پديد آورندگان :
رستمي، زينب دانشگاه اصفهان - دانشكده علوم تربيتي و روانشناسي , عابدي، محمدرضا دانشگاه اصفهان - دانشكده علوم تربيتي و روانشناسي , نيلفروشان، پريسا دانشگاه اصفهان - دانشكده علوم تربيتي و روانشناسي
چكيده فارسي :
زمينه و هدف
پژوهش حاضر با هدف واكاوي پديدار شناختي تجربه زيسته ي مشكلات شغلي بيماران مبتلا به اختلال خلقي دوقطبي انجام شد.
روش كار
مطالعه ي حاضر به روش كيفي و از نوع پديدار شناختي توصيفي تجربه زيسته انجام گرفت. 48 بيمار دوقطبي با استفاده از روش نمونه گيري در دسترس انتخاب شدند. جهت گردآوري داده ها از مصاحبه ي عميق نيمه ساختاريافته و براي تحليل داده ها از روش تحليل موضوعي كلايزي استفاده شد. نتايج تحليل موضوعي در زمينه ي تجربه زيسته ي بيماران دوقطبي در محيط كار منجر به شناسايي 554 كد اوليه يا گزاره مفهومي شد كه اين كدها بر اساس شباهت ها و تفاوت هايشان مورد ارزيابي قرار گرفتند و نهايتا در 14 مقوله فرعي و 3 مقوله اصلي طبقه بندي شدند.
يافته ها
مشكلات شغلي بيماران دوقطبي در برگيرنده ي 14 مقوله فرعي بود كه در قالب 3 مقوله اصلي مشكلات شغلي در سايه ي علايم اختلال دوقطبي (قهر از محيط كار، نياز به استقلال، مشكل زايي، مشكلات مالي، ولنگاري شغلي، بي قيدي در ارتباط با جنس مخالف، افشاي رازهاي شغلي، عدم حفظ حريم و دخالت در كار ديگران، مشكل با صاحبان قدرت)، مشكلات شغلي مرتبط با محيط كاري (احساس ناامني در محيط كار، عدم درك علايم بيماري در محيط كار، دريافت انگ بيماري، استخدام نشدن و كار پاره وقت) و مشكلات شغلي مرتبط با ماهيت كار (چالشي نبودن كار) طبقه بندي شدند.
نتيجه گيري
بررسي تجربه زيسته ي مشكلات شغلي بيماران دوقطبي حاكي از آن است كه به علت خاصيت ناتوان كننده ي اين اختلال در كار، بيش تشخيصي و يا كم تشخيصي اين اختلال و ناكافي بودن درمان هاي روانپزشكي و روان شناختي و اثربخشي ضعيف آن ها بر مشكلات شغلي تاكنون، بهتر است كه سمت و سوي بهبودي و مديريت اين اختلال به سمت رويكردهاي توانبخشي شغلي حركت كند.
چكيده لاتين :
Bipolar disorder is one of the types of mood disorders that due to its fluctuating symptoms and properties, has adverse effects on the work performance of people with it. In fact, work problems are more common among people with bipolar disorder than other people with other mental disorders, and these people are more likely than other people with other mental disorders to quit their works, change works, or quit their works. They lose their work and are often unemployed. Despite the many work problems of bipolar patients and the losses caused by the impact of this disorder on their work, researches are needed to examine these problems in depth; However, no study has been found in Iran that has studied the occupational problems of bipolar patients in depth. Also researches conducted in this field abroad are mainly related to the subject and content of health insurance reports or reports of costs and economic and sociological losses of bipolar disorder and reporting statistics in this field or meta-analysis of researches and no research has not examined the lived experience of these patients in the workplace. Accordingly, the aim of the present study was to analyze the lived experience of people with bipolar disorder in the workplace and to address the question of what is the work problems of patients with bipolar disorder in the workplace.The aim of this study was to phenomenologically analyze the lived experience of wok problems of patients with bipolar disorder.
Methods
In order to investigate the experiences and mental perceptions of patients with bipolar disorder type 2 and type 3 of their work problems, the phenomenological method of lived experience was selected from various qualitative research approaches. 48 bipolar patients participating in the study were selected using the available sampling method. Thus, from people with this disorder who received a diagnosis of type 2 or type 3 bipolar disorder from a psychiatrist and counselor and referred to a counseling clinic for psychological treatment, people who wished to participate in the study were selected. Sampling and interviewing continued until saturation and repetition in the work problems discovered from the content of the interviews were achieved. To collect data from in-depth semi-structured interviews (with questions such as: What are the work problems you have faced in the past or now? What are the factors and issues have been most effective in creating your work problems? What do others think of your work problems? Which of your work problems has been most annoying to you? Which of your work problems has not been solved and persisted? And...) was used. Interviews were conducted at a counseling center. The text of the interview was carefully rewritten and in the next session, the accuracy of the written text of the interview with the patient was examined. Kolaizi thematic analysis method was used to analyze the data. The results of the thematic analysis of the lived experience of bipolar patients in the workplace led to the identification of 554 primary codes or conceptual propositions that were evaluated based on their similarities and differences and finally classified into 14 sub-categories and 3 main categories.
Results
Work problems of bipolar patients included 14 sub-categories which are classified into 3 main categories (work problems due to the symptoms of bipolar disorder, work problems related to the workplace and work problems related to the nature of work). Work problems in the shadow of the symptoms of bipolar disorder, ie problems that cause work problems for a person under the influence of clinical signs and symptoms of the disorder, whose sub-categories are: (sulks from the workplace, independence, creating problem, financial problems, poor work performance, problems with the opposite sex, disclosure of job secrets, lack of privacy and interference in the work of others, problems with those in power), work problems related to the workplace, in fact problems that a bipolar patient has due to This disorder is encountered in the workplace and these problems will exacerbate the symptoms of the disorder and its recurrence. Subcategories of work problems related to the workplace in bipolar patients include: (feeling insecure in the workplace, lack of understanding the symptoms of the disorder in the workplace, get stigmatized disorder, not being employed and part-time job opportunity) and work problems related to the nature of work. Work problems related to the nature of work mean that sometimes the characteristics of the job and its quality become problematic for the patient and create consequences that the sub-category of this problem is classified as (not challenging work).
Conclusion
The lived experience of people with bipolar disorder showed that the work problems of these patients in the workplace fall into three main categories of work problems in the shadow of symptoms of bipolar disorder, work problems related to the workplace and work problems related to the nature of work. Therefore, it seems that in the first step of the intervention, the symptoms of the disorder should be managed by prescribing medication and psychological strategies and the patient should be taught to overcome the symptoms. Naturally, because this disorder is not definitely curable, use rehabilitation counseling approaches to manage the symptoms of the disorder. Also, after managing the symptoms of the disorder, it seems necessary to use career rehabilitation counseling approaches to prevent and correct work-related problems, as well as career planning to solve work problems related to the nature of the selected work. In general, due to the debilitating nature of this work disorder, overdiagnosis or underdiagnosis of this disorder and the inadequacy of psychiatric and psychological therapies and their poor effectiveness on work problems among these patients so far, it is better to improve and manage this disorder towards rehabilitation approaches.
