ﻲﺸﻫوﮋﭘ ﻞﻴﺻا ﻪﻟﺎﻘﻣ
ﻦﻳﺪّﻟﻮﺘﻣ ﺖﻴﻌﺿو يرﺎﺠﻨﻫﺎﻧ ﺎﺑ
ﺶﺷﻮﭘ ﺖﺤﺗ يدازردﺎﻣ يﺎﻫ
ﻲﺘﺷاﺪﻬﺑ ﺰﻛاﺮﻣ و
ﺪﻨﺟﺮﻴﺑ نﺎﺘﺳﺮﻬﺷ ﻲﻧﺎﻣرد
،
لﺎﺳ ﻲﻃ يﺎﻫ
90 - 1386
ﻨﻴﻣا اﺮﻫز ﻲ
١ﺐﺴﻧ ، ﻦﻴﻣا هﺪﻨﺧﺮﻓ وﺮﻜﺷ
2ي
، يدﻮﻣ اﺮﺘﻴﻣ ﻲﻟﺎﺒﻗا لﻮﺘﺑ ،3
،4
ﻤﻃﺎﻓ تادﺎﺳ هﺰﺋﺎﻓ ﻲ
1مﺪﻘﻣ
هﺪﻴﻜﭼ
ﻪﻨﻴﻣز فﺪﻫ و يرﺎﻤﻴﺑ لﺮﺘﻨﻛ ﺎﺑ: و ﺮﻴﮔاو يﺎﻫ
يرﺎﺠﻨﻫﺎﻧ ،ﺎﻬﻧآ عﻮﻴﺷ ﺶﻫﺎﻛ يدازردﺎﻣ يﺎﻫ
، ﺖﺳا ﻪﺘﻓﺮﮔ راﺮﻗ يﺮﺘﺸﻴﺑ ﻪﺟﻮﺗ درﻮﻣ .
ًﺎﺒﻳﺮﻘﺗ
20 ﻚﻳ ﺮﻳز نﺎﻛدﻮﻛ ﺮﻴﻣ و گﺮﻣ ﺪﺻرد لﺎﺳ
، يرﺎﺠﻨﻫﺎﻧ ﻪﺑ طﻮﺑﺮﻣ ﺖﺳا ﺪﻟﻮﺗ وﺪﺑ رد يدازردﺎﻣ يﺎﻫ
ﻪﻌﻟﺎﻄﻣ ﻦﻳا .
، ﻦﻴﻴﻌﺗ فﺪﻫ ﺎﺑ
ﻴﺻﻮﺼﺧ
ﻴﻌﻤﺟ تﺎ ﺖ يرﺎﺠﻨﻫﺎﻧ ﺎﺑ ﻦﻳﺪﻟﻮﺘﻣ ﻲﺘﺧﺎﻨﺷ ﻲﺘﺷاﺪﻬﺑ ﺰﻛاﺮﻣ ﺶﺷﻮﭘ ﺖﺤﺗ يدازردﺎﻣ يﺎﻫ
و ﺪﻨﺟﺮﻴﺑ نﺎﺘﺳﺮﻬﺷ ﻲﻧﺎﻣرد ﻲﻃ
لﺎﺳ يﺎﻫ 1386 - 1390 ﺪﺷ مﺎﺠﻧا .
شور ﻖﻴﻘﺤﺗ رد: ﻲﻔﻴﺻﻮﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا -
ﻲﻠﻴﻠﺤﺗ ﻪﺘﺷﺬﮔ ﺮﮕﻧ
، داﺪﻌﺗ 118
ّﻟﻮﺘﻣ يدازردﺎﻣ يرﺎﺠﻨﻫﺎﻧ ياراد نﺎﻛدﻮﻛ ﻪﺑ طﻮﺑﺮﻣ هﺪﻧوﺮﭘ ﺪ
لﺎﺳ يﺎﻫ 1386 ﺎﺗ 1390
، ﺮﺑ درﻮﻣ ﺖﻓﺮﮔ راﺮﻗ ﻲﺳر .
تﺎﻋﻼﻃا
، هدﺎﻔﺘﺳا ﺎﺑ زا ﻪﻣﺎﻨﺸﺳﺮﭘ
ّﻘﺤﻣ ﻖ ﻪﺘﺧﺎﺳ ﺗ نآ ﻲﻳاﻮﺘﺤﻣ ﻲﻳاور ﻪﻛ ﺄ
هﺪﺷ ﺪﻴﻳ
دﻮﺑ
، ﻊﻤﺟ ﺪﻳدﺮﮔ يروآ .
هداد ،ﻪﻣﺎﻨﺸﺳﺮﭘ ﻞﻴﻤﻜﺗ زا ﺲﭘ زا هدﺎﻔﺘﺳا ﺎﺑ ﺎﻫ
ﻮﻣزآ ﻲﻔﻴﺻﻮﺗ يرﺎﻣآ ن -
لﺎﻜﺳوﺮﻛ ﻲﻠﻴﻠﺤﺗ ﺲﻴﻟاو
و ﻚﻤﻛ ﻪﺑ
مﺮﻧ راﺰﻓا يرﺎﻣآ )SPSS
ﺶﻳاﺮﻳو 16 ( ، ﻲﻨﻌﻣ ﺢﻄﺳ رد يراد
05 / 0 α= ﺪﺷ ﻞﻴﻠﺤﺗ و ﻪﻳﺰﺠﺗ .
ﻪﺘﻓﺎﻳ ﺎﻫ 118: زا درﻮﻣ 22076
ّﻟﻮﺗ كدﻮﻛ ﺪ ﻪﺘﻓﺎﻳ
، ﺪﻧدﻮﺑ يدازردﺎﻣ يرﺎﺠﻨﻫﺎﻧ ياراد .
داد نﺎﺸﻧ ﺞﻳﺎﺘﻧ يرﺎﺠﻨﻫﺎﻧ ﻪﻛ
يﺎﻫ يدازردﺎﻣ
، رد
ناﺮﺴﭘ ) 9 / 55 (%
ناﺮﺘﺧد زا ﺮﺘﺸﻴﺑ )
1 / 44 (%
دﻮﺑ . 5 / 58 % ﺪﻨﺘﺷاد ﺮﮕﻳﺪﻜﻳ ﺎﺑ يﺪﻧوﺎﺸﻳﻮﺧ ﺖﺒﺴﻧ ،رﺎﺠﻨﻫﺎﻧ كدﻮﻛ ياراد ﻦﻳﺪﻟاو .
ﻊﻳﺎﺷ ﻦﻳﺮﺗ
يرﺎﺠﻨﻫﺎﻧ عﻮﻧ ﺎﻫ
، يرﺎﻤﻴﺑ يﺎﻫ ﻲﺒﻠﻗ - ﻲﺴﻔﻨﺗ ) 4 / 36 (%
ﻲﺘﻠﻜﺳا تﻻﻼﺘﺧا و )
1 / 16 (%
دﻮﺑ . ا ﺐﻠﻏ رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ )
78 (%
، رد نﺎﻣز
هدﺮﻛ تﻮﻓ ﻪﻌﻟﺎﻄﻣ ﺪﻧدﻮﺑ
. ﻲﻨﻌﻣ فﻼﺘﺧا د
ﺖﺷاد دﻮﺟو يرﺎﺠﻨﻫﺎﻧ عﻮﻧ ﺐﺴﺣ ﺮﺑ رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ تﻮﻓ ﻦﺳ ﻦﻴﮕﻧﺎﻴﻣ رد يرا )
03 /
P=0 .(
ﻪﺠﻴﺘﻧ يﺮﻴﮔ ا : ﺐﻠﻏ ﻲﻟﺎﻣﻮﻧآ ﻫ يدازردﺎﻣ يﺎ
، ﻲﻣ ﻲﺒﻠﻗ و ﻲﺒﺼﻋ ﻢﺘﺴﻴﺳ ﻪﺑ طﻮﺑﺮﻣ ﺪﺷﺎﺑ
. رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ رد ﺮﻴﻣ و گﺮﻣ لﺎﻤﺘﺣا
،
دﺎﻳزرﺎﻴﺴﺑ ﻲﻣ ﺪﺷﺎﺑ ﻲﻣ قﺎﻔﺗا لﺎﺳ ﻚﻳ ﺮﻳز رد ﺐﻠﻏا ﻪﻛ ﺪﺘﻓا
.
ﺟﻮﺗ ﺎﺸﻣ ﻪﺑ ﻪ يروﺮﺿ ﺪﻟﻮﺗ زا ﻞﺒﻗ ﻲﺼﻴﺨﺸﺗ تﺎﺸﻳﺎﻣزآ و جاودزا زا ﻞﺒﻗ هرو
ﺖﺳا .
هژاو يﺪﻴﻠﻛ يﺎﻫ يدازردﺎﻣ يرﺎﺠﻨﻫﺎﻧ:
؛ نﺎﻛدﻮﻛ
؛
ﻴﻌﻤﺟ ﺖ ﻲﺘﺧﺎﻨﺷ
؛ ﺪﻨﺟﺮﻴﺑ
ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻤﻠﻋ ﻪﻠﺠﻣ .
1393
؛ 21 ) 1 :(
96 - 103 .
ﺖﻓﺎﻳرد : 18 / 05 / 1392 شﺮﻳﺬﭘ : 26 / 01 / 1393
،ﺖﺷاﺪﻬﺑ شزﻮﻣآ ﺪﺷرا سﺎﻨﺷرﺎﻛ1
ﺴﻣ سﺎﻨﺷرﺎﻛ ﺆ ،ﺖﻴﻌﻤﺟ و هداﻮﻧﺎﺧ ﺖﻣﻼﺳ لو ﻮﻀﻋ
ﻣ ﻲﻋﺎﻤﺘﺟا ﻞﻣاﻮﻋ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ﺆ
ّﺛ ﺰﻛﺮﻣ ،ﺖﻣﻼﺳ ﺮﺑ ﺮ ﺖﺷاﺪﻬﺑ
نﺎﺘﺳﺮﻬﺷ ،ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﺪﻨﺟﺮﻴﺑ
ناﺮﻳا ،ﺪﻨﺟﺮﻴﺑ
لوﺆﺴﻣ هﺪﻨﺴﻳﻮﻧ2
؛ رﺎﻳدﺎﺘﺳا ، ﻜﺷﺰﭘ هﺪﻜﺸﻧاد ،ﺖﻣﻼﺳ ءﺎﻘﺗرا و ﺖﺷاﺪﻬﺑ شزﻮﻣآ هوﺮﮔ ﻲ
، ناﺮﻬﺗ ،سرﺪﻣ ﺖﻴﺑﺮﺗ هﺎﮕﺸﻧاد ناﺮﻳا ،
.
سردآ : ناﺮﻬﺗ - و ﺖﺷاﺪﻬﺑ شزﻮﻣآ هوﺮﮔ ،ﻲﻜﺷﺰﭘ هﺪﻜﺸﻧاد ،سرﺪﻣ ﺖﻴﺑﺮﺗ هﺎﮕﺸﻧاد ،ﺎﺸﻴﮔ ﻞﭘ ﺮﻳز ﺖﻣﻼﺳ ءﺎﻘﺗرا
ﻲﻜﻴﻧوﺮﺘﻜﻟا ﺖﺴﭘ [email protected] :
رﺎﻳدﺎﺘﺳا3
، ﻮﻀﻋ ﻣ ﻲﻋﺎﻤﺘﺟا ﻞﻣاﻮﻋ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ﺆ
ّﺛ ناﺮﻳا ،ﺪﻨﺟﺮﻴﺑ ،ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﺖﺷاﺪﻬﺑ هﺪﻜﺸﻧاد ،ﻲﻣﻮﻤﻋ ﺖﺷاﺪﻬﺑ هوﺮﮔ ،ﺖﻣﻼﺳ ﺮﺑ ﺮ .
ﻲﻣﻮﻤﻋ ﻚﺷﺰﭘ4
و نﺎﻬﻔﺻا ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻜﺷﺰﭘ شزﻮﻣآ يﺮﺘﻛد يﻮﺠﺸﻧاد ناﺮﻳا ،ﺪﻨﺟﺮﻴﺑ ،ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﻲﻜﺷﺰﭘ مﻮﻠﻋ شزﻮﻣآ ﻪﻌﺳﻮﺗ و تﺎﻌﻟﺎﻄﻣ ﺰﻛﺮﻣ سﺎﻨﺷرﺎﻛ ،
.
ﻪﻣﺪﻘﻣ يرﺎﺠﻨﻫﺎﻧ د ،يدازردﺎﻣ يﺎﻫ
نارود ﻲﻃ ﺎﻳ حﺎﻘﻟ نﺎﻣز ر
ّﻟﻮﺗ مﺎﮕﻨﻫ و هداد خر ﻲﻤﺣر ﻞﺧاد ﻞﻣﺎﻜﺗ ﻲﻣ ﺮﻫﺎﻇ ﺪ
ﻮﺷ ﻧ ﺪ ) 1 .(
يرﺎﺠﻨﻫﺎﻧ يدازردﺎﻣ يﺎﻫ
، ،ﻲﻜﺷﺰﭘ تﻼﺧاﺪﻣ ﻊﻳﺎﺷ ﻞﻠﻋ زا
يرﺎﻤﻴﺑ ﻲﻣ گﺮﻣ و تﺪﻣ ﻲﻧﻻﻮﻃ يﺎﻫ ﺪﻨﺷﺎﺑ
.
» يرﺎﺠﻨﻫﺎﻧ
«
، ﻪﺑ
ﺮﻫ ﻪﺘﺷاد فﻼﺘﺧا لﻮﻤﻌﻣ ﺖﻟﺎﺣ ﺎﺑ ﻪﻛ يرﺎﺘﺧﺎﺳ ﺺﻘﻧ عﻮﻧ
ﻲﻣ ﻪﺘﻔﮔ ،ﺪﺷﺎﺑ و دﻮﺷ
» دﺎﻣ يدازر
«
، ﻪﺑ زا ﺺﻘﻧ نآ دﻮﺟو يﺎﻨﻌﻣ
ﺖﺳا ﺪﻟﻮﺗ وﺪﺑ )
2 .(
تﻻﻼﺘﺧا ﻦﻳا
، زا ﻪﻠﺣﺮﻣ ﺮﻫ رد ﺖﺳا ﻦﻜﻤﻣ
ﺘﻓا قﺎﻔﺗا ﻦﻴﻨﺟ ﻞﻣﺎﻜﺗ ﺪ
،عﻮﻧ ،هﺪﻨﻨﻛدﺎﺠﻳا ﻞﻣاﻮﻋ ﺮﻈﻧ زا و
ﻲﻣ توﺎﻔﺘﻣ زوﺮﺑ بوﺎﻨﺗ و ﺖﻌﺳو ﺪﻨﺷﺎﺑ
) 3 .(
ﻦﻳا زا ﻲﺧﺮﺑ
يرﺎﺠﻨﻫﺎﻧ ﺎﻫ
،
ﺒﻃ ﺮﻈﻧ زا ﺎﺗ ﺖﺳا ﻦﻜﻤﻣ ﻲﺘﺣ و ﺪﻧراﺪﻧ ﻲﺘﻴﻤﻫا ﻲ
ﺑ ﻲﺗﺪﻣ دراﻮﻣ ﺮﻳﺎﺳ رد ﺎﻣا ،ﺪﻧدﺮﮕﻧ زرﺎ
، لﻼﺘﺧا ﻲﺘﺣ ﺖﺳا ﻦﻜﻤﻣ
ﺪﻳﺪﻬﺗ ﻪﺘﺷاد يرﻮﻓ ﻲﺘﺒﻗاﺮﻣ ﺮﻴﺑاﺪﺗ ﻪﺑ زﺎﻴﻧ و هدﻮﺑ ﻲﮔﺪﻧز هﺪﻨﻨﻛ
ﺪﻨﺷﺎﺑ ) 4 .(
يرﺎﺠﻨﻫﺎﻧ يدازردﺎﻣ يﺎﻫ
، ﻲﻧاﻮﺗﺎﻧ ﻊﻳﺎﺷ ﺖﻠﻋ ﻚﻳ
ﻪﭽﺑ ﻲﻣ تﺪﻣزارد رد ﺎﻫ ﺮﺿﺎﺣ نﺮﻗ رد و ﺪﻨﺷﺎﺑ
،
ﻤﻬﻣ ﺶﺨﺑ زا ﻲ
ﺎﺴﻣ ﺋ هداد صﺎﺼﺘﺧا دﻮﺧ ﻪﺑ ار ﻲﻜﺷﺰﭘ ﻞ ﺪﻧا
) 5 .(
يرﺎﺠﻨﻫﺎﻧ يدازردﺎﻣ يﺎﻫ
،
ًﻻﻮﻤﻌﻣ ،ﻲﺛرا ﻞﻣاﻮﻋ زا ﻲﺷﺎﻧ
ود ﺮﻫ ﻞﺧاﺪﺗ ﺎﻳ و ﻲﻄﻴﺤﻣ ي
ﺎﻬﻧآ ﻲﻣ ﺪﻨﺷﺎﺑ ترﻮﺻ ﻦﻳا رد ﻪﻛ
،
ﻲﻠﻣﺎﻋﺪﻨﭼ ثراﻮﺗ نآ ﻪﺑ ﻲﻣ1
ﺪﻨﻳﻮﮔ ) 6 .(
يرﺎﻤﻴﺑ لﺮﺘﻨﻛ ﺎﺑ و ﺮﻴﮔاو يﺎﻫ
،ﺎﻬﻧآ عﻮﻴﺷ ﺶﻫﺎﻛ
يرﺎﺠﻨﻫﺎﻧ يدازردﺎﻣ يﺎﻫ
، ﺘﻓﺮﮔ راﺮﻗ يﺮﺘﺸﻴﺑ ﻪﺟﻮﺗ درﻮﻣ و ﻪ
ﻜﻣا ﻪﻠﺌﺴﻣ ﻦﻳا دوز ﻲﻳﺎﺳﺎﻨﺷ نﺎ
ﻪﻣﺎﻧﺮﺑ و مﺎﮕﻨﻫ يﺰﻳر
يﺎﻫ
ﺐﺳﺎﻨﻣ ياﺮﺑ ﺖﺳا هدروآ ﻢﻫاﺮﻓ ار نارﺎﻤﻴﺑ ﺖﻴﻌﺿو دﻮﺒﻬﺑ )
7 .(
ﺎﺒﻳﺮﻘﺗ 20 ﻚﻳ ﺮﻳز نﺎﻛدﻮﻛ ﺮﻴﻣ و گﺮﻣ ﺪﺻرد لﺎﺳ
، ﻪﺑ طﻮﺑﺮﻣ
يرﺎﺠﻨﻫﺎﻧ ﺖﺳا ﺪﻟﻮﺗ وﺪﺑ رد يدازردﺎﻣ يﺎﻫ
) 8 .(
ﻲﻠﻛ رﻮﻃ ﻪﺑ
،
ﻦﻴﺑ 3 ﺎﺗ 5 ﺪﻟﻮﺗ ياﺪﺘﺑا رد ﺺﻴﺨﺸﺗ ﻞﺑﺎﻗ ﺺﻘﻧ ،نادازﻮﻧ ﺪﺻرد
ﺪﻧراد ) 9 .(
تﻻﻼﺘﺧا ﻦﻳا
، ﺎﻳ و ﻲﻄﻴﺤﻣ ،ﻲﻜﻴﺘﻧژ ﻞﻣاﻮﻋ زا ﻲﺷﺎﻧ
ﺖﺳﺎﻬﻧآ يود ﺮﻫ )
10 .(
نﻮﭼ نﻮﮔﺎﻧﻮﮔ ﻞﻣاﻮﻋ :
،ﺎﻫوراد
ﺖﻧﻮﻔﻋ يرﺎﻤﻴﺑ و ﺎﻫ ﺐﻴﺳآ ،ﻒﻠﺘﺨﻣ يﺎﻫ
ﺳ نﺪﻴﺸﻛ ،ﺎﻫ ،رﺎﮕﻴ
راﺮﻗ و ﻻﺎﺑ ّﻦﺳ ،ﻪﻳﺬﻐﺗ ءﻮﺳ ﻲﻃ رد ﻪﻌﺷا ضﺮﻌﻣ رد ﻦﺘﻓﺮﮔ
يرادرﺎﺑ
، يرﺎﺠﻨﻫﺎﻧ ﻦﻳا زوﺮﺑ ﻞﻠﻋ زا ﺪﻨﺘﺴﻫ ﺎﻫ
) 10 .(
ﺐﺴﺣﺮﺑ
1
ﻚﻴﺘﻧژ ﻞﻠﻋ ،ﻊﺑﺎﻨﻣ )
ﻲﻣوزﻮﻣوﺮﻛ ﺺﻘﻧ (
20 - 25 ،ﺪﺻرد
ﺖﻧﻮﻔﻋ ﺎﻫ 3 - 5 دوﺪﺣ ﺎﻫوراد ،ﺪﺻرد ﻚﻳ
ﻞﻠﻋ و ﺪﺻرد
ﻪﺘﺧﺎﻨﺷﺎﻧ و ﻪﻧﺎﮔﺪﻨﭼ 65
- 75
ّﻠﻋ ﺪﺻرد يرﺎﺠﻨﻫﺎﻧ ﺖ
ار ﺎﻫ
ﻲﻣ ﻞﻴﻜﺸﺗ ﺪﻨﻫد
) 9 .(
يرﺎﺠﻨﻫﺎﻧ ﻦﻳا عﻮﻴﺷ ناﺰﻴﻣ رﺎﻜﺷآ يﺎﻫ
زا ﻲﺷﺎﻧ ﺖﺳا ﻦﻜﻤﻣ ﻪﻛ ﺖﺳا توﺎﻔﺘﻣ نﺎﻬﺟ و ناﺮﻳا رد توﺎﻔﺗ يﺎﻫ ﺪﺷﺎﺑ يدﺎﺼﺘﻗا و ﻲﻋﺎﻤﺘﺟا ،يداﮋﻧ ،ﻲﻳﺎﻴﻓاﺮﻐﺟ .
رد
50 يرﺎﺠﻨﻫﺎﻧ ﻞﻠﻋ ،دراﻮﻣ ﺪﺻرد ﻲﻣ ﻪﺘﺧﺎﻨﺷﺎﻧ ﺎﻫ
ﺎﻣا ،ﺪﺷﺎﺑ
ﻲﺧﺮﺑ سﺎﺳاﺮﺑ ﻲﺳرﺮﺑ
،ﺎﻫ 18 ﺮﺘﻤﻛ ،ﻲﻣوزﻮﻣوﺮﻛ ﻞﻣاﻮﻋ ﺪﺻرد
زا 10 و ﻲﻄﻴﺤﻣ ﻞﻣاﻮﻋ ﺪﺻرد ﺐﻴﺳآ
ياز و ﻲﻳﺎﻴﻤﻴﺷ 25
ﺪﺻرد
ﻲﻄﻴﺤﻣ و ﻲﻜﻴﺘﻧژ تاﺮﺛا ﺐﻴﻛﺮﺗ ،ﻞﻠﻋ )
ﻲﻠﻣﺎﻋﺪﻨﭼ ثراﻮﺗ (
ﺎﺑ
ﻢﻫ ﻪﻛ ﺪﻨﺘﺴﻫ يرﺎﺠﻨﻫﺎﻧ ﺐﺒﺳ
ﻲﻣ يدازردﺎﻣ يﺎﻫ ﺪﻧﻮﺷ
) 11 .(
يرﺎﺠﻨﻫﺎﻧ زا ﻲﺷﺎﻧ ﻦﻴﻟﻮﻠﻌﻣ ﻲﻧاﻮﺗﻮﻧ و نﺎﻣرد يﺎﻫ
ﻲﻣ ﻞﻴﻤﺤﺗ ﻪﻌﻣﺎﺟ ﻪﺑ ار ﻲﺘﻔﮕﻨﻫ ﻪﻨﻳﺰﻫ ،يدازردﺎﻣ و ﺪﻨﻛ
و لﻮﻠﻌﻣ دﺮﻓ ياﺮﺑ ار بﻮﻠﻄﻣ ﺞﻳﺎﺘﻧ ﻪﺸﻴﻤﻫ ،ﻦﻳا زا ﻪﺘﺷﺬﮔ ﺖﺷاد ﺪﻫاﻮﺨﻧﺮﺑ رد ﻪﻌﻣﺎﺟ )
12 (
؛ زا ﻲﺧﺮﺑ ،ﻲﻓﺮﻃ زا
يرﺎﺠﻨﻫﺎﻧ ﻣ يﺎﻫ
ﺪﻳﺪﺷ يدازردﺎ
، ﻞﺧاد گﺮﻣ ﺎﻳ و ﻂﻘﺳ ﺚﻋﺎﺑ
ﻲﻣ ﻦﻴﻨﺟ ﻲﻤﺣر ﺪﻧﻮﺷ
؛ ﻲﻣ ﺮﻈﻧ ﻪﺑ ﻲﻘﻄﻨﻣ اﺬﻟ ﺖﺧﺎﻨﺷ ﻪﻛ ﺪﺳر
يرﺎﺠﻨﻫﺎﻧ زوﺮﺑ زا يﺮﻴﮕﺸﻴﭘ و يدازردﺎﻣ يﺎﻫ
، ﻊﻣاﻮﺟ ياﺮﺑ
ﻪﺑ ﻪﻓﺮﺻ ﺎﺑ ﺐﺗاﺮﻣ دﻮﺑ ﺪﻫاﻮﺧ ﻲﻧاﻮﺗزﺎﺑ ﺎﻳ و نﺎﻣرد زا ﺮﺗ
) 13 .(
ﺑ يﺎﻫرﺎﻣآ سﺎﺳاﺮﺑ ﻪ
ﺖﺳد نﺎﻛدﻮﻛ گﺮﻣ ﺖﺒﻗاﺮﻣ مﺎﻈﻧ زا هﺪﻣآ
1 - 59 ﻪﻫﺎﻣ ﺪﻨﺟﺮﻴﺑ لﺎﺳ رد 1390 دوﺪﺣ ، 40 دراﻮﻣ زا ﺪﺻرد
نﺎﻛدﻮﻛ ﺮﻴﻣ و گﺮﻣ 1
- 59 رد ﻪﻫﺎﻣ لﺎﺳ
، ﻪﺑ يرﺎﺠﻨﻫﺎﻧ ﻞﻴﻟد
ﻲﻣ قﺎﻔﺗا يدازردﺎﻣ نﺎﻛدﻮﻛ ﺮﻴﻣ و گﺮﻣ ﺖﻠﻋ ﻦﻴﻟوا ﻪﻛ ﺪﺘﻓا
1 - 59 ﺖﺳا هداد صﺎﺼﺘﺧا دﻮﺧ ﻪﺑ ار ﻪﻫﺎﻣ )
14 .(
ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ
يرﺎﺠﻨﻫﺎﻧ زا ﻲﺷﺎﻧ ﺮﻴﻣ و گﺮﻣ يﻻﺎﺑ رﺎﻣآ زردﺎﻣ يﺎﻫ
مﺪﻋ و يدا
ﻪﻌﻟﺎﻄﻣ مﺎﺠﻧا
،ﺪﻨﺟﺮﻴﺑ ﺮﻬﺷ رد ﻪﻨﻴﻣز ﻦﻳا رد يا ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ
، ﺎﺑ
ﻴﻌﻤﺟ تﺎﻴﺻﻮﺼﺧ ﻦﻴﻴﻌﺗ فﺪﻫ ﺖ
ّﻟﻮﺘﻣ ﻲﺘﺧﺎﻨﺷ ﻳﺪ
يرﺎﺠﻨﻫﺎﻧ ﺎﺑ ﻦ
ﺖﺳا ﻪﺘﻓﺮﮔ ترﻮﺻ يدازردﺎﻣ .
شور ﻖﻴﻘﺤﺗ
ﻲﻔﻴﺻﻮﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا -
ﻲﻠﻴﻠﺤﺗ
، ﻲﻌﻄﻘﻣ عﻮﻧ زا Cross-
Sectional )
ﻪﺘﺷﺬﮔ ﺮﮕﻧ ( ﻮﺑ اﺪﺘﺑا زا هﺪﻧز ﻦﻳﺪﻟﻮﺘﻣ ﻪﻛ د ي
ﻦﻳدروﺮﻓ 1386
ﻔﺳا نﺎﻳﺎﭘ ﺎﺗ ﺪﻨ
1390 داد راﺮﻗ ﻪﻌﻟﺎﻄﻣ درﻮﻣ ار .
ﻪﻧﻮﻤﻧ شور يرﺎﻤﺷﺮﺳ ،يﺮﻴﮔ
دﻮﺑ نآ ﻲﻃ ﻪﻛ
،
ّﻠﻛ نادازﻮﻧ ﻪﻴ
ّﻟﻮﺘﻣ رﺎﻜﺷآ يدازردﺎﻣ يرﺎﺠﻨﻫﺎﻧ رﺎﭼد ﺪ
ﻊﻄﻘﻣ ﻦﻳا رد هﺪﺷ
ﻲﺘﺷاﺪﻬﺑ ﺰﻛاﺮﻣ ﺶﺷﻮﭘ ﺖﺤﺗ ﻪﻛ ﻲﻧﺎﻣز و
نﺎﺘﺳﺮﻬﺷ ﻲﻧﺎﻣرد
هدﻮﺑ ﺪﻨﺟﺮﻴﺑ ﺪﻧﺪﺷ ﻲﺳرﺮﺑ ،ﺪﻧا
. ياﺮﺑ ﻊﻤﺟ يروآ هداد ﺎﻫ زا ،
دﻮﺧ ﻪﻣﺎﻨﺸﺳﺮﭘ ﻪﺘﺧﺎﺳ
فاﺪﻫا سﺎﺳا ﺮﺑ ﻪﻛ ﺪﺷ هدﺎﻔﺘﺳا يا
ﻪﻌﻟﺎﻄﻣ
، ﻂﺳﻮﺗ نآ ﻲﻳاﻮﺘﺤﻣ ﻲﻳاور و ﻲﺣاﺮﻃ 10
يﺎﻀﻋا زا ﺮﻔﻧ
ﻴﻫ ﺄ و ﻲﻤﻠﻋ ت ﺐﺣﺎﺻ نﺎﺳﺎﻨﺷرﺎﻛ
ﺮﻈﻧ ﺗﺄ ﺪﻳدﺮﮔ ﺪﻴﻳ .
ﻪﻣﺎﻨﺸﺳﺮﭘ
ﻞﻣﺎﺷ هدﺎﻔﺘﺳا درﻮﻣ :
ﺳ ﺆ نزو ،ﺲﻨﺟ ﺎﺑ طﺎﺒﺗرا رد ﻲﺗﻻا
، نﺎﻣز
و ﺪﻟﻮﺗ
ّﻦﺳ دازﻮﻧ ﻲﻤﺣر ﻞﺧاد ﺰﻴﻧ و
،ردﺎﻣ و رﺪﭘ ﻞﻐﺷ ،ﻦﺳ
ﺖﺒﺴﻧ ،ﺪﻟﻮﺗ ﻪﺒﺗر ،ﻲﮔﺪﻧز ﻞﺤﻣ ،ﻦﻳﺪﻟاو تﻼﻴﺼﺤﺗ ناﺪﻧوﺎﺸﻳﻮﺧ رد يرﺎﺠﻨﻫﺎﻧ ﻪﻘﺑﺎﺳ ،ردﺎﻣ و رﺪﭘ ﻦﻴﺑ يﺪﻧوﺎﺸﻳﻮﺧ ﺮﻳز كدﻮﻛ گﺮﻣ ﻪﻘﺑﺎﺳ ،ﻚﻳ ﻪﺟرد 5
،هداﻮﻧﺎﺧ رد لﺎﺳ
ﺖﺒﻗاﺮﻣ رد ردﺎﻣ شزﻮﻣآ ﺖﻴﻌﺿو ،يرادرﺎﺑ نارود يﺎﻫ درﻮﻣ
عﻮﻧ و يرادرﺎﺑ نارود رد يدازردﺎﻣ يرﺎﺠﻨﻫﺎﻧ دﻮﺑ يرﺎﺠﻨﻫﺎﻧ
.
ﻪﻘﺒﻃ سﺎﺳاﺮﺑ يرﺎﺠﻨﻫﺎﻧ عﻮﻧ ترازو ﺮﻴﻣ و گﺮﻣ ﻞﻠﻋ يﺪﻨﺑ
ﻲﻜﺷﺰﭘ شزﻮﻣآ و نﺎﻣرد ،ﺖﺷاﺪﻬﺑ ICD10)
( ﺪﺷ ﻦﻴﻴﻌﺗ .
رﺎﻴﻌﻣ
ﻪﻌﻟﺎﻄﻣ ﻪﺑ دورو
،
ّﻠﻛ لﺎﺳ ﻲﻃ هﺪﻧز ﻦﻳﺪﻟﻮﺘﻣ ﻪﻴ يﺎﻫ
86 - 90 دﻮﺑ
يرﺎﺠﻨﻫﺎﻧ ﻪﺑ ﻼﺘﺑا و ﺪﻧدﻮﺑ ﻲﺘﺷاﺪﻬﺑ ﺰﻛاﺮﻣ ﺶﺷﻮﭘ ﺖﺤﺗ ﻪﻛ هﺪﺷ ﺖﺒﺛ ﺎﻬﻧآ هﺪﻧوﺮﭘ رد يدازردﺎﻣ دﻮﺑ
. ﺖﻳﺎﻬﻧرد
، تﺎﻋﻼﻃا
يروآدﺮﮔ هﺪﺷ
، مﺮﻧ رد راﺰﻓا )SPSS ﺶﻳاﺮﻳو 16 ( ﻪﻳﺰﺠﺗ و دراو
ﻧآ ﻞﻴﻠﺤﺗ و ﺎﻬ
نﻮﻣزآ زا هدﺎﻔﺘﺳا ﺎﺑ و ﻲﻔﻴﺻﻮﺗ يرﺎﻣآ يﺎﻫ
لﺎﻜﺳوﺮﻛ ﻲﻠﻴﻠﺤﺗ ﺲﻴﻟاو
، ﻲﻨﻌﻣ ﺢﻄﺳ رد يراد
05 / α=0 مﺎﺠﻧا
ﺪﺷ .
ﻪﺘﻓﺎﻳ ﺎﻫ
ﺑ ﻪ ﻲﻠﻛ رﻮﻃ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد
، 22076 ﺪﻟﻮﺘﻣ كدﻮﻛ
هﺪﺷ
ﻛاﺮﻣ ﺶﺷﻮﭘ ﺖﺤﺗ ﻲﺘﺷاﺪﻬﺑ ﺰ
و ﻲﻃ ﺪﻨﺟﺮﻴﺑ نﺎﺘﺳﺮﻬﺷ ﻲﻧﺎﻣرد
لﺎﺳ يﺎﻫ 1386 - 1390 داﺪﻌﺗ ﻦﻳا زا و ﻲﺳرﺮﺑ
، 118 درﻮﻣ
) 34 / 5 راﺰﻫ رد ( ﺪﻧدﻮﺑ يدازردﺎﻣ يرﺎﺠﻨﻫﺎﻧ ياراد .
ﻦﻳا زا
رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ
، 5 / 52 % و ﺮﻬﺷ ﻦﻛﺎﺳ 9
/ 55 % ﺪﻧدﻮﺑ ﺮﺴﭘ .
22 % و ناردﺎﻣ 5
/ 30
% نارﺪﭘ يﻻﺎﺑ ، 35 ﻪﺘﺷاد ﻦﺳ لﺎﺳ ا
ﺪﻧ . زا ﻪﻘﺑﺎﺳ ﺮﻈﻧ يﺪﻧوﺎﺸﻳﻮﺧ
، 5 / 58 % و ﻪﺘﺷاد ﻲﻠﻴﻣﺎﻓ ﺖﺒﺴﻧ ﻦﻴﺟوز
3 / 15 % ﻪﺘﺷاد ﻚﻳ ﻪﺟرد ﻞﻴﻣﺎﻓ رد يرﺎﺠﻨﻫﺎﻧ ﻪﻘﺑﺎﺳ ﺪﻧا
؛
رد ﻦﻴﻨﭽﻤﻫ 7
/ 12 % ﺮﻳز كدﻮﻛ تﻮﻓ ﻪﻘﺑﺎﺳ ،رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ
5 ﻪﺘﺷاد هداﻮﻧﺎﺧ رد لﺎﺳ ﺪﻧا
. 5 / 30 % كدﻮﻛ ياراد ناردﺎﻣ
ﻞﻣﺎﻛ يرادرﺎﺑ نارود ﺖﺒﻗاﺮﻣ ،رﺎﺠﻨﻫﺎﻧ )
ﻞﻗاﺪﺣ 6 سﺎﺳاﺮﺑ رﺎﺑ
اﺪﻧﺎﺘﺳا ﺖﺷاﺪﻬﺑ ترازو در (
ﺪﻧدﻮﺑ هدﺮﻜﻧ ﺖﻓﺎﻳرد .
ناﺰﻴﻣ ﺮﻈﻧ زا
تﻼﻴﺼﺤﺗ
، 2 / 71 % و ناردﺎﻣ 4
/ 64 % ﺮﻳز تﻼﻴﺼﺤﺗ نارﺪﭘ
ﻪﺘﺷاد ﻢﻠﭙﻳد ﺪﻧا
. ﻞﻐﺷ ﺮﻈﻧ زا
، 5 / 91 % ﻪﻧﺎﺧ ناردﺎﻣ و راد
5 / 41
%
هدﻮﺑ ﺮﮔرﺎﻛ ﺎﻳ رﺎﻜﻴﺑ نارﺪﭘ ﺪﻧا
) لوﺪﺟ 1 .(
لوﺪﺟ 1 - رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ ﻲﻧاواﺮﻓ ﻊﻳزﻮﺗ
ﺐﺴﺣﺮﺑ ﻪﻌﻟﺎﻄﻣ درﻮﻣ
ﻐﺘﻣ ﺖﻴﻌﻤﺟ يﺎﻫﺮﻴ ﻲﺘﺧﺎﻨﺷ
ﺮﻴﻐﺘﻣ ﻲﻧاواﺮﻓ
ﺪﺻرد
ﺲﻨﺟ ﺮﺘﺧد
ﺮﺴﭘ 52
66 1 / 44
9 / 55
ﺖﻧﻮﻜﺳ ﻞﺤﻣ ﺮﻬﺷ
ﺎﺘﺳور 62
56 5 / 52
5 / 47
يﺪﻧوﺎﺸﻳﻮﺧ ﺖﺒﺴﻧ دراد
دراﺪﻧ 69
49 5 / 58
5 / 41
ردﺎﻣ ﻦﺳ ﺮﻳز
18 لﺎﺳ
35 - 18 لﺎﺳ
يﻻﺎﺑ 35 لﺎﺳ 2
90
26 7 / 1
3 / 76
22
رﺪﭘ ﻦﺳ ﺮﻳز
18 لﺎﺳ
35 - 18 لﺎﺳ
يﻻﺎﺑ 35 لﺎﺳ 0
82
36 0
5 / 69
5 / 30
ﻲﻠﻴﻣﺎﻓ ﻪﻘﺑﺎﺳ يدازردﺎﻣ يرﺎﺠﻨﻫﺎﻧ
ﻲﻠﺑ
ﺮﻴﺧ 18
100 3 / 15
7 / 84
كدﻮﻛ تﻮﻓ ﻪﻘﺑﺎﺳ ﺮﻳز 5 هداﻮﻧﺎﺧ رد لﺎﺳ
ﻲﻠﺑ
ﺮﻴﺧ
15
103
7 / 12
3 / 87
ﻞﻣﺎﻛ ندﻮﺑ
ﺖﺒﻗاﺮﻣ نارود يﺎﻫ
يرادرﺎﺑ ﻲﻠﺑ
ﺮﻴﺧ 82
36 5 / 69
5 / 30
ردﺎﻣ تﻼﻴﺼﺤﺗ
ﻢﻠﭙﻳدﺮﻳز
ﻢﻠﭙﻳد
ﻲﻫﺎﮕﺸﻧاد تﻼﻴﺼﺤﺗ
84
21
13 2 / 71
8 / 17
11
تﻼﻴﺼﺤﺗ ﺪﭘ
ر ﻢﻠﭙﻳدﺮﻳز
ﻢﻠﭙﻳد
ﻲﻫﺎﮕﺸﻧاد تﻼﻴﺼﺤﺗ
76
27
15 4 / 64
9 / 22
7 / 12
لوﺪﺟ 2 - زﻮﺗ ﻳ ﻊ ﻧاواﺮﻓ ﻲ رﺎﺠﻨﻫﺎﻧ عﻮﻧ ي
رد نﺎﻛدﻮﻛ ﻪﻌﻟﺎﻄﻣ درﻮﻣ
يرﺎﺠﻨﻫﺎﻧ عﻮﻧ ﻲﻧاواﺮﻓ
ﺪﺻرد
ﺺﻘﻧ ﻲﺒﺼﻋ ﻪﻟﻮﻟ يﺎﻫ
16 6
/ 13
ﻲﺘﻠﻜﺳا تﻻﻼﺘﺧا
19 1
/ 16
ﻲﺷراﻮﮔ 17
4
/ 14
نواد مورﺪﻨﺳ
6 1
/ 5
ﻲﺒﻠﻗ 34
8
/ 28
ﻲﺴﻔﻨﺗ 9
6
/ 7
يرﺎﺠﻨﻫﺎﻧ ﻒﻳﺮﻌﺗ يدازردﺎﻣ يﺎﻫ هﺪﺸﻧ
17
4
/ 14
ﻊﻤﺟ 118
100
لوﺪﺟ 3 - ﺎﻘﻣ ﻳ ﻪﺴ ﻣ ﻴ ﮕﻧﺎ ﻴ ﻦ رﺎﺠﻨﻫﺎﻧ عﻮﻧ ﺐﺴﺣﺮﺑ رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ تﻮﻓ مﺎﮕﻨﻫ ﻦﺳ
ي
7 / 45 % نﺎﻛدﻮﻛ
، ﺮﻳز نزو ﺪﻟﻮﺗ مﺎﮕﻨﻫ رد 2500
ﺮﮔ م
ﻪﺘﺷاد
؛ﺪﻧا 8 / 39 % ﻛدﻮﻛ و لوا ﻲﮕﻠﻣﺎﺣ ﻪﺠﻴﺘﻧ ،رﺎﺠﻨﻫﺎﻧ نﺎ
7 / 17 % ﻲﮕﻠﻣﺎﺣ ﻪﺠﻴﺘﻧ 4
هدﻮﺑ ﺮﺗﻻﺎﺑ و ﺪﻧا
. 2 / 26 % نﺎﻛدﻮﻛ
،
ﺮﺘﻤﻛ ﻲﻤﺣر ﻞﺧاد ﻦﺳ زا
37 و ﻪﺘﻔﻫ 84 / 0 % زا ﺶﻴﺑ 40 ﻪﺘﻔﻫ
ﻪﺘﺷاد ﺪﻧا . هﺪﻫﺎﺸﻣ يرﺎﺠﻨﻫﺎﻧ ﻲﻧاواﺮﻓ ﻦﻳﺮﺘﺸﻴﺑ درﻮﻣ نﺎﻛدﻮﻛ رد هﺪﺷ
ﻲﺳرﺮﺑ
، يرﺎﻤﻴﺑ ﻲﺒﻠﻗ يﺎﻫ )
8 / 28 (%
تﻻﻼﺘﺧا ﺲﭙﺳ و
ﻲﺘﻠﻜﺳا )
1 / 16 ( % ﺖﺳا هدﻮﺑ )
لوﺪﺟ 2 .(
ﻲﺳرﺮﺑ ﺖﻴﻌﺿو
ﻪﻌﻟﺎﻄﻣ درﻮﻣ نﺎﻛدﻮﻛ ﻲﺗﺎﻴﺣ ﻪﻛ داد نﺎﺸﻧ
78
% نﺎﻛدﻮﻛ
رﺎﺠﻨﻫﺎﻧ
، ﻦﺳ ﻪﺑ نﺪﻴﺳر زا ﻞﺒﻗ 5
هدﺮﻛ تﻮﻓ ﻲﮕﻟﺎﺳ ﺪﻧا
. نﻮﻣزآ
لﺎﻜﺳوﺮﻛ يرﺎﻣآ ﺲﻴﻟاو
، ﻲﻨﻌﻣ فﻼﺘﺧا ﻦﺳ ﻦﻴﮕﻧﺎﻴﻣ رد يراد
داد نﺎﺸﻧ يرﺎﺠﻨﻫﺎﻧ عﻮﻧ ﺐﺴﺣﺮﺑ رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ تﻮﻓ ﻪﻛ
ﻦﻴﺑ فﻼﺘﺧا ﻦﻳا ﺺﻘﻧ ياراد نﺎﻛدﻮﻛ ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ
ﻪﻟﻮﻟ يﺎﻫ
يرﺎﺠﻨﻫﺎﻧ و ﻲﺒﺼﻋ ﻲﺒﻠﻗ يﺎﻫ
- و ﻲﺴﻔﻨﺗ يرﺎﺠﻨﻫﺎﻧ ﺮﻳﺎﺳ
يﺎﻫ ﻒﻳﺮﻌﺗ ﻲﻨﻌﻣ هﺪﺸﻧ راد
؛دﻮﺑ و ﻲﺘﻠﻜﺳا تﻻﻼﺘﺧا ﻦﻴﺑ ﻦﻴﻨﭽﻤﻫ
يرﺎﺠﻨﻫﺎﻧ ﻲﺒﻠﻗ يﺎﻫ
- ﻲﺴﻔﻨﺗ
، ﻲﻨﻌﻣ ﻪﻄﺑار راد
ي اد دﻮﺟو ﺖﺷ
) لوﺪﺟ 3 (
؛
،شزﻮﻣآ ﺮﻈﻧ زا ﻦﻴﻨﭽﻤﻫ 89
% ياراد ناردﺎﻣ
رﺎﺠﻨﻫﺎﻧ كدﻮﻛ و ﻲﻫوﺮﮔ شزﻮﻣآ ﭻﻴﻫ ،
4 / 81 % شزﻮﻣآ ﭻﻴﻫ
يرﺎﺠﻨﻫﺎﻧ زا يﺮﻴﮕﺸﻴﭘ درﻮﻣ رد يدﺮﻓ ﺖﻓﺎﻳرد يدازردﺎﻣ يﺎﻫ
ﺪﻧدﻮﺑ هدﺮﻜﻧ .
ﺚﺤﺑ ﺶﻫوﮋﭘ ﻦﻳا ﻲﻃ
، يرﺎﺠﻨﻫﺎﻧ عﻮﻴﺷ نﺎﻴﻣ رد يدازردﺎﻣ يﺎﻫ
ﻲﺳرﺮﺑ درﻮﻣ نﺎﻛدﻮﻛ 53
/ 0 % ارا رﺎﻣآ ﺎﺑ ﻪﻛ ﺪﺷ ﻦﻴﻴﻌﺗ ﺋ
ﻪ رد هﺪﺷ
ﻲﺳرﺮﺑ ترﻮﺻ يﺎﻫ كارا رد ﻪﺘﻓﺮﮔ
) 82 / 0 (%
ﻛﺮﻬﺷ ، دﺮ ) 5 / 2 (%
،
ﻞﺑﺎﺑ ) 4 / 0 (%
ﺮﻬﺷﻮﺑ ، ) 03 / 5 (%
و ناﺮﻬﺗ ) 2 / 5 (%
، طﺎﻘﻧ ﻲﺧﺮﺑ رد
ﻢﻫ اد ﻲﻧاﻮﺧ ﻪﺘﺷ
و ﺎﺑ دراﺪﻧ ﻲﻧاﻮﺨﻤﻫ ﻲﺧﺮﺑ )
15 - 19 ( . ﻦﻳا
ﺾﻗﺎﻨﺗ
، ﻪﺑ ﻪﻧﻮﻤﻧ ﻢﺠﺣ و ﻪﻌﻟﺎﻄﻣ نﺎﻣز تﺪﻣ لﻮﻃ توﺎﻔﺗ ﻞﻴﻟد
يرﺎﺠﻨﻫﺎﻧ عﻮﻧ داﺪﻌﺗ
ﻦﺳ ﻦﻴﮕﻧﺎﻴﻣ )
هﺎﻣ ( فاﺮﺤﻧا رﺎﻴﻌﻣ لﺎﻜﺳوﺮﻛ نﻮﻣزآ ﺲﻴﻟاو
ﻲﺒﺼﻋ ﻪﻟﻮﻟ يﺎﻬﺼﻘﻧ
11 74
/ 10 66
/ 11 79
/ 11
X2=
DF=5 03 /
P=0
ﻲﺘﻠﻜﺳا تﻻﻼﺘﺧا
8 9
/ 4 76
/ 4
ﻲﺷراﻮﮔ 14
25
/ 4 92
/ 4
نواد مورﺪﻨﺳ
4 5
/ 6 26
/ 5
ﻲﺒﻠﻗ - ﻲﺴﻔﻨﺗ 39
69
/ 4 61
/ 9
يرﺎﺠﻨﻫﺎﻧ ﻒﻳﺮﻌﺗ يدازردﺎﻣ يﺎﻫ هﺪﺸﻧ
16 5
/ 3 04
/ 7
ﻊﻤﺟ 92
25
/ 5 51
/ 8
ﺶﻫوﮋﭘ رد ﻪﻌﻟﺎﻄﻣ ﻲﻣ ﺮﮕﻳد يﺎﻫ
ﺪﺷﺎﺑ . رﺎﺠﻨﻫﺎﻧ نادازﻮﻧ زا
ﻲﺳرﺮﺑ ﺶﻫوﮋﭘ ﻦﻳا رد هﺪﺷ
، 9 / 55 % و ﺮﺴﭘ 1 / 44 % ﺮﺘﺧد
هدﻮﺑ مﺎﺠﻧا ﻪﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ ﺎﺑ ﻪﻛ ﺪﻧا ناﺮﻬﺗ رد هﺪﺷ
؛ ﻲﻨﻌﻳ 62 %
و ﺮﺴﭘ 38 % عﻮﻴﺷ ﻪﻛ نﻮﮔﺎﻧﻮﮔ ﻊﺑﺎﻨﻣ و تﻻﺎﻘﻣ رﺎﻣآ ﺰﻴﻧ و ﺮﺘﺧد
يرﺎﺠﻨﻫﺎﻧ ﻦﻳا هدﺮﻛ حﺮﻄﻣ ﺮﺘﺸﻴﺑ ناﺮﺴﭘ رد ار ﺎﻫ
ﺪﻧا
، ﻢﻫ ﻲﻧاﻮﺧ
دراد ) 15
، 19 .(
2 / 26 % رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ
، ﻦﺳ ﺎﺑ ناردﺎﻣ زا
رادرﺎﺑ ي زﻳ ﺮ 37 ﺪﻧدﻮﺑ هﺪﺷ ﺪﻟﻮﺘﻣ لﺎﺳ ﻲﺳرﺮﺑ رد ﻪﻛ
ترﻮﺻ ناﺮﻬﺗ رد ﻪﺘﻓﺮﮔ
، ﻢﻗر ﻦﻳا 7
/ 38 ) % 20 ( و رد كارا
4 / 46 % ﺖﺳا هدﻮﺑ )
15 (
؛ ﻦﻴﻨﭽﻤﻫ 7
/ 45 % رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ
،
زا ﺮﺘﻤﻛ نزو 2500
ﺪﻨﺘﺷاد مﺮﮔ .
ا ﺐﻠﻏ ﻊﺑﺎﻨﻣ
، طﺎﺒﺗرا ﻪﺑ ﻦﻴﺑ
يرﺎﺠﻨﻫﺎﻧ عﻮﻴﺷ و ﺪﻟﻮﺗ نﺎﻣز نزو هرﺎﺷا يدازردﺎﻣ يﺎﻫ
هدﻮﻤﻧ ﺪﻧا ) 20 .(
زا يﺪﻧوﺎﺸﻳﻮﺧ ﺖﺒﺴﻧ ﺮﻈﻧ
، 5 / 58 ﻦﻳﺪﻟاو ﺪﺻرد
رﺎﺠﻨﻫﺎﻧ كدﻮﻛ ياراد
، ﺘﺷاد ﺮﮕﻳﺪﻜﻳ ﺎﺑ يﺪﻧوﺎﺸﻳﻮﺧ ﺖﺒﺴﻧ ﻪ
ا ﺪﻧ
نﺎﺸﻧ ﻪﻛ ﺖﺒﺴﻧ ﺎﺑ يرﺎﺠﻨﻫﺎﻧ ﻢﻴﻘﺘﺴﻣ طﺎﺒﺗرا هﺪﻨﻫد
دراد ﻦﻳﺪﻟاو يﺪﻧوﺎﺸﻳﻮﺧ
؛
ّﻓﻮﻣ ﻪﻌﻟﺎﻄﻣ رد ﻪﻛ نآ لﺎﺣ ﻖ
و
نارﺎﻜﻤﻫ ﻲﺘﺸﻬﺑ ﺪﻴﻬﺷ هﺎﮕﺸﻧاد رد
، 26 / 7 ناﺪﻧزﺮﻓ ﺪﺻرد
يرﺎﺠﻨﻫﺎﻧ ياراد
، ﻴﺘﻧ ﺪﻧدﻮﺑ يﺪﻧوﺎﺸﻳﻮﺧ ﺖﺒﺴﻧ ﻪﺠ )
21 ( رد ﺎﻣا ،
رﻮﻬﻇ ﻪﻌﻟﺎﻄﻣ نارﺎﻜﻤﻫ و
ﺖﻓﺮﻴﺟ رد
، 84 ﻦﻳﺪﻟاو نادازﻮﻧ ﺪﺻرد
ﺪﻧوﺎﺸﻳﻮﺧ
، ﺪﻨﺘﺷاد يرﺎﺠﻨﻫﺎﻧ )
22 .(
يوﺮﺴﺧ ﻪﻌﻟﺎﻄﻣ رد و
نارﺎﻜﻤﻫ كارا رد
، 4 / 29 % يرﺎﺠﻨﻫﺎﻧ دراﻮﻣ
، و رﺪﭘ ﻦﻴﺑ ردﺎﻣ
ﺖﺷاد دﻮﺟو ﺪﻧوﺎﺸﻳﻮﺧ )
14 .(
يﻻﺎﺑ عﻮﻴﺷ ﻞﻳﻻد زا ﻲﻜﻳ
رد يرﺎﺠﻨﻫﺎﻧ رﻮﺸﻛ قﺮﺷ ﻖﻃﺎﻨﻣ
، ﻲﻣ ندﻮﺑﻻﺎﺑ ﺪﻧاﻮﺗ
جاودزا ﺪﺷﺎﺑ ﻲﻠﻴﻣﺎﻓ يﺎﻫ
؛ هروﺎﺸﻣ ﺶﻘﻧ اﺬﻟ جاودزا زا ﻞﺒﻗ يﺎﻫ
رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ ﺪﻟﻮﺗ زا يﺮﻴﮕﺸﻴﭘ رد
، ﻲﺘﺴﻳﺎﺑ ﺶﻴﭘ زا ﺶﻴﺑ
درﻮﻣ ﻪﺟﻮﺗ دﺮﻴﮔ راﺮﻗ .
8 / 39 % نﺎﻛدﻮﻛ ﻦﻳا ناردﺎﻣ زا
، ﺖﺴﺨﻧ از
هدﻮﺑ
ًﺎﺒﻳﺮﻘﺗ ﻪﻛ ﺪﻧا رﺎﻣآ ﺮﻳﺎﺳ ﺎﺑ
يﺎﻫ ارا ﺋ ﻪ اﺮﻳا رد هﺪﺷ ﻢﻫ ن
ﻲﻧاﻮﺧ
دراد ) 23 ( ﺮﻛذ ﺐﻟﺎﻄﻣ ﺎﺑ ﻦﻴﻨﭽﻤﻫ ؛ تﻻﺎﻘﻣ ﻲﺧﺮﺑ رد هﺪﺷ
ﺖﺳردﺎﻧ ﺮﺑ ﻲﻨﺒﻣ ﻲﺟرﺎﺧ
ﻮﺼﺗ ندﻮﺑ ﺮﺘﺸﻴﺑ ر
يرﺎﺠﻨﻫﺎﻧ رد ﺎﻫ
دراد ﺖﻘﺑﺎﻄﻣ ﺰﻴﻧ لوا نادازﻮﻧ )
4 .(
يرﺎﺠﻨﻫﺎﻧ عﻮﻴﺷ ﻪﺑ يدازردﺎﻣ يﺎﻫ
ﺐﻴﺗﺮﺗ : 5 / 36 % ﻲﺒﻠﻗ -
و ﻲﺴﻔﻨﺗ 1
/ 16
% ﺖﺳا هدﻮﺑ ﻲﺘﻠﻜﺳا تﻻﻼﺘﺧا .
ﻲﺳرﺮﺑ ﻲﻃ
لﺎﺳ 1382 رد ﻪﺑ ناﺮﻬﺗ ﺐﻴﺗﺮﺗ
: ﻢﺘﺴﻴﺳ ،ﻲﻧاﻮﺨﺘﺳا تﻻﻼﺘﺧا يراردا
- ﻲﺒﻠﻗ و ﻲﻠﺳﺎﻨﺗ
، هﺪﺷ حﺮﻄﻣ ﻊﻳﺎﺷ تﻻﻼﺘﺧا زا ﺪﻧا
) 19 .(
ﻪﻌﻟﺎﻄﻣ رد ﺪﺷ مﺎﺠﻧا ﺎﻴﻟﺎﺘﻳا رد ﻪﻛ يا
، ﻢﺘﺴﻴﺳ ﺺﻘﻧ
ﻲﺒﺼﻋ
، ﺖﺳا هدﻮﺑ نادازﻮﻧ ﻲﻧﺎﻬﮔﺎﻧ ﺮﻴﻣ و گﺮﻣ ﻞﻴﻟد ﻦﻳﺮﺘﺸﻴﺑ
) 24 (
؛ ﻪﻌﻟﺎﻄﻣ رد ﻦﻴﻨﭽﻤﻫ ﺪﺷ مﺎﺠﻧا ﻞﻴﺋاﺮﺳا رد ﻪﻛ يا
،
ﺘﺸﻴﺑ يرﺎﺠﻨﻫﺎﻧ ﻞﻴﻟد ﻦﻳﺮ ﻲﻟﺎﻣﻮﻧآ ،يدازردﺎﻣ يﺎﻫ
ﻲﺒﻠﻗ يﺎﻫ
ﺖﺳا هﺪﺷ شراﺰﮔ )
25 ( دراد ﻲﻧاﻮﺨﻤﻫ ﺎﻣ ﻪﻌﻟﺎﻄﻣ ﺎﺑ ﻪﻛ .
نﺎﺸﻧ ﻪﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ ﻦﻴﻨﭽﻤﻫ ﻪﻛ داد
78 % رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ
ﺪّﻟﻮﺘﻣ هﺪﺷ
، هدﻮﻤﻧ تﻮﻓ ﻲﺳرﺮﺑ هرود ﻲﻃ ﺪﻧا
؛ ﻪﺑ يرﻮﻃ ﻪﻛ
ﻪﻛ داد نﺎﺸﻧ رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ تﻮﻓ مﺎﮕﻨﻫ ﻦﺳ ﻦﻴﮕﻧﺎﻴﻣ ﻃ ﻦﻳﺮﺘﻤﻛ ﻒﻳﺮﻌﺗ يدازردﺎﻣ يرﺎﺠﻨﻫﺎﻧ ﻪﺑ طﻮﺑﺮﻣ ﺮﻤﻋ لﻮ
هﺪﺸﻧ
ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ ﺎﺑ 5
/ 3 ﻪﺑ طﻮﺑﺮﻣ ﺮﻤﻋ لﻮﻃ ﻦﻳﺮﺘﺸﻴﺑ و هﺎﻣ
ﺺﻘﻧ ﺎﺑ نﺎﻛدﻮﻛ ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ ﺎﺑ ﻲﺒﺼﻋ ﻪﻟﻮﻟ يﺎﻫ
7 / 10 هﺎﻣ
دﻮﺑ . ﻪﺘﻓﺎﻳ ﺑ يﺎﻫ ﻪ ﺖﺳد ﻦﻳا رد شزﻮﻣآ ﺐﺴﻛ ﺎﺑ ﻪﻄﺑار رد هﺪﻣآ
ﻪﻛ داد نﺎﺸﻧ ﻪﻨﻴﻣز 9
/ 88 % ناردﺎﻣ
، ﭻﻴﻫ نﻮﻨﻛﺎﺗ ﻲﺷزﻮﻣآ ﻪﻧﻮﮔ
يرﺎﺠﻨﻫﺎﻧ زا يﺮﻴﮕﺸﻴﭘ و ﻚﻴﺘﻧژ هروﺎﺸﻣ صﻮﺼﺧ رد ﻪﺘﺷاﺪﻧ يدازردﺎﻣ ﺪﻧا
. ﺴﻣ ﻦﻳا ﺌ ﻪﻠ
، تﻼﺧاﺪﻣ مﺎﺠﻧا تروﺮﺿ
ﻲﺷزﻮﻣآ ياﺮﺑ
ﺎﻘﺗرا ي ﻪﺑ ناردﺎﻣ ﻲﻫﺎﮔآ ﺢﻄﺳ مﺎﺠﻧا رﻮﻈﻨﻣ
يرﺎﺠﻨﻫﺎﻧ زا يﺮﻴﮕﺸﻴﭘ و ﻚﻴﺘﻧژ هروﺎﺸﻣ ار يدازردﺎﻣ يﺎﻫ
ﻲﻣ ﺪﺒﻠﻃ .
ﻪﺠﻴﺘﻧ يﺮﻴﮔ
ﺎﺑ ﺑ ﺞﻳﺎﺘﻧ ﻪﺑ ﻪﺟﻮﺗ ﻪ
ﺖﺳد ﻣآ هﺪ
، ا ﺐﻠﻏ ﻲﻟﺎﻣﻮﻧآ يﺎﻫ
طﻮﺑﺮﻣ ،يدازردﺎﻣ ﻲﻣ ﻲﺒﻠﻗ و ﻲﺒﺼﻋ ﻢﺘﺴﻴﺳ
ﺪﺷﺎﺑ
؛ ﻦﻴﻨﭽﻤﻫ
ﻲﻣ دﺎﻳزرﺎﻴﺴﺑ ،رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ رد ﺮﻴﻣ و گﺮﻣ لﺎﻤﺘﺣا ﺪﺷﺎﺑ
؛
ﺑ ﻪ يرﻮﻃ ﻪﻛ 78 % رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ و ﺪﻧدﺮﻛ تﻮﻓ ﺪﻟﻮﺗ زا ﺲﭘ
5 / 58 % رﺎﺠﻨﻫﺎﻧ كدﻮﻛ ياراد ﻦﻳﺪﻟاو
، ﺎﺑ يﺪﻧوﺎﺸﻳﻮﺧ ﺖﺒﺴﻧ
ﺪﻨﺘﺷاد ﺮﮕﻳﺪﻜﻳ
؛ ﻪﺟﻮﺗ ﺎﺑ اﺬﻟ ﻪﻨﻳﺰﻫ ﻪﺑ
و نﺎﻣرد ﺖﻔﮕﻨﻫ يﺎﻫ
ﺖﻳﺎﻬﻧ رد ﻪﻛ رﺎﺠﻨﻫﺎﻧ نﺎﻛدﻮﻛ ﻲﻧاﻮﺗزﺎﺑ
، ﻪﺑ ﺮﺠﻨﻣ ﺎﻬﻧآ ﺮﺘﺸﻴﺑ
ﻲﻣ تﻮﻓ ﻦﻴﻳﺎﭘ و ﺪﻧﻮﺷ
رد شزﻮﻣآ ناﺰﻴﻣ ندﻮﺑ ﻪﻌﻣﺎﺟ ﺢﻄﺳ
ﺺﻴﺨﺸﺗ و ﻚﻴﺘﻧژ هروﺎﺸﻣ ﺖﻴﻤﻫا و ﻪﻌﻟﺎﻄﻣ درﻮﻣ زا ﻞﺒﻗ يﺎﻫ
رﺎﺠﻨﻫﺎﻧ كدﻮﻛ ﺪﻟﻮﺗ زا يﺮﻴﮕﺸﻴﭘ رد ﺪﻟﻮﺗ
، ﻪﺑ ﻪﺟﻮﺗ هروﺎﺸﻣ
زا ﻞﺒﻗ جاودزا آ و يروﺮﺿ ﺪﻟﻮﺗ زا ﻞﺒﻗ ﻲﺼﻴﺨﺸﺗ تﺎﺸﻳﺎﻣز
ﺖﺳا .
ﺮﻜﺸﺗ و ﺮﻳﺪﻘﺗ
ﻦﻳا ﺶﻫوﮋﭘ
، رد ﺐﻟﺎﻗ حﺮﻃ ﻲﺗﺎﻘﻴﻘﺤﺗ ﺪﻛ ﺎﺑ
و 836 ﺎﺑ
ﺖﻳﺎﻤﺣ ﻲﻟﺎﻣ هﺎﮕﺸﻧاد مﻮﻠﻋ ﻲﻜﺷﺰﭘ ﺪﻨﺟﺮﻴﺑ مﺎﺠﻧا هﺪﺷ ﺖﺳا . نﺎﮔﺪﻨﺴﻳﻮﻧ
،ﻪﻟﺎﻘﻣ ﺐﺗاﺮﻣ ﺮﻜﺸﺗ دﻮﺧ ار زا و تﺎﻘﻴﻘﺤﺗ ﺖﻧوﺎﻌﻣ
هﺎﮕﺸﻧاد يروﺎﻨﻓ ﻪﺑ ،
هﮋﻳو يﺪﻨﻜﻬﭼ دﻮﻤﺤﻣ يﺎﻗآ بﺎﻨﺟ ﮋﻧ
رد دا
ﻲﻟﺎﻣ رﻮﻣا ﺖﻧوﺎﻌﻣ ﻦﻳا
و ﺰﻴﻧ ﺆﺴﻣ ﺰﻛاﺮﻣ ﻦﻴﻟو ﻲﺘﺷاﺪﻬﺑ
و
ﻪﻛ ﻲﻧﺎﻣرد ﺖﻳﺎﻬﻧ
يرﺎﻜﻤﻫ ار
ﺎﺑ ﻦﻴﻟوﺆﺴﻣ ياﺮﺟا
حﺮﻃ
،ﺪﻨﺘﺷاد
ﻲﻣ زاﺮﺑا ﺪﻧراد .
ﻊﺑﺎﻨﻣ :
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Abstract Original Article
Demographical condition of neonates with congenital abnormalities under Birjand city health centers during 2007-
2012
Zahra Amini Nasab1,Farkhondeh Aminshokravi2, Mitra Moodi3, Batool Eghbali4, Faezeh Fatemimogadam1
Background and Aim: Along with extensive control of communicable diseases and decrease in their prevalence, congenital anomalies (CA) has grasped much attention in recent years. Almost 20% of babies’
mortality under one year of age is associated with CA. The present study was conducted to determine the percent of newborns with CA under Birjand city health centers.
Materials and Methods: In this descriptive-analytical and retrospective study all newborns with CA under Birjand city health centers during 2007-2012 were studied. Necessary data was collected by means of a researcher- designed questionnaire .whose content validity had already been confirmed. . The obtained data was analyzed using SPSS software (version 16) and Kruskal Wallis descriptive analytical statistical test at the significant level α=0.05.
Results: Out of 22076 newborn babies during 2007-2012, 118 cases had CA (CA prevalence was 5.34%). It was found that CA was more prevalent in boys than in girls (55.9% vs. 44.1%).The babies’ parents were mainly (58.5%) relatives. Congenital heart diseases (36.5%) and musculoskeletal disorders (16.1%) were accounted as the most prevalent.Most of the babies with CA had passed away when the present study began CA. Kruskal wallis analysis showed a significant difference in mean age of the deceased babies regarding their types of abnormalities (P=0.03).
Conclusion: Most of congenital anomalies had a relationship with nervous and cardiovascular systems.
Abnormal babies were very prone to death, and frequently they died while being uner one year.Thus,regard to premarital genetic counseling and undergoing prenatal diagnostic tests are necessary.
Key Words: Congenital anomalies; Health centers; Demographic; Genetic counseling; Prenatal diagnosis
Journal of Birjand University of Medical Sciences. 2014; 21 (1): 96-103.
Received: August 9, 2013 Accepted: April 15, 2014
1 M.Sc in Health Education, Population and Family Health, Member of the Research Center of Effective Social Factors on Health, Health center the city of Birjand, Birjand University of Medical Sciences, Birjand, Iran.
2Corresponding author, Assistant Professor, Department of Health Education and Health Promotion, Faculty of Medicine, Tarbiat Modarres University, Tehran, Iran. [email protected]
3Assistant Professor, Member of the Research Center of Effective Social Factors on Health, Department of Public Health, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran.
4MD and Ph.D student in Medical Education in Isfahan University of Medical Sciences, Expert Medical Education Development
