ﺗﺄﺛﻴﺮ آﻣﻮزش رواﻧﻲ ﺑﺮ ﺗﺎب آوري و ﻛﻨﺘﺮل ﺧﺸﻢ ﻛﺎرﻛﻨﺎن ﻓﻮرﻳﺖ ﻫﺎي ﭘﻴﺶ ﺑﻴﻤﺎرﺳﺘﺎﻧﻲ: ﻳﻚ ﻣﻄﺎﻟﻌﻪ ﻧﻴﻤﻪ ﺗﺠﺮﺑﻲ

The effect of psycho-education on resilience and anger control among pre-hospital emergency staff: A quasi-experimental study

ﻨﻪ و ﻫﺪف: ﻓﻮرﻳﺖ ﻫﺎي ﭘﻴﺶ ﺑﻴﻤﺎرﺳﺘﺎﻧﻲ ﻳﻜﻲ از ﭘﺮ اﺳﺘﺮس ﺗﺮﻳﻦ ﺣﺮﻓﻪ ﻫﺎي ﭘﺰﺷـﻜﻲ اﺳـﺖ . ﻣﺸـﺎﻏﻞ ﭘـﺮ اﺳﺘﺮس ﺑﺮ ﺗﺎب آوري و ﺗﻮاﻧﺎﻳﻲ ﻛﻨﺘﺮل ﺧﺸﻢ ﻛﺎرﻛﻨﺎن ﺗﺄﺛﻴﺮ ﻣﻲ ﮔﺬارﻧﺪ. ﻟﺬا ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿـﺮ ﺑـﺎ ﻫـﺪف ﺗﻌﻴـﻴﻦ ﺗﺄﺛﻴﺮ آﻣﻮزش رواﻧﻲ ﺑﺮ ﻣﻴﺰان ﺧﺸﻢ و ﺗﺎب آوري ﻛﺎرﻛﻨﺎن ﻓﻮرﻳﺖ ﻫﺎي ﭘﻴﺶ ﺑﻴﻤﺎرﺳﺘﺎﻧﻲ اﻧﺠﺎم ﮔﺮﻓﺘﻪ اﺳﺖ. روش ﺑﺮرﺳﻲ: در اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻧﻴﻤﻪ ﺗﺠﺮﺑﻲ ﺗﻌﺪاد 120 ﻧﻔﺮ از ﻛﺎرﻛﻨﺎن ﻓﻮرﻳﺖ ﻫﺎي ﭘﻴﺶ ﺑﻴﻤﺎرﺳﺘﺎﻧﻲ ﺷﻬﺮ زاﻫﺪان ﺷﺮﻛﺖ ﻧﻤﻮدﻧﺪ. اﻓﺮاد واﺟﺪ ﺷﺮاﻳﻂ در ﭘﺎﻳﮕﺎه ﻫﺎي ﺷﻬﺮي و ﺟﺎده اي ﺣﻮزه ﺷﻬﺮ زاﻫﺪان ﺑـﻪ ﺷـﻴﻮه در دﺳـﺘﺮس وارد ﻣﻄﺎﻟﻌﻪ ﺷﺪﻧﺪ. ﺑﺮاي ﺗﻌﻴﻴﻦ ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﻛﻨﺘﺮل از ﻣﻴﺎن 24 ﭘﺎﻳﮕﺎه ﻣﻮﺟﻮد ﺑﻪ ﺷﻴﻮه ﺗﺼﺎدﻓﻲ 12 ﭘﺎﻳﮕﺎه در ﮔﺮوه ﻣﺪاﺧﻠﻪ و 12 ﭘﺎﻳﮕﺎه در ﮔﺮوه ﻛﻨﺘﺮل ﻗﺮار ﮔﺮﻓﺘﻨﺪ. اﺑﺘـﺪا ﻓـﺮم اﻃﻼﻋـﺎت ﻓـﺮدي و ﭘﺮﺳﺸـﻨﺎﻣﻪ ﻫـﺎي ﺧﺸـﻢ و ﺗﺎب آوري ﺗﻮﺳﻂ ﻫﺮ دو ﮔﺮوه ﺑﻪ ﺻﻮرت ﺧﻮدﮔﺰارش دﻫﻲ ﺗﻜﻤﻴﻞ ﺷﺪ. ﺳﭙﺲ ﮔﺮوه ﻣﺪاﺧﻠﻪ ﺑﻪ ﺻﻮرت ﮔﺮوه ﻫﺎي 12- 8 ﻧﻔﺮي در 5 ﺟﻠﺴﻪ آﻣﻮزش رواﻧﻲ ﺷﺮﻛﺖ ﻛﺮدﻧﺪ. ﭘﺮﺳﺸﻨﺎﻣﻪ ﻫـﺎ دو ﻣـﺎه ﺑﻌـﺪ از ﻣﺪاﺧﻠـﻪ در ﻫـﺮ دو ﮔـﺮوه دوﺑﺎره ﺗﻜﻤﻴﻞ ﺷﺪ. ﺗﺤﻠﻴﻞ داده ﻫﺎ در ﻧﺮم اﻓﺰار SPSS ﻧﺴﺨﻪ 16 و ﺑﺎ اﺳﺘﻔﺎده از آﻣﺎر ﺗﻮﺻﻴﻔﻲ )ﻣﻴﺎﻧﮕﻴﻦ و اﻧﺤﺮاف ﻣﻌﻴﺎر( و اﺳﺘﻨﺒﺎﻃﻲ )آزﻣﻮنﻫﺎي ﻛﺎي دو، ﺗﻲ ﻣﺴﺘﻘﻞ، ﺗﻲ زوﺟﻲ( اﻧﺠﺎم ﮔﺮﻓﺖ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﻧﺘﺎﻳﺞ آزﻣﻮن ﺗﻲ ﻣﺴﺘﻘﻞ ﻧﺸﺎن داد ﻛﻪ ﻣﻴﺎﻧﮕﻴﻦ و اﻧﺤﺮاف ﻣﻌﻴﺎر ﻧﻤﺮه ﺗﺎب آوري ﻛﺎرﻛﻨﺎن ﻓﻮرﻳﺖ ﻫﺎي ﭘﻴﺶ ﺑﻴﻤﺎرﺳﺘﺎﻧﻲ در ﺑﻴﻦ دو ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﻛﻨﺘﺮل ﻗﺒﻞ از ﻣﺪاﺧﻠﻪ ﺗﻔﺎوت ﻣﻌﻨﺎدار ﻧﺪاﺷﺘﻪ اﺳـﺖ )0/492=p( وﻟﻲ ﭘﺲ از ﻣﺪاﺧﻠﻪ ﺗﻔﺎوت ﻣﻌﻨﺎدار ﻣﺸﺎﻫﺪه ﺷﺪه اﺳﺖ )0/009=p(. ﻫﻤﭽﻨﻴﻦ ﻧﺘﺎﻳﺞ آزﻣﻮن ﺗﻲ ﻣﺴـﺘﻘﻞ ﻧﺸـﺎن داد ﻛﻪ ﻣﻴﺎﻧﮕﻴﻦ و اﻧﺤﺮاف ﻣﻌﻴﺎر ﻧﻤﺮه ﻛﻨﺘﺮل ﺧﺸﻢ ﻛﺎرﻛﻨﺎن ﻓﻮرﻳﺖ ﻫﺎي ﭘﻴﺶ ﺑﻴﻤﺎرﺳﺘﺎﻧﻲ دو ﮔﺮوه ﻣﺪاﺧﻠـﻪ و ﻛﻨﺘﺮل ﻗﺒﻞ از ﻣﺪاﺧﻠﻪ ﺗﻔﺎوت ﻣﻌﻨﺎداري ﺑﺎ ﻫﻢ ﻧﺪاﺷﺘﻪ اﺳﺖ )0/672=p( وﻟﻲ ﭘـﺲ از ﻣﺪاﺧﻠـﻪ ﻣﻴـﺰان آن در ﮔﺮوه ﻣﺪاﺧﻠﻪ ﺑﻪ ﻃﻮر ﻣﻌﻨﺎداري از ﮔﺮوه ﻛﻨﺘﺮل ﺑﻴﺶ ﺗﺮ ﺑﻮد )p<0/001(. ﻧﺘﻴﺠﻪ ﮔﻴﺮي: ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﻧﺸﺎن داد آﻣﻮزش رواﻧﻲ، ﺗﺎب آوري ﻛﺎرﻛﻨﺎن ﻓﻮرﻳﺖ ﻫـﺎي ﭘـﻴﺶ ﺑﻴﻤﺎرﺳـﺘﺎﻧﻲ را ارﺗﻘﺎ داده اﺳﺖ و ﺑﺎ ارﺗﻘـﺎ ي آن ﻛﺎرﻛﻨـﺎن ﺗﻮاﻧﺴـﺘ ﻪ اﻧـﺪ ﺧﺸـﻢ ﺧـﻮد را ﻛﻨﺘـﺮل ﻧﻤﺎﻳﻨـﺪ . ﭘﻴﺸـﻨﻬﺎد ﻣـﻲ ﺷـﻮد در ﺑﺮﻧﺎﻣﻪ ﻫﺎي آﻣﻮزش ﺿﻤﻦ ﺧﺪﻣﺖ ﻛﺎرﻛﻨﺎن ﻓﻮرﻳﺖ ﻫﺎي ﭘﻴﺶ ﺑﻴﻤﺎرﺳﺘﺎﻧﻲ، ﺑﺮﻧﺎﻣﻪ آﻣﻮزش رواﻧﻲ ﺑـﺮاي ارﺗ ﻘـ ﺎي ﺗﺎب آوري و ﻛﻨﺘﺮل ﺧﺸﻢ آﻧﺎن ﻛﻪ در ﺑﺎ ﻣﻮﻗﻌﻴﺖ ﻫﺎي ﭘﺮ ﺗﻨﺶ ﻓﺮاواﻧﻲ رو ﺑﻪ رو ﻣﻲ ﺷﻮﻧﺪ ﻟﺤﺎظ ﺷﻮد.

Background & Aim: Pre-hospital emergencies are one of the most stressful medical professions. Stressful jobs affect employees’ resilience and their ability to control anger. The aim of this study is to determine the effect of psycho-education on the level of anger and resilience among pre-hospital emergency staff. Methods & Materials: In this quasi-experimental study, 120 people employed in urban and road centers in Zahedan were included through the convenience sampling method. To determine the intervention and control group, out of 24 available centers, 12 centers were randomly assigned to the intervention group and 12 centers to the control group. First, a demographic information form and the self-reported anger and resilience questionnaires were completed by both groups. Then, the intervention group participated in five sessions of psycho-education in groups of 8-12 people. The questionnaires were completed again by both groups two months after the intervention. Data was analyzed by the SPSS software version 16 using descriptive (mean and standard deviation) and inferential statistics (Chi-square test, independent t-test and paired t-test). Results: The results of independent t-test showed no significant difference in the mean and standard deviation of resilience score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.492), but after the intervention the difference was significant (P=0.009). Also, the results of independent t-test showed no significant difference in the mean and standard deviation of anger control score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.672), but after the intervention, mean and standard deviation of anger control score in the intervention group were significantly higher than those of in the control group (P<0.001). Conclusion: The present study showed that psycho-education improved the resilience of emergency workers, and the employees were able to control their anger by enhancing resilience. It is suggested that in-service training programs for pre-hospital emergency staff include a psycho-education program to enhance resilience and control anger in those who face many stressful situations.