مدل ساختاری دردهای شکمی روان تنی کودکان 10 تا 12 سال بر اساس رابطه والد کودک و یادگیری اجتماعی بامیانجی گری مهارت های سازگاری

نوع مقاله : مقاله پژوهشی

نویسندگان
سمیه معینی نسب 1
مجتبی انصاری شهیدی 2
حمیدرضا نیکیار 3
حسین صانعیان 4
امیرمحسن راه نجات 5
1 دانشجوی دکتری روانشناسی، گروه روانشناسی سلامت، دانشکده پزشکی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران
2 استادیار، گروه روانشناسی سلامت، دانشکده پزشکی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران
3 استادیار، مرکز توسعه پژوهش های بالینی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران
4 استادیار، مرکز تحقیقات رشد و نمو کودکان، دانشگاه علوم پزشکی اصفهان، ایران.
5 استادیار، گروه روانشناسی بالینی، دانشکده پزشکی، دانشگاه علوم پزشکی آجا، تهران، ایران.
10.22034/pjms.2024.2031256.1143
چکیده
مقدمه: بیماری های مزمن مانند دردهای عملکردی شکم در کودک علاوه بر علایم جسمی، تغییرات روانی را ایجاد می کند که می تواند آسیب های ناشی از این بیماری را افزایش دهد. پژوهش حاضر با هدف بررسی دردهای شکمی روان تنی کودکان 10 تا 12 سال بر اساس رابطه والد کودک و یادگیری اجتماعی با میانجی گری مهارت های سازگاری انجام شد.
روش کار: روش تحقیق حاضر مقطعی و معادلات ساختاری بود. جامعه آماری شامل کلیه کودکان 10 تا 12 ساله مبتلا به اختلال درد عملکردی شکم شهر اصفهان در سال 1401-1402 بود. تعداد 179 کودک به روش نمونه گیری در دسترس از کلینیک های تخصصی اختلالات گوارشی شهر اصفهان بر اساس معیارهای ورود انتخاب شدند. ابزار جمع آوری داده ها شامل پرسشنامه های رابطه والد-کودک، یادگیری رفتارهای درد والدین فرم کوتاه، پرسشنامه رفتارهای مقابله ای کودکان (CCBQ) و شاخص تجدیدنظر شده درد شکم بود. تجزیه و تحلیل داده ها با کمک روش آماری معادلات ساختاری در نرم افزار SMART PLS-4 استفاده شد.
یافته ها: یافته ها نشان داد که مهارت های سازگاری می تواند به طور غیرمستقیم و به طور معناداری رابطه بین والد -کودک و یادگیری اجتماعی با دردهای شکمی عملکردی کودکان را میانجی گری کند (0.05>P). مسیرهای رگرسیونی مستقیم رابطه والد- کودک و کنارآمدن ویرانگر به دردهای شکمی به ترتیب برابر با 0.17- و 0.24- و همچنین مسیرهای مستقیم رابطه والد-کودک و یادگیری اجتماعی به کنار آمدن با مشکل به ترتیب برابر با 0.34 و 0.23 بود که معنادار گزارش شد (0.05>P). از بین شش مسیر غیرمستقیم با میانجی گری نقش سه سبک سازگاری رفتاری، تنها دو مسیر غیرمستقیم رابطه والد کودک و کنارآمدن با مشکل دردهای شکمی با ضریب رگرسیونی برابر با 0.080- و 2.23=t، و یادگیری اجتماعی و کنارآمدن ویرانگر یا دردهای شکمی با ضریب رگرسیونی برابر با 0.050 و 1.99= t از لحاظ آماری معنادار بود (0.05>P).
نتیجه گیری: وجود ارتباط مثبت و سالم بین والد و کودک به عنوان یک عامل محافظتی در برابر دردهای شکمی عملکردی عمل می کند. ایجاد یک فضای باز برای بیان احساسات و نیازهای آن ها و ارائه حمایت و پشتیبانی مناسب توسط والدین می تواند به بهبود مشکلات عاطفی، روانی و اجتماعی کودکان کمک کند.
کلیدواژه‌ها
درد شکمی عملکردی
رابطه کودک -والد
مهارت های سازگاری
یادگیری اجتماعی

عنوان مقاله English

Structural model of psycho-somatic abdominal pain in 10-12-year-old children based on parent-child relationship and social learning with the mediation of adaptation skills

نویسندگان English

Somayeh Moini Nasab 1
Mojtaba Ansari Shahidi 2
Hamid Reza Nikyar 3
Hosein Saneian 4
Amir Mohsen Rah Nejat 5
1 PhD student in psychology, Department of Health Psychology, Faculty of Medicine, Najafabad Branch, Islamic Azad University, Najafabad, Iran
2 Department of Health Psychology, Faculty of Medicine, Najafabad Branch, Islamic Azad University, Najafabad, Iran
3 Assistant Professor, Clinical Research Development Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
4 Assistant Professor, Children's Growth and Development Research Center, Isfahan University of Medical Sciences, Iran
5 Assistant Professor, Department of Clinical Psychology, Faculty of Medicine, University of Medical Sciences of the Islamic Republic of Iran Army, Tehran, Iran.
چکیده English

Introduction: Chronic diseases such as functional abdominal pain in children cause psychological changes in addition to physical symptoms, which can increase the damage caused by this disease. Therefore, the necessity of research in the field of examining the psychological factors of these patients in order to increase their mental health is significant. The present study was conducted with the aim of determining the mediating role of adaptation skills in explaining the relationship between parent-child relationship and social learning in functional abdominal pain in 10-12-year-old children.
Materials & Methods: The current research method was cross-sectional and structural equations type. The statistical population of the study included all children aged 10 to 12 years with functional abdominal pain disorder in Isfahan city in 1402. A number of 179 children were selected from the specialized clinics of digestive disorders in Isfahan based on the inclusion criteria. Data collection tools include parent-child relationship questionnaires (Pianta, 2011), learning parental pain behaviors short form, Stone, Children's Coping Behavior Questionnaire (CCBQ) and the revised abdominal pain index. To test the hypotheses, the statistical method of structural equations was used in SMART PLS-4 software.
Results: The findings of the present study showed that adaptation skills can indirectly and significantly mediate the relationship between parent-child and social learning with children's functional abdominal pain (P<0.05). The direct regression paths of parent-child relationship and destructive coping with abdominal pain are equal to -0.17 and -0.24, respectively, and the direct paths of parent-child relationship and social learning to cope with the problem are equal to 0.34 and 23, respectively. It is 0.05 which is significant at the 0.05 level. Out of the six indirect paths with the mediation of the role of three behavioral adjustment styles, only two indirect paths parent-child relationship coping with the proble ، abdominal pains with regression coefficient equal to - 0.080 and t=2.23 and social learning، destructive coping ، Abdominal pains with a regression coefficient equal to 0.050 and t=1.99 are at the p<0.05 level, which is statistically significant. This means that the strategy of coping with the problem has an indirect and meaningful effect on the child's parent's relationship and social learning with children's abdominal pain and can play a mediating role.
Conclusion: Having a positive and healthy relationship between parent and child acts as a protective factor against functional abdominal pain.Creating an open space to express their feelings and needs and providing appropriate support by parents can help improve children's emotional, psychological and social problems

کلیدواژه‌ها English

Functional Abdominal Pain
Child-Parent Relationship
Adaptation Skills
Social Learning
1. Rouhani N, Jalali MR, Mousavi AM. Relationship
between personality traits, attachment and parenting
styles of parents with children's physical health. J
Child Mental Health. 2019; 6 (3): 215-27. [Persian]
2. Khatchadourian, M. The influence of a social skills
program on children's social behaviour, affective
perspective-taking, and empathy skills. Thesis.
Concordia University: 2010.
3. Brett T, Rowland M, Drumm B. An approach to
functional abdominal pain in children and
adolescents. General Practitioners. 2021; 62(600):
386–7.
4. Qomian S, Shoairi MR. Effectiveness of Acceptance
and Commitment Therapy for Children with Chronic
Pain (CHACT) on internalizing symptoms in 7- to 12-
year-old children with chronic pain. Clinical Psychol
Stud. 2017; 8(29): 1-19.
5. American Psychiatric Association. Diagnostic and
Statistical Manual of Mental Disorders DSM-5 2019
Update. Savalan Publisher: 2017.
6. Clinical Hypnosis in Children. Handbook of Pediatric
Chronic Pain. Current Science and Integrative
Practice. 2011; 303-14.
7. Alfvén RGJ. Psychosomatic pain in children: A
psychomuscular tension reaction? Pain. 2012; 1: 5-14.
8. Meyre M, Gold S, Bielefeld K, Zeltzer L,lockner J.
Functional gastrointestinhbal abdominal pain in
adolescence biopsychosocial phenomenon.. Pain.
2008; 9(11): 984-90.
9. Walker SM. Neuropathic pain in children: Steps
towards improved recognition and management.
EBioMedicine. 2020;62:103124.
10. Logan DE, Donado C, Kaczynski K, Lebel A,
Schechter N. From One Pain to Many: The Emergence
of Overlapping Pains in Children and Adolescents.
Clin J Pain. 2021;37(6):404-12.
11. Baiba M, Carmel C, Conte E. Social-Emotional
Skills, Behavioural Problems and Learning Outcomes
of Elementary School Children. 2023.
12. Danielle R, Kleckner N. Social Learning Theory.
2014.
13. Weitzman M. Social Influences on Child Health.
Pediatr Rev. 2021 Jul;42(7):402-4.
14. Stone AL, Bruehl S, Smith CA, Garber J, Walker
LS. Social learning pathways in the relation between
parental chronic pain and daily pain severity and
functional impairment in adolescents with functional
abdominal pain. Pain. 2018; 159(2): 298–305.
15. Agnes K, Gasto F, Tumaini N, Ave Maria S,
Deodatus K. Coping strategies available for women
living with HIV/AIDS experiencing intimate partner
violence in the Singida region, Tanzania. Com Med
Public Health. 2021; 8(6):2658-64.
16. Ansari M, Mahmoudi A. The relationship between
emotional intelligence, religious beliefs and coping
strategies with marital satisfaction of physically
disabled people in Shiraz. Psychol Sci. 2016; 2 (3): 79-
2. [Persian]
17. Abby D, Adler Laren R, Conklin Daniel R, Strunk
D. Quality of coping skills predicts depressive
symptom reactivity over repeated stressors. Clin
Psychol. 2013; 2:18-23.
18. Li C, Jiang S, Fan X, Zhang Q. Exploring the impact
of marital relationship on the mental health of
children: Does parent-child relationship matter?
Health Psychol. 2020; 25(10-11): 1669–8077.
19. Driscoll K, Pianta RC. Mothers' and Fathers'
Perceptions of Conflict and Closeness in Parent-Child
Relationships during Early Childhood. Early Child
Infant Psychol 2011; 7.
20.Tabachnick BG, Fidell LS. Using multivariate
statistics (4th ed). Boston: 2007.
21. Satorian A, Tahmasian K, Ahmadi MR. The role of
parenting dimensions and parent-child relationship in
children's internalized and externalized behavioral
problems. Family Res 2016; 12(4): 683-705. [Persian]
22. Walker LS, Smith CA, Garber J, Van Slyke DA.
Development and validation of the pain response
inventory for children. Psychol Assess. 1997; 9:392-
405.
23. Falahi M, Kafi M, Khosro Javid M, Karimi R.
Preliminary investigation of the psychometric
properties of children's coping behavior questionnaire
(CCBQ). Psychiatry Clin Psychol. 2017; 4:494-509.
[Persian]
24. Stone ALS, Walker LS. Adolescents’ Observations
of Parent Pain Behaviors: Preliminary Measure
Validation and Test of Social Learning Theory in
Pediatric Chronic Pain. Pediatric Psychol. 2015; 1–10.
25. Love Sarah C, Mara Constance A, Mara Constance
AA, Kalomiris R, Cunningham R, Cunningham R.
The Influence of Caregiver Distress and Child
Anxiety in Predicting Child Somatization in Youth
with Functional Abdominal Pain Disorders. Child
Today. 2019; 6(12): 134-45.26. Newton D, Schosheim A, Patel S, Chitkara D,
Tilburg MA. The rol of psychological Factor in
paediatric functiona abdominal pain Disorder’’.
Gastroenterol. 2018; 105: 946–56.
27. Riahi F, Golzari M, Mootabi F. The Relationship
between Emotion Regulation and Marital Satisfaction
using the Actor-Partner Independence Model.
Psychiatry Clin Psychol. 2020; 26(1): 44-7. [Persian]
28. Alfvén RGJ. Psychosomatic pain in children: A
psychomuscular tension reaction? Pain. 2021; 1: 5-14.
29. Li C, Jiang S, Fan X, Zhang Q. Exploring the impact
of marital relationship on the mental health of
children. Health Psychol 2020; 25 (10-11): 1669–80.
30. van Tilburg MA, Levy RL, Walker LS, Von Korff
M, Feld LD, Garner M, Feld AD, Whitehead WE.
Psychosocial mechanisms for the transmission of
somatic symptoms from parents to children. World J
Gastroenterol. 2015;21(18):5532-41.
31.Ramchandani PG, Stein A, Hotopf M, Wiles NJ,
Team AS. Early parental and child predictors of
recurrent abdominal pain at school age: results of a
large population-based study. Child Adoles Psychiat.
2006; 45(6): 729-36.
32. Stone AL, Bruehl S, Smith CA, et al. Social learning
pathways in the relation between parental chronic pain
and daily pain severity and functional impairment in
adolescents with functional abdominal pain. Pain.
2018; 159: 298‐305.
33.Sherman AL, Bruehl S, Smith CA, Walker LS.
Individual and additive effects of mothers’ and
fathers’ chronic pain on health outcomes in young
adults with a childhood history of functional
abdominal pain. Pediatric Psychol. 2013; 38(4): 365-
75.
34.Guite JW, Lobato DJ, Shalon L, Plante W, Kao BT.
Pain, disability, and symptoms among siblings of
children with functional abdominal pain. Develop
Behav Pediatrics. 2007; 28(1): 2-8.
35.Shirkey KC, Smith CA, Walker LS. Dispositional
versus episode-specific assessment of children’s
coping with pain. Pediatric Psychol. 2010; 36(1): 74-
83.
36.Warschburger P, Hänig J, Friedt M, Posovszky C,
Schier M, Calvano C. Healthrelated quality of life in
children with abdominal pain due to functional or
organic gastrointestinal disorders. Pediatric Psychol.
2013; 39(1): 45-54.
37. van der Veek SM, Derkx H, de Haan E, Benninga
MA, Boer F. Emotion awareness and coping in
children with functional abdominal pain: A controlled
study. Social Sci Med. 2012; 74(2): 112-9: 47.
مجله علوم پزشکی پارس
دوره 22، شماره 3
پاییز 1403
صفحه 37-46