﻣﺮاﺣﻞ ﭘﯿﺶآزﻣﻮن و ﭘﺲآزﻣﻮن اﺳﺘﻔﺎده ﺷﺪ. ﮔﺮوه ﻫﻨﺮ ـ ﺑﺎز ي درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ ـ رﻓﺘﺎري و ﻗﺼﻪ درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ ـ رﻓﺘﺎر ي ﻫﺮ ﯾﮏ ﺑﻪ ﻣﺪت 12 ﺟﻠﺴﻪ، ﺗﺤﺖ درﻣﺎن ﻗﺮار ﮔﺮﻓﺘﻨﺪ. دادهﻫﺎ از ﻃﺮﯾﻖ ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮي ﺗﺤﻠﯿﻞ ﺷﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﮐﻪ ﺑﯿﻦ ﻫﻨﺮ ـ ﺑﺎز ي درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ ـ رﻓﺘﺎر ي و ﻗﺼﻪ درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ ـ رﻓﺘﺎر ي ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل در ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ واﺑ ﺴﺘﻪ ﺑﻪ ﺳﻼﻣﺖ ) 0/001P(. پيشنهاد مي شود هنر- بازي درماني شناختي - رفتاري و قصه درماني شناختي -رفتاري در محيط هاي آموزشي و درماني براي ارتقاء سطح كيفيت زندگي وابسته به سلامت كودكان مبتلا به سرطان مورد استفاده قرار گيرد

Children with cancer need psychological treatment to increase their quality of life along with medical treatments. Accordingly, the aim of this study was to determine the comparing the effectiveness of cognitive-behavioral art-play therapy group and the cognitive-behavioral story therapy on health related quality of life among children with cancer. Materials and Methods The research method was semi-experimental, and research design was three groups with two stages (pre-test and post-test design). From statistical population of 8-12 years old children with cancer in Amir Hospital (Shiraz city, Iran) in the Summer of 2018, 36 children were selected and then randomly assigned in two therapeutic groups (each group with 12 cases) and a control group (with 12 cases). Children Health related Quality of Life Scale (KiD-KINDL-Bullinger & Ravens-Sieberer, 1998) was used to measure the dependent variable in the pretest and post-test. The group of cognitive-behavioral art-play therapy and cognitive-behavioral story therapy received 12 sessions of treatment. The data were analyzed using multivariate analysis of covariance. Results The results showed that there was a significant difference between cognitive-behavioral art-play therapy and cognitive-behavioral story therapy with the control group in health related quality of life (P<0.001) and their components. However, there was no significant difference between cognitive-behavioral art-play therapy and cognitive-behavioral story therapy in increasing the health related quality of life in children with cancer (P>0.05). Conclusion It is suggested that cognitive-behavioral story therapy and cognitive-behavioral art-play therapy should be used in educational and therapeutic environments to promote the level of health related quality of life for children with cancer.