اثربخشی طرح واره درمانی بر مدیریت حل تعارض زنان دارای افکار خودکشی (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
خودکشی، از مهم ترین شاخص های بهداشت روانی یک جامعه محسوب می شود و عوامل متعدد اقتصادی، اجتماعی، روانی در بروز آن دخیل هستند. این پژوهش با هدف بررسی اثربخشی رویکرد طرح واره درمانی بر مدیریت حل تعارض در زنان دارای افکار خودکشی مراجعه کننده به بیمارستان خورشید اصفهان انجام شد. طرح پژوهش نیمه آزمایشی از نوع پیش آزمون-پس آزمون با گروه کنترل بود. جامعه آماری شامل کلیه زنان دارای افکار خودکشی مراجعه کننده به بیمارستان خورشید در شهر اصفهان بود. نمونه گیری به روش تصادفی ساده انجام شد و 30 زن دارای افکار خودکشی مراجعه کننده به بیمارستان خورشید اصفهان در سال 1400 انتخاب و به صورت تصادفی به گروه های آزمایش و کنترل گمارده شدند. ابزار سنجش شامل پرسشنامه سبک مدیریت تعارض بود. گروه آزمایش در هشت جلسه به صورت هفته ای دو بار بسته آموزشی طرح واره درمانی را دریافت کردند. طول مدت جلسات 90 دقیقه بود. نتایج تحلیل کوواریانس نشان دهنده آن بود که رویکرد طرح واره درمانی بر مدیریت تعارض زنان دارای افکار خودکشی اثربخش بوده است و این رویکرد درمانی توانسته است، ابعاد حل تعارض شامل کنترل، راه حل مداری و عدم رویارویی را در زنان دارای افکار خودکشی در مرحله پس آزمون بهبود بخشد. نتایج پژوهش حاکی از آن بود که رویکرد طرح واره درمانی بر بهبود ارتباطات و مدیریت صحیح شیوه های حل تعارض در زنان دارای افکار خودکشی مؤثر بود؛ درنتیجه با برگزاری جلسات گروهی طرح واره درمانی برای این زنان تا حدودی از این آسیب اجتماعی جلوگیری می شود.The Effectiveness of the Schema Therapy on Conflict Resolution Management in Women with Suicidal Thoughts
Suicide is one of the most important indicators of mental health in a society, and many economic, social, psychological and individual factors are involved in its occurrence. The aim of this research was investigation the effectiveness of schema therapy approach on conflict resolution management in women with suicidal thoughts referred to Khurshid Hospital in Isfahan. The research design was a semi-experimental pre-test post-test type with a control group. The statistical population included all of the women with suicidal thoughts in Isfahan city. Sampling was done by simple random method and 30 women with suicidal thoughts referred to Khurshid Hospital were selected, and randomly assigned to experimental and control groups. The measurement instrument included the Robbins’ Conflict Management Style Questionnaire. The experimental group received package of Young et al’ schema therapy training package in 8 sessions twice a week. The duration of the sessions was 90 minutes. The results of Covariance Analysis showed that schema therapy approach was effective on the conflict management of women with suicidal thoughts and this therapy approach was able to improve the dimensions of conflict resolution styles including control, circuit solution, and non-confrontation. Improve competition in women with suicidal thoughts in the post-test stage. The results indicate that schema therapy approach is effective in improving communication and correct management of conflict resolution in women with suicidal thoughts. As a result, it is possible to prevent this social harm to some extent by holding group therapy sessions for these women. IntroductionSuicide is considered one of the most important indicators of mental health of a society, which is caused by several factors, such as age, gender, marital status, economic factors, family, substance abuse, conflict and divorce between parents, lack of social support, and physical unemployment and Psychological factors, especially depression, are involved in this issue (Kwan et al., 2021). Women constitute almost half of the people in a society, and statistics show that the rate of suicide attempts in women is three times that of men, but the rate of success in suicide is four times that of women (Kochanek & Smith, 2004). People with suicidal thoughts are those who intellectually or in the form of mental rumination are involved with the concepts of suicide, death, worthlessness of life and self, but have not acted on it (Khosravi, 2011). Psychologists believe that suicide is related to weak self-confidence and feelings of emptiness in humans (Chang et al., 2021). However, humans are social creatures, and investigating the causes and social factors of suicide and what happens in interpersonal communication is also of great importance. People have different communication methods, aspirations, political and religious views, and cultural backgrounds. In different societies, the existence of such differences leads to the creation of differences between individuals and groups (Robbins, 1983/2011). Conflict resolution styles are responses or a set of patterned behaviors that people use when dealing with conflict and disagreement (Hocker, 2000). Schema therapy, with the aim of helping to form a healthy mentality, is one of the fundamental methods of psychotherapy to help people face stressful situations and act in the best way to solve the problem (Karkanis et al., 2017). Moazeni et al., (2017) found in their study that schema therapy reduces the intensity of depressive symptoms and suicidal thoughts in patients with resistant depression. The research results of Wojcik et al., (2022) showed that schema therapy reduced depressive symptoms and improved maladaptive schemas in patients with post-traumatic stress disorder (Wojcik et al., 2022). Regarding the relationship between schema therapy and conflict resolution management, Alami et al.'s research (2019) showed that schema therapy has led to the reduction of conflicts in couples applying for divorce. Also, Qanatir's research (2021) showed that schema therapy improves conflict resolution styles and increases empathy in conflicted couples. This research was aimed at this goal; Determining the effectiveness of the schema therapy approach on conflict resolution management methods (including control, circuit solution and non-confrontation) in women with suicidal thoughts referring to Khorshid Shahr Hospital in Isfahan. MethodThe design of this research was a semi-experimental pre-test-post-test type with a control group. Sampling was done by simple random method and 30 women with suicidal thoughts referred to Khorshid Hospital of Isfahan in 1400 were selected and randomly assigned to experimental and control groups. The experimental group received schema therapy intervention (Young et al., 2003) for 8 sessions of 90 minutes twice a week, and the control group did not receive any intervention. Robbins’ Conflict Management Style Questionnaire (1994): This questionnaire was created by Robbins in 1994 and has 30 questions and five conflict management methods in the dimensions of control strategy (competition), non-confrontation and non-confrontation (avoidance) and solution orientation (cooperation and compromise) in a 7-option Likert scale. It measures from always=1 to never=7 (Robbins, 1994). ResultsDescriptive findings including the mean and standard deviation of the conflict management variable and its dimensions (control, orbital solution and non-confrontation) in the pre-test and post-test phases for the experimental and control groups are given in Table 1. Table 1. Mean, standard deviation of conflict management and its dimensions in experimental and control groupsControlExamination Statistical indicatorsSubscalesStandard deviationAverageStandard deviationAveragethe level21/35115/9319/31115/66Pre- testconflict resolution20/56115/8016/88127/86Post-test9/2727/809/0827/93Pre- testcontrol9/2827/936/3731/33Post-test14/5341/3311/4841/13Pre- testcircuit solution14/0341/4010/1245/60Post-test12/1646/808/6646/60Pre- testnon-confrontation12/0946/466/6750/93Post-test Before univariate covariance analysis, scores of conflict management variables and its dimensions were tested for normality and homogeneity of variances. The results of the Kolmgrove-Smirnov test showed that the variables of conflict management and dimensions of control, orbital solution and non-confrontation were significantly 0.2, 0.2, 0.09 and 0.2 in the experimental group and 0.2, 0.2 respectively. 0, 0.2 and 0.1 in the control group, which are all higher than 0.05, have a normal distribution. Also, the results of Levin's test showed that the variables of conflict management and dimensions of control, orbital solution and non-confrontation with significance of 0.199, 0.051, 0.057 and 0.151 respectively, which are all higher than 0.05. They have the homogeneity of variances in both experimental and control groups.The findings of covariance analysis showed that there is a significant difference between the women of the experimental and control groups at the level of P<0.001 and P<0.05 in the two stages of pre-test and post-test regarding the general variable of conflict resolution management methods and its dimensions including control, circuit solution and non-confrontation and considering that the average score of conflict resolution management and its dimensions in the experimental group is higher than the average of the control group in the post-test, this difference is in favor of the experimental group. That is, the schema therapy approach has been able to improve conflict management and its dimensions in women with suicidal thoughts referring to Khorshid Hospital in Isfahan in the post-test phase, and the amount of this effect for the variables of conflict resolution management, control, circuit solution and non-confrontation It was equal to 0.47, 0.205, 0.254 and 0.582 respectively (P>0.001) and (P>0.05). Table 2. Results of Univariate covariance analysis (ANCOVA) for the effect of schema therapy on conflict management and its dimensionsVariableSourceSum of SquaresdfMean SquareFSigEtaStatistical Powerconflict resolutionPre- test8384.69018384.690162.9810.0010.8671Post-test1131.99111131.99122.0040.0010.4680.995controlPre- test1011.41211011.41280.3110.0010.7631Post-test81.326181.3266.4580.0180.2050.685circuit solutionPre- test2989.54612989.546176.1810.0010.8761Post-test144.4621144.4628.5130.0070.2540.801non-confrontationPre- test2058.61912058.619442.6920.0010.9471Post-test161.7351161.73534.7800.0010.5821 Discussion and conclusionThis research was conducted with the aim of determining the effectiveness of the schema therapy approach on conflict resolution management methods and its dimensions in women with suicidal thoughts referring to Khorshid Hospital in Isfahan. The findings showed that schema therapy intervention has a positive effect on conflict resolution management and its dimensions including control (competition), circuit solution (cooperation and compromise) and non-confrontation (avoidance) (Table 1). These findings are consistent with the results of scientific researches by Alami et al. (2019); Qanatir (2021); Ghovati et al. (2017); Moazeni et al. (2018); Arora (2021); and Wojcik et al., (2022). Usually, the inconsistent nature of schemas appears when people act in their life process and in interaction with others in such a way that their schemas are confirmed, even if their initial impression is incorrect (Tashke et al., 2018). In explaining the effectiveness of the educational intervention of schema therapy on the conflict resolution management of women with suicidal thoughts referring to Khorshid Hospital, Isfahan, it can be said that this perspective, by providing and facilitating insight into the deep roots of current behaviors in these women, increases their awareness and insight into the importance of schemas and Their role increases in maintaining interpersonal problem-causing situations. These people by clarifying the evolutionary roots of each schema, these people realize that the cause of their current behavior is the thoughts and attitudes that have been created in them before and can be changed with training and special solutions. As a result of these findings, it can be explained that schema therapy causes conflict resolution management in women with suicidal thoughts. One of the limitations of this research is that the statistical community and sample of this research is limited to women with suicidal thoughts referring to Khurshid Shahr Hospital in Isfahan, as a result, caution should be observed in generalizing the results to other women and communities. Based on the results of this research, it is recommended that schema therapy workshops and sessions be held for women with suicidal thoughts referring to Khurshid Hospital, and by improving the schemas and communication skills of these women, an effective step can be taken to help ensure the health of the society.
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