بررسی اثربخشی آموزش خودشفقتی ذهن‌آگاهانه با تاکید بر سبک زندگی اسلامی-ایرانی بر کیفیت زندگی مادران دارای کودک با اختلال اوتیسم

زمینه و هدف: مادران دارای کودک با اختلال اوتیسم سطوح شدیدی از استرس را تجربه می‌کنند که تاثیر منفی بر کیفیت زندگی آن‌ها می‌گذارد. تدوین برنامهٔ مناسب برای بهبود کیفیت زندگی آنان اهمیت دارد؛ بنابراین این پژوهش با هدف بررسی اثربخشی آموزش برنامهٔ خودشفقتی ذهن‌آگاهانه با تاکید بر سبک زندگی اسلامی-ایرانی بر کیفیت زندگی مادران دارای کودک با اختلال اوتیسم انجام شد. روش‌بررسی: پژوهش حاضر از نوع نیمه‌آزمایشی با طرح پیش‌آزمون، پس‌آزمون و پیگیری سه‌ماهه بود. جامعهٔ آماری را تمامی مادران دارای کودک با اختلال اوتیسم در انجمن اوتیسم شهر کاشان در سال 1398 تشکیل دادند. نمونهٔ آماری شامل 24 مادر دارای کودک با اختلال اوتیسم بود که داوطلب مشارکت در مطالعه شدند. به‌روش نمونه‌گیری دردسترس و با جایگزینی تصادفی 12 مادر در گروه آزمایش و 12 مادر در گروه گواه قرار گرفتند. گروه آزمایش به‌مدت هشت جلسه در برنامهٔ آموزش خود‌شفقتی ذهن‌آگاهانه با تاکید بر سبک زندگی اسلامی-ایرانی شرکت کرد و گروه گواه در فهرست انتظار برای آموزش قرار گرفت. برای سنجش کیفیت زندگی از فرم کوتاه پرسشنامهٔ کیفیت زندگی سازمان جهانی بهداشت (1996) استفاده شد. تجزیه‌و‌تحلیل یافته‌های به‌دست‌آمده با استفاده از آزمون‌های تی‌استودنت، خی‌دو، بونفرونی و تحلیل واریانس با اندازه‌گیری مکرر و نرم‌افزار spss نسخهٔ 22 صورت گرفت. سطح معناداری آزمون‌های آماری 0٫05 بود.یافته‌ها: نتایج حاصل از تحلیل داده‌ها نشان داد که آموزش برنامهٔ خودشفقتی ذهن‌آگاهانه با تاکید بر سبک زندگی اسلامی-ایرانی در بهبود مولفه‌های کیفیت زندگی مادران دارای کودک با اختلال اوتیسم یعنی در سلامت جسمانی، سلامت روانی و روابط اجتماعی، عامل گروه (0٫001>p)، عامل زمان (0٫001>p) و تعامل زمان و گروه (0٫001>p) معنادار است و در سلامت محیط، عامل گروه (0٫440=p)، عامل زمان (0٫875=p)و تعامل زمان و گروه (0٫071=p) معنادار نیست؛ همچنین در سلامت جسمانی، سلامت روانی و روابط اجتماعی، تفاوت معناداری بین میانگین‌ها، در مراحل پیش‌آزمون با پس‌آزمون و پیگیری وجود دارد (0٫001≤p).نتیجه‌گیری: باتوجه به یافته‌ها، نتیجه گرفته می‌شود که آموزش برنامهٔ خودشفقتی ذهن‌آگاهانه با تاکید بر سبک زندگی اسلامی-ایرانی در بهبود کیفیت زندگی مادران دارای کودک با اختلال اوتیسم موثر است.

The Effects of Mindful Self-Compassion Training With Focus on the Islamic-Iranian Lifestyle on the Quality of Life Mothers of Children With Autism

Background & Objectives: Autism Spectrum Disorders (ASDs) are neurodevelopmental conditions, i.e., characterized by impairments in domains, such as social interaction and communication across multiple contexts as well as the presence of repetitive and stereotyped behaviors. ASD imposes high stress on parents or caregivers. The stress negatively impacts parents’ Quality of Life (QoL) and coping styles, and disrupts their daily and social functioning. Findings indicate that caregivers, especially the mothers of children with autism, experience a poor QoL. Considering the effects of caregiving for a child with ASD on the family members and particularly parents and their QoL, it is essential to provide a solution to improve their QoL. Therefore, the present study aimed to investigate the effects of mindful self–compassion training with a focus on the Islamic–Iranian lifestyle on the QoL of the mothers of children with ASD.Methods: This was a quasi–experimental study with a pretest–posttest and three–month follow–up and a control group design. The statistical population of the study was all the mothers of children with ASD who were registered in the Autism Association of Kashan City, Iran, in 2019. The statistical sample included 24 mothers who volunteered to participate in the current study. They were divided into two groups of test and control (n=12/group). The inclusion criteria for the mothers were holding high school diploma or higher degrees, being married, not being pregnant, not having respiratory and cardiovascular diseases (according to their medical records), not receiving any psychological or psychiatric treatments (according to their medical and psychological records), and scoring ≤50 in the World Health Organization Quality of Life (WHOQOL–BREF) (1996). Absence in two training sessions and not performing homework assignments were the exclusion criteria for the mothers. To develop a mindful self–compassion program focused on Islamic–Iranian lifestyle, based on the theoretical framework of cognitive–behavioral approach and Islamic teachings, the material was firstly extracted from works of Kabat–Zinn on mindfulness (2003), Neff and Germer on self–compassion (2013), Germer and Neff mindful self–compassion (2020), Gilbert and Procter on the compassionate mind (2006), Kalhori et al.’s mindfulness–based on Islamic–Iranian Teachings (2020), as well as the Islamic sources and texts, the Holy Quran, Nahj al–Balaghah, Bihar al–Anwar, Mizan al–Hikmah, Ghurar al–Hikam, the Masnavi by Rumi, the Divan by Hafez, and Saadi’s Divan. Subsequently, they were organized using the content analysis method and the content and tasks of each session were designed under the supervision of the advisors of this research. To evaluate the content validity, the program was presented to 9 specialists (6 clinical, general, & exceptional children’s psychologists with the academic rank of professor and assistant professor and >10 years of clinical experience, 2 specialist in theology, religions, and mysticism with the academic rank of assistant professor, and 1 Persian literature expert with the academic rank of an assistant professor). After obtaining the opinions of experts and applying them, to quantify the content validity of the program, the Content Validity Ratio (CVR), proposed by Lawshe (1975) and Waltz and Bausell’s Content Validity Index (CVI) (1983) were used per session. The CVR and CVI amounts were approved at 0.78 and 0.88, respectively. The program was first applied to a preliminary single–group study, consisting of 5 mothers of children with ASD, and a poor QoL; then, it was prepared for the final implementation. To measure the explored mothers’ QoL, the WHOQOL–BREF, a short version of QoL, i.e., developed by the World Health Organization was used in the pretest, posttest, and follow–up stages of this study. The experimental group received an 8–session training, one session per week, and each session lasted two and a half hours; the training was performed by the first researcher and the control group remained on a waiting list for training. A 15–minute break was included in all sessions. First, the obtained data were analyzed by descriptive statistical measures, such as mean and standard deviation. The collected data were also analyzed by Student’s t–test, Bonferroni test, Chi–squared test, and repeated–measures Analysis of Variance (ANOVA) in SPSS. The significance level of statistical tests was α=0.05.Results: The repeated–measures ANOVA results for the QoL components indicated that in physical health, mental health, and social relationships, group factor (p<0.001), time factor (p<0.001), and time and group relation (p<0.001) was significant. In environment health, group factor (p=0.440), time factor (p=0.875), and time and group relation (p=0.071) were not significant. The results of Bonferroni post–hoc test suggested a significant difference between the mean scores of physical health, mental health, and social relationships in the pretest and posttest stages (p≤0.001), also in the pretest and follow–up stages (p≤0,001); however, no significant difference was found between the mean scores in the posttest and follow–up stages. Plus, there was no significant difference between the mean values of environment health, in the pretest and posttest stages (p=0.077), as well as the pretest and follow–up stages (p=0.091).Conclusion: The present research findings revealed that the mindful self–compassion with a focus on Islamic–Iranian lifestyle program training was effective in improving the QoL of mothers of children with ASD. Therefore, educational and medical centers can use this training to improve the individual and social functions of the parents and caregivers of children with ASD or other developmental disorders.