مقایسه سیستم های مغزی-رفتاری در بیماران قبل و بعد از جراحی قلب باز

زﻣﯿﻨﻪ و ﻫﺪف ﺟﺮاﺣﯽ ﻗﻠﺐ ﯾ ﮑﯽ از ﻣﻬﻢ ﺗﺮﯾﻦ اﻋﻤﺎل ﺟﺮاﺣﯽ اﺳﺖ ﮐﻪ اﯾﻦ روزﻫﺎ ﺑﻪ ﻓﺮاواﻧﯽ اﻧﺠﺎم ﻣﯽﺷﻮد. ﻫﺪف از ﭘﮋوﻫﺶ ﺣﺎﺿﺮ، ﻣﻘﺎﯾﺴﻪ ﺳﯿﺴﺘﻢﻫﺎی ﻣﻐﺰی- رﻓﺘﺎری در اﻓﺮاد، ﻗﺒﻞ و ﺑﻌﺪ از ﻋﻤﻞ ﺟﺮاﺣﯽ ﻗﻠﺐ ﺑﺎز ﻣﯽ ﺑﺎﺷﺪ. ﻣﻮاد و روشﻫﺎ ﭘﮋوﻫﺶ ﺣﺎﺿﺮ از ﻧﻮع ﻣﻄﺎﻟﻌﺎت ﺗﻮﺻﯿﻔﯽ ﺑﺎ روش ﻋﻠﯽ ﻣﻘﺎﯾﺴﻪای و ﭘﺲ روی دادی ﺑﺎ روش ﻧﻤﻮﻧﻪ ﮔﯿﺮی ﻫﺪﻓﻤﻨﺪ ﺑﻮد. ﺟﺎﻣﻌﻪ آﻣﺎری ﭘﮋوﻫﺶ ﺷﺎﻣﻞ 210 ﻧﻔﺮ ﮐﻪ 70ﻧﻔﺮ ﺗﺤﺖ ﺟﺮاﺣﯽ ﻗﻠﺐ ﺑﺎز ﻗﺮار ﮔﺮﻓﺘﻪ اﻧﺪ، 70ﻧﻔﺮ داوﻃﻠﺐ ﺟﺮاﺣﯽ ﻗﻠﺐ ﺑﺎز و 70ﻧﻔﺮ ﺑﺎ ﺳﺎﺑﻘﻪ ﺑﯿﻤﺎر ی ﻗﻠﺒﯽ ﺑﻮدﻧﺪ. در اﯾﻦ ﭘﮋوﻫﺶ داده ﻫﺎ از ﻃﺮﯾﻖ ﭘﺮﺳﺶ ﻧﺎﻣﻪ ﺟﻤﻌﯿﺖ ﺷﻨﺎﺧﺘﯽ و ﻧﯿﺰ ﭘﺮﺳﺶ ﻧﺎﻣﻪ ﺷﺨﺼﯿﺘﯽ ﮔﺮی- وﯾﻠﺴﻮن ﺟﻤﻊ آوری ﺷﺪﻧﺪ. ﺳﭙﺲ ﺑﻪﻣﻨﻈﻮر ﺗﺠﺰﯾﻪوﺗﺤﻠﯿﻞ آﻧﻬﺎ از ﻣﺪل ﻫﺎی آﻣﺎری ﺗﺤﻠﯿﻞ وارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮ ی و ﺗﮏ ﻣﺘﻐﯿﺮی اﺳﺘﻔﺎده ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﺑﯿﻤﺎراﻧﯽ ﮐﻪ داوﻃﻠﺐ ﻋﻤﻞ ﺟﺮاﺣﯽ ﻗﻠﺐ ﺑﺎز ﻫﺴﺘﻨﺪ ﻧﺴﺒﺖ ﺑﻪ ﺑﯿﻤﺎراﻧﯽ ﮐﻪ ﺟﺮاﺣﯽ ﺷﺪه اﻧﺪ و ﮔﺮوه ﮐﻨﺘﺮل ﻧﻤﺮات ﺑﺎﻻﺗﺮی در ﻣﻘﯿﺎس ﻓﻌﺎل ﺳﺎزی رﻓﺘﺎری ﮐﺴﺐ ﮐﺮدﻧﺪ. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﯾﺎﻓﺘﻪﻫﺎ ﻣﯿﺎن ﺳﻪ ﮔﺮوه، در ﻣﺆﻟﻔﻪ ﺑﺎزداری رﻓﺘﺎری اﺧﺘﻼف ﻣﻌﻨﺎداری وﺟﻮد دارد. ﺑﯿﻤﺎراﻧﯽ ﮐﻪ ﻋﻤﻞ ﺟﺮاﺣﯽ داﺷﺘﻪاﻧﺪ، ﻧﻤﺮات ﮐﻤﺘﺮی در اﺟﺘﻨﺎب ﻓﻌﺎل داﺷﺘﻨﺪ و اﻓﺮادی ﮐﻪ ﻋﻤﻞ ﺟﺮاﺣﯽ ﻗﻠﺐ ﺑﺎز ﺷﺪهاﻧﺪ ﻧﺴﺒﺖ ﺑﻪ ﺑﯿﻤﺎراﻧﯽ ﮐﻪ داوﻃﻠﺐ ﺟﺮاﺣﯽ ﻫﺴﺘﻨﺪ و ﮔﺮوه ﮐﻨﺘﺮل، ﻧﻤﺮات ﺑﺎﻻﺗﺮی در ﺧﺮده ﻣﻘﯿﺎس ﺧﺎﻣﻮﺷ ﯽ ﮐﺴﺐ ﮐﺮده اﻧﺪ. ﻧﺘﯿﺠﻪ ﮔﯿﺮی: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﮐﺎﻫﺶ ﻋﻤﻠﮑﺮد ﺳﯿﺴﺘﻢ ﻓﻌﺎل ﺳﺎزی رﻓﺘﺎری و اﻓﺰاﯾﺶ ﻋﻤﻠﮑﺮد ﺳﯿﺴﺘﻢ ﺑﺎزداری رﻓﺘﺎری ﻣﺪاﺧﻼت ﻣﺒﺘﻨﯽ ﺑﺮ ﻓﻌﺎل ﺳﺎزی رﻓﺘﺎری زﯾﺮ ﻧﻈﺮ ﻣﺘﺨﺼﺼﺎن ﺑﺎﻟﯿﻨﯽ ﺑﺮای اﯾﻦ ﺑﯿﻤﺎران ﺑﺮﻧﺎﻣﻪرﯾﺰی و اﺟﺮا ﺷﻮد.

The Comparing of brain/behavioral systems in patients before and after open heart surgery

Introduction: The aim of this study is to compare the brainbehavioral systems in people before and after openheart surgery.Method:The present research is a descriptive study with a comparative and retrospective causal method with purposeful sampling. The statistical population of the study includes 210 people, encompassing 70 people who underwent openheart surgery, 70 volunteered for openheart surgery and 70 other with a history of heart diseases. the information was collected in addition to the demographic questionnaire through the GrayWilson personality questionnaire. Then, in order to analyze the collected data, statistical models of multivariate and univariate analysis of variance were used.Results: The results showed that, patients candidate for openheart surgery scored higher than patients who underwent surgery and the control group in behavioral activation measure. According to the findings in the behavioral inhibition component, there is a significant difference between the three groups. Patients who underwent surgery received the minimum scores in active avoidance, further people who underwent openheart surgery received lower scores than patients who were candidate for surgery and the control group in extinction measurement.Conclusion:Therefore, due to the decrease in the performance of the behavioral activation system and the increase in the performance of the behavioral inhibition system, behavioralactivationbased interventions under the supervision of psychologists should be planned and implemented for these patients.