* :ﻪﺒﺗﺎﮑﻣ سردآ ﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،دﺎﺑآ مﺮﺧ
ﯽ ،نﺎﺘﺳﺮﻟ هﺪﮑﺸﻧاد زﺎﺳوراد ي ، هوﺮﮔ دﺎﺼﺘﻗا و ﺪﻣ ﯾ ﺮ ﯾ ﺖ وراد .
ﺖﺴﭘ :ﮏﯿﻧوﺮﺘﮑﻟا [email protected]
ﻞﯿﻠﺤﺗ ﺦﺴﻧ وراد ﯽﯾ و ﻮﺴﮐ تار ﻪﻤﯿﺑ نﺎﺘﺳﺮﻟ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﯽﺘﻟود ﻪﻧﺎﺧوراد يا
دﺎﻫ ي ﺣ ﯿ ﺗﺎ ﯽ
2
،1
ﯽﻟدرا دﺮﻓ ﯽﻠﯿﻠﺧ داﻮﺟ ،
* 3، 4
1 - ،رﺎﯾدﺎﺘﺳا ﻘﺤﺗ ﺰﮐﺮﻣ ﯿ تﺎﻘ ﺎﻫوراد ي ﮔ ﯿ ﻫﺎ ﯽ زار ،ي ﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﯽ
نﺎﺘﺳﺮﻟ ناﺮﯾا ،دﺎﺑآ مﺮﺧ ،
2 - ،يزﺎﺳوراد هﺪﮑﺸﻧاد ،وراد ﺖﯾﺮﯾﺪﻣ و دﺎﺼﺘﻗا هوﺮﮔ ،رﺎﯾدﺎﺘﺳا ﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد
ﯽ
،نﺎﺘﺳﺮﻟ ا ،دﺎﺑآ مﺮﺧ ﯾ ناﺮ
3 - رﺎﯾدﺎﺘﺳا ، ﻘﺤﺗ ﺰﮐﺮﻣ ﯿ تﺎﻘ دﺮﺑرﺎﮐ ي ﺋوراد
،ﯽ ﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﯽ
ﺮﺒﺗ ﯾﺰ ، ﺮﺒﺗ ﯾﺰ ،ا ﯾ ناﺮ
4 - ،رﺎﯾدﺎﺘﺳا ژﻮﻟﻮﮐﺎﻣرﺎﻓ هوﺮﮔ ي
ﺴﮐﻮﺗ و ﯿ ژﻮﻟﻮﮑ
،ي زﺎﺳوراد هﺪﮑﺸﻧاد
،ي ﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﯽ
ﺮﺒﺗ ﯾﺰ
، ﺮﺒﺗ
،ﺰﯾ اﯾ ناﺮ
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/ ﻞﺴﻠﺴﻣ 93
:ﻪﻟﺎﻘﻣ ﺖﻓﺎﯾرد 6
/ 4 / 1401 :ﻪﻟﺎﻘﻣ شﺮﯾﺬﭘ 15
/ 9 / 1401
ﻪﻣﺪﻘﻣ :
ﻮﻧ ﻪﺨﺴﻧ ﯾ ﺴ ﯽ اﺰﻓا ﺚﻋﺎﺑ ﺎﻫدراﺪﻧﺎﺘﺳا ﺎﺑ ﻖﺑﺎﻄﻣ ﯾ
ﺶ ﺸﺨﺑﺮﺛا ﯽ ﺶﻫﺎﮐ ﻪﻠﻤﺟ زا ﯽﻟﺎﻣ ﻊﺑﺎﻨﻣ ﻪﻨﯿﻬﺑ ﺖﯾﺮﯾﺪﻣ و نﺎﻣرد ﺰﻫ
ﯾﻨ ﻪ ﺎﻫ زا ﯽﺷﺎﻧ ي
ﺶﻫﺎﮐ ﻦﯾاﺮﺑﺎﻨﺑ .ددﺮﮔ ﯽﻣ ﺎﻫ ﻪﻤﯿﺑ تارﻮﺴﮐ ﻮﺴﮐ
تار ﯽﯾوراد ﺦﺴﻧ ﺮﺑ
هرادا يا ﺮﮐ وراد ند ﻧﺎﺧ ـ ﻪ ،ﻧ ـ ﻪ ﻻ ﺎﻬﻨﺗ ،مز ﺿ ﻪﮑﻠﺑ ﺮ يرو ﻪﺑ ﯽﻣ ﺮﻈﻧ ر ﺪﺳ .
ﺬﻟ ا ﺪﻫ ﺎﺑ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ف
ﺮﺑ ر ﯽﺳ ﻠﺤﺗ ﯿ ﻞ وراد ﺦﺴﻧ ﯽﯾ و ﻮﺴﮐ تار نﺎﺘﺳﺮﻟ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﯽﺘﻟود ﻪﻧﺎﺧوراد يا ﻪﻤﯿﺑ مﺎﺠﻧا
دﺮﮔ ﯾ ﺪ .
شور و داﻮﻣ :ﺎﻫ
ا ﮋﭘ ﻦﯾ و ﻪﻌﻟﺎﻄﻣ ﮏﯾ ﺶﻫ ﯽﻌﻄﻘﻣ
ﺮﮕﻧﻪﺘﺷﺬﮔ ﯽﺳرﺮﺑ ﻞﻣﺎﺷ ﻪﮐ ﺖﺳا
ﺎﻫﻪﻤﯿﺑ ﺦﺴﻧ ﯽﻣﺎﻤﺗ ي
ﻦﯿﻣﺄﺗ ا ﯽﻋﺎﻤﺘﺟ و ﺮﯿﻧ و ﻫ ـ ﺎ ي
ﺴﻣ ـ ﺢﻠ ﺑ ﯽﻣ .ﺪﺷﺎ ا ﻋﻼﻃ ـﺎ ت ﻣ ـ ﻮ در ﻈﻧ ـ ﺮ زا ﯾﺮﻃ ـ ﻖ ﮏﭼ ﻊﻤﺟ ﺖﺴﯿﻟ يروآ
ﺮﮔ د ﺪﯾ ﺲﭙﺳ. هداد ﺎﻫ ﺎﺑ ﺮﻧ م اﻓ ـ ﺰ را 22 ﻣSPSS ـ ﻮ در ﯾﺰﺠﺗ ﻪ و
ﻞﯿﻠﺤﺗ آ ﺎﻣ ير ﺮﻗ را ﺪﻨﺘﻓﺮﮔ .
ﻪﺘﻓﺎﯾ :ﺎﻫ
ﺎﺸﻧ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﺞﯾﺎﺘﻧ داد ن
ﻪﮐ ﺑﯿ ﺮﺘﺸ ﯾ ﻦ داﺪﻌﺗ ﺦﺴﻧ يﺰﯾﻮﺠﺗ ﻣﻮﻤﻋ نﺎﮑﺷﺰﭘ ﻪﺑ طﻮﺑﺮﻣ و ﺪﻨﺷﺎﺑ ﯽﻣ ﯽ
طﺎﺒﺗرا رد ر تارﻮﺴﮐ ﺎﺑ ﯽﻟﺎﯾ
ﻦﯾا ،ﻪﻤﯿﺑ ود ﺑﯿ ﺮﺘﺸ ﯾ ﻦ ﻣ ﯿ ناﺰ ر ﯾﻟﺎ ﯽ ﻪﻧﺎﻫﺎﻣ ﻪﻤﯿﺑ ﻧﯿ ﺎﻫوﺮ ي ﺪﻌﺗ ﻪﺑ طﻮﺑﺮﻣ ﺢﻠﺴﻣ ﯾ
ﻞ ﻗ ﯿ ﺘﻤ ﯽ ﺘﺳاﻮﺧرد و ﯽ
)ﺮﺘﻤﮐ 1700606 لﺎﯾر ( و ﺎﺑ طﺎﺒﺗرا رد
ﺑﯿ ﻪﻤ ﻣﺎﺗ ﯿ ﻦ ﻋﺎﻤﺘﺟا ﯽ ﺑﯿ ﺮﺘﺸ ﯾ ﻦ ﻣ ﯿ ناﺰ ﮑﺷﺰﭘ مﺎﻈﻧ ﺪﮐ ﻪﺑ طﻮﺑﺮﻣ تارﻮﺴﮐ ﯽ
) هﺎﺒﺘﺷا 4617125 لﺎﯾر ( دﻮﺑ .
ﻪﺠﯿﺘﻧ و ﺚﺤﺑ :يﺮﯿﮔ
ﺮﺑ ا ﺎﺳ س ﻮﺗﯽﻣ ﻞﺻﺎﺣ ﺞﯾﺎﺘﻧ نا
ﻧ ﺖﻓﺮﮔ ﻪﺠﯿﺘ ﻠﻋ ﻦﯾﺮﺘﻤﻬﻣ ﻪﮐ
ﺖ زا دﻮﺑ ﯽﻧﺎﺴﻧا يﺎﻄﺧ ﻪﺑ طﻮﺑﺮﻣ تارﻮﺴﮐ ور ﻦﯾا
ﺮﺑ يا
ﮐ ـ ﺶﻫﺎ نداد ﻮﺴﮐ تار ﺎﻫﻪﺨﺴﻧ زا يرﻮﻣا ﺖﻬﺟ ﺎﻫ ﻪﻧﺎﺧوراد و ﺎﻫ ﻪﻤﯿﺑ ﻦﯿﺑ يﺮﺘﺸﯿﺑ ﯽﮕﻨﻫﺎﻤﻫ ﺪﯾﺎﺑ اﺪﺘﺑا ﺮﮐ ﺺﺨﺸﻣ ﻞﯿﺒﻗ
ند ﻮﻣ ا در ﺖﺤﺗ
ﻪﻤﯿﺑ ﺶﺷﻮﭘ و
آ و دﺮﯿﮔ ترﻮﺻ ﺎﻫ ﻪﻣﺎﻧ ﻦﯿﯾ ﻦﯿﻨﭽﻤﻫ
ﺎﻈﻧ آو تر ﻮﻣ داﺮﻓا زور ﻪﺑ شز هرﺎﺑرد
ﺢﯿﺤﺻ دراو ﺮﮐ ا ند ﺎﻋﻼﻃ ﯽﻨﺘﺒﻣ ﺦﺴﻧ ت دراﺪﻧﺎﺘﺳا ﺮﺑ
و ﺎﻫ آ ا ﺎﻫ ﻪﻣﺎﻧ ﻦﯿﯾ ﺠﻧ
ـ ﺎ .دﻮﺷ م
هژاو ﺪﯿﻠﮐ يﺎﻫ :ي
وراد ﺦﺴﻧ ﯽﯾ ، ﻮﺴﮐ تار ، ﻦﯿﻣﺄﺗ ا ﯽﻋﺎﻤﺘﺟ ، ﺮﯿﻧ و ﺎﻫ ي ﺴﻣ ـ ﺢﻠ ﯽﺘﻟود ﻪﻧﺎﺧوراد ،
.
هﺪﯿﮑﭼ
ﻪﻣﺪﻘﻣ
ﻮﺠﺗ ﯾﺰ وراد فﺮﺼﻣ و ﯾﮑ
ﯽ ﺮﺘﻤﻬﻣ زا ﯾ ﻦ ﺛﺎﺗ ﻞـﻣاﻮﻋ ﯿ
راﺬـﮔﺮ
ﺑ ﺮﺜﮐا نﺎﻣرد ﺮﺑ ﯿ
رﺎﻤ ي ﻣ ﺎﻫ ﯽ ﺪـﺷﺎﺑ ﯽـﺑ ﯽﻬﺟﻮـﺗ ﺎﻋر ﻪـﺑ ـﯾ ﺖ
ﻮﻧ ﻪﺨـﺴﻧ لﻮـﺻا ﯾ
ـﺴ ﯽ ﺎــﻫ ﺶﻟﺎـﭼ زوﺮـﺑ ﺚـﻋﺎﺑ دراﺪﻧﺎﺘــﺳا ي
ﺴﺑ ﯿ رﺎ ي ﻧﺎﻣرد ﺪﻌﺑ زا ﻢﻫ ﯽ
ﺰﻫ ﻢﻫ و ﯾ ﻪﻨ ﺖﻣﻼـﺳ مﺎـﻈﻧ ﻪـﺑ ﺎﻫ
ﻣ ﯽ ﺪﻫاﻮﺧ هاﺮﻤﻫ ﻪﺑ ار ﻖﻓﻮﻣﺎﻧ و ﺖﺳردﺎﻧ نﺎﻣرد ﻪﮐ اﺮﭼ دﻮﺷ
ﺗرﻮﺻ رد ﺖﺷاد ﯽ
ﻮﺠﺗ ﻪﮐ ﯾﺰ ﻘﻄﻨﻣ فﺮﺼﻣ و ﺖﺳرد ﯽ
ﺎـﻫوراد
ﮔﻮﻠﺟ و داﺮﻓا ﺖﻣﻼﺳ ءﺎﻘﺗرا ﺚﻋﺎﺑ ﯿﺮ
ي ﻫ زا ﺰﯾ ﻪﻨ ﺎـﻫ ي ﻟﺎـﻣ ﯽ و
ﻧﺎﺴﻧا ﯽ ﻣ ﯽ دﻮﺷ ) 1،2 ( . اﺮﺑﺎﻨﺑ ﯾ ﻦ اﯾ ﻦ ﺎﺑ ار ﻪـﺘﮑﻧ ـﯾ
ﺪ ﺮـﻈﻧ ﺪـﻣ
ﻮﻧ ﻪﺨــﺴﻧ ﻪــﮐ ﺖــﺷاد ﯾ
ــﺴ ﯽ ﻏ ــﯿ ﺮ ــﻘﻄﻨﻣ ﯽ زا جرﺎــﺧ و
بﻮﭼرﺎﻬﭼ ﺎﻫ
دراﺪﻧﺎﺘـﺳا ي ﻮـﺳ زا
ي ـﺼﺼﺨﺘﻣ و نﺎﮑـﺷﺰﭘ ﯿ
ﻦ
ﺪﻣآرﺎﮐﺎﻧ ﺚﻋﺎﺑ ي
ﻏ نﺎﻣرد و ﯿﺮ
ﺮﺛﻮﻣ ﻦﯿﻨﭽﻤﻫ و اﺰﻓا
ﯾ ﺶ تﺪـﻣ
ﺑ ﺖﻣﺎﻗا ﯿ رﺎﻤ ﺑ رد ﯿ نﺎﺘﺳرﺎﻤ ﻣ ﯽ ﺰﻫ نآ ﻊـﺒﺗ ﻪﺑ و دﻮﺷ ﯾ
ـﻨ ﻪ ﺎﻫ ي
ﻏﯿ ﺮ ﻘﻄﻨﻣ ﯽ اﺮـﺑ ﺎـﻬﻨﺗ ﻪﻧ ي
ﺑﯿ رﺎـﻤ ﻪـﮑﻠﺑ اﺮـﺑ ي ﺑﯿ نﺎﺘـﺳرﺎﻤ و
ﺳ ﯿ ﻢﺘﺴ ﺎﻫ ي ﺘﺷاﺪﻬﺑ ﯽ ﻧﺎﻣرد ﯽ ) ﺖـﺷاد ﺪـﻫاﻮﺧ هاﺮـﻤﻫ ﻪﺑ 1
،
3 ، 4 ( ﭘ نآ ﻊﺒﺗ ﻪﺑ و ﯿ
ﺎﻫﺪﻣﺎ ي ﺒﺳﺎﻨﻣﺎﻧ ﯽ ار ﺖﻬﺟ زا ﺎـﺿرﺎﻧ ﯾﺘ ﯽ
ﺑﯿ رﺎــﻤ
، ﺪــﺸﺗ ﯾﺪ ﺒﻧﺎــﺟ ضراﻮــﻋ
،ﯽ ﺑ نﺪــﺷ كﺎــﻧﺮﻄﺧ ﯿ
رﺎــﻤ
،ي
ﺑ و ﮏﺷﺰﭘ طﺎﺒﺗرا نﺪﺷ ﮓﻧﺮﻤﮐ ﯿ
رﺎﻤ اﺰـﻓا و ﯾ ﺶ ﺰﻫ ﯾ ﻪـﻨ ﺎـﻫ ي
ﻧﺎﻣرد ﯽ ﻮـﺒﻤﮐ و د ﺪـﻫاﻮﺧ هاﺮـﻤﻫ ﻪـﺑ رﻮـﺸﮐ رد وراد ﺖـﺷاد
) 5،6 .(
زا ﺮﮕﯾد ﯽﯾﻮﺳ ﺰﻫ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ
ﯾ ﻪﻨ ﺎﻫ ي ور و روآ مﺎﺳﺮﺳ
ﻮـﺳ زا ﻊﺑﺎـﻨﻣ دﻮـﺒﻤﮐ و نﺎـﻣرد و ﺖﺷاﺪﻬﺑ ﺪﺷر ﻪﺑ ي
د ﯾ ﺮـﮕ
،
مﺎﻈﻧ ﺎـﻫ ي ﺑ صﻮــﺼﺧ ﻪـﺑ و ﺖﻣﻼــﺳ ﯿ
نﺎﺘـﺳرﺎﻤ ﺎﻫ
دﻮــﺒﻤﮐ ﺎــﺑ
) ﺪﻨﺘﺴﻫ وﺮﺑور ﻪﺟدﻮﺑ 7،8
.(
اﺮﺑﺎﻨﺑ ﯾ ﻦ ﺖﻣﻼـﺳ يﺎـﻫ مﺎـﻈﻧ ﺎـﺑ
روﺮﺿ ﺬﭘﺎﻧ بﺎﻨﺘﺟا ت ﯾﺮ
ﺪﻣ ﯾﺮ ﯾ ﺖ ﻬﺑ ﯿ ﻪﻨ ﺎﺗ ﺪﻨﺘﺴﻫ ﻪﺟاﻮﻣ ﻊﺑﺎﻨﻣ
ﺮﺘﻬﺑ ﻪﺑ ﺪﻨﻧاﻮﺘﺑ ﯾ
ﻦ اﺰـﻓا ﺖﻬﺟ دﻮﺟﻮﻣ ﻊﺑﺎﻨﻣ زا ﻞﮑﺷ ﯾ
ﺶ هﺮـﻬﺑ
رو ي ﺪﻨﻨﮐ هدﺎﻔﺘﺳا )
7،9 ا رد .(
ﯾ ناﺮ ﺮـﺘﻤﻬﻣ ﯾ ﻦ ﻪـﺟدﻮﺑ ﻊﺑﺎـﻨﻣ
ﺑﯿ نﺎﺘﺳرﺎﻤ ﺑ ﺎﺑ ﺎﻫدادراﺮﻗ ﺎﻫ ﯿ
ﻪﻤ اﺮﺑﺎﻨﺑ ﺖﺳﺎﻫ ﯾ
ﻦ ﺑﯿ ﻪﻤ ﺶﻘﻧ ﺎﻫ
ﺴﺑ ﯿ رﺎ ﻤﻬﻣ ﯽ ﻣﺎﺗ رد ﯿ ﻦ ﻟﺎﻣ ﻊﺑﺎﻨﻣ ﯽ اﺮﺑ ي ﺑﯿ ﺘﺳرﺎﻤ نﺎ ﺎﻫ هﺪﻬﻋﺮﺑ
اﺮﺑﺎﻨﺑ ﺪﻧراد ﯾ
ﻦ ﺧﺎﺗ ﻪﻧﻮﮔﺮﻫ ﯿﺮ
ﺶﻫﺎـﮐ ﻪﺑ ﺮﺠﻨﻣ ﺎﻫ ﺖﺧادﺮﭘ رد
ﺪﺷ ﯾﺪ ﺑ ﻪﺑ تﺎﻣﺪﺧ ﻪﺋارا ﯿ
نارﺎﻤ ﻣ ﯽ دﻮﺷ ) 10 ( . ا رد ـﯾ ﻦ ﺎﺘـﺳار
ﺰﻫ ﻊﻗﻮﻤﺑ ﺖﺧادﺮﭘ ﺮﺑ هوﻼﻋ ﯾ
ﻪﻨ ﻨﺘﺒﻣ ﺎﻫ ﺖﺧادﺮﭘزﺎﺑ و ﺎﻫ ﯽ
ﺮـﺑ
ﺑ ﻪﺑ هﺪﺷ ﻪﺋارا دﺎﻨﺳا ﯿ
ﻪﻤ د ﻢﻬﻣ ﻪﻠﺌﺴﻣ ﯾ
ﺮﮕ ﺑ تارﻮﺴﮐ ﯿ ﻪـﻤ ا ي ﺎﻫ ﺖﮐﺮﺷ ﻪﮐ ﺖﺳا
ي ﺑﯿ ﻪﻤ ﺴﻧ ﺮﺑ ـﻣ لﺎﻤﻋا ﺦ ﯽ
ﺪـﻨﻨﮐ ﻦـﯾا و
ﺮﻣا ﺚﻋﺎﺑ رد ﺪﯾﺪﺸﺗ ﺎﻫﺪـﻣآرد ﺶﻫﺎـﮐ
ي ﻧﻮﻧﺎـﻗ ﯽ ﺑﯿ ﺎﻬﻧﺎﺘـﺳرﺎﻤ
ﻣ ﯽ دﻮــﺷ ) 8،11 ﺎــﺷ .(
ﯾﺪ زا ﺦــﺴﻧ تارﻮــﺴﮐ ﺖــﻔﮔ ناﻮــﺘﺑ
ﺮﺘﻤﻬﻣ ﯾ ﻦ ﺸﻟﺎﭼ ﻞﺋﺎﺴﻣ ﯽ
ﮕﻧا ﺚﺤﺑ و ﯿﺰ
ـﺑ ﯿ ﻦ نﺎﮔﺪـﻨﻫد ﻪـﺋارا
ﻣﺪﺧ ﺎ ﺎﻬﻧﺎﻣزﺎﺳ و ت ي
ﺑﯿ ﻪﻤ ﺮﮔ ﺖﺳا ) 7 ( . ﻧ ﺎﻫ ﻪﻧﺎﺧوراد ـﯿ
ﺰ ﻪـﺑ
ﺎﭘ ﻂﺧ ناﻮﻨﻋ ﯾ
نﺎ ﺑ ﻪﺑ تﺎﻣﺪﺧ ﻪﺋارا ﯿ
رﺎﻤ ﻠﮐ ﺶﻘﻧ ﯿ ﺪ ي ﻪـﺋارا رد
تﺎﻣﺪﺧ ﺪﻧراد اﺮﺑﺎﻨﺑ ﯾ ﻦ ﻣﺎﺗ ﯿ ﻦ ﻟﺎﻣ ﯽ ﻪﻧﺎﺧوراد ﻊﻗﻮﻣ ﻪﺑ ﺖﻬﺟ ﺎﻫ
ﻊﻗﻮﻣ ﻪﺑ ﻪﺋارا وراد
ﺳﺮﺘﺳد و ﯽ ﺑ ﻪﻧﻻدﺎﻋ ﯿ نارﺎﻤ وراد ﻪﺑ و ﻢـﻬﻣ
ﯽﺗﺎﯿﺣ ﺖـﺳا ) 12،13 اﺮﺑﺎـﻨﺑ .(
ﯾ ﻦ ﺶﻫﺎـﮐ رد ﺺـﻘﻧ ﻪـﻧﻮﮔﺮﻫ
ﺎﻫﺪﻣآرد ي ﺎﻫرﺮﺿ ﻪﺑ ﺮﺠﻨﻣ ﺎﻫ ﻪﻧﺎﺧوراد ي
ﺟ ناﺮﺒ ﺬﭘﺎﻧ ﯾﺮ ي رد
وراد تﺎﻣﺪﺧ ﻪﺋارا ﯽﯾ
ـﻣ ﯽ ـﻤﻫ ﻪـﺑ دﻮـﺷ ﯿ
ﻦ ﻟد ـﯿ ﻞ تارﻮـﺴﮐ
وراد ﯽﯾ ﺦﺴﻧ يا ﻪﻤﯿﺑ ﯾ ﮏ ﺳﺎﺳا ﻞﻀﻌﻣ ﯽ
ﭘ ﯿ ﺶ ور ي تﺎﻣﺪـﺧ
وراد ﯽﯾ ﺖﺳﺎﻫ ﻪﻧﺎﺧوراد )
14 ( . اﺮﭼ ﻪﮐ ﻻد ﻪﺑ ﺎﻫ ﻪﻧﺎﺧوراد ـﯾ
ﻞ
ﺎﻫﺪﻣآرد ﺶﻫﺎﮐ ﺚﻋﺎﺑ ﻒﻠﺘﺨﻣ ي
ﻧﻮﻧﺎﻗ ﯽ ﻪﻧﺎﺧوراد تﺎﻣﺪﺧ و ﺎﻫ
وراد ﯽﯾ ﻣ ﯽ ﻮﺷ ﻧﺪ اﺮﺑﺎﻨﺑ ﯾ ﻦ روﺮﺿ و مزﻻ ي
ﻪﮐ ﺖﺳا ﯽـﺳرﺮﺑ ﻪﺑ
ﺦــﺴﻧ ﯽــﻧاواﺮﻓ ﻊــﯾزﻮﺗ ﻞــﯿﻠﺤﺗ و و ﺖــﺧادﺮﭘ ﯽــﯾوراد
و ﻞــﻠﻋ
ﮕﻧﻮــﮕﭼ ﯽ ﺎــﺳﺎﻨﺷ تارﻮــﺴﮐ
،ﯽﯾ ــﺳرﺮﺑ ﯽ ﺎــﺗ ددﺮــﮔ حﻼــﺻا و
ﺎﻫﺪﻣآرد ي ﻧﻮﻧﺎﻗ ﯽ اﺰﻓا ﺎﻫ ﻪﻧﺎﺧوراد ﯾ
ﺶ ﯾ ﺪﺑﺎ ) 15،16 ( ﻦﯾاﺮﺑﺎﻨﺑ .
ﺳرﺮﺑ ﻪﺑ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﯽ
تارﻮـﺴﮐ ﺦـﺴﻧ
اد ور ﯽـﯾ ﻢﻬﻣ ﺮـﺗ ﯾ ﻦ
ﺑﯿ ﻪﻤ ﺎﻫ ي ﺎﺑ دادراﺮﻗ درﻮﻣ ﻪﻧﺎﺧوراد ﺎﻬﻨﺗ
ﺘﻟود ﯽ مﻮـﻠﻋ هﺎﮕـﺸﻧاد
ﮑﺷﺰﭘ ﯽ ﺖﺳا ﻪﺘﺧادﺮﭘ نﺎﺘﺳﺮﻟ .
شور و داﻮﻣ ﺎﻫ
اﯾ ﻦ ﻪﻌﻟﺎﻄﻣ ﯾ ﮏ دﺮﺑرﺎﮐ ﺶﻫوﮋﭘ ي
ﻪﺘـﺷﺬﮔ ترﻮﺻ ﻪﺑ
دﻮﺑ ﺮﮕﻧ ه ﺳرﺮﺑ ﻪﺑ ﻪﮐ ﯽ
ﻠﮐ ﯿ ﻪ ﺦﺴﻧ عاﻮﻧا هﺎﮔﺪﯾد زا ﯽﯾوراد
هﺪـﻨﻨﮐ ﺰﯾﻮﺠﺗ نﺎﮑﺷﺰﭘ رﺎﻤـﺷﺮﺳ ترﻮـﺻ ﻪـﺑ
ي لﺎـﺳ رد
1398 ﺘﺧادﺮﭘ ﻪ و ﻠﮐ ﯿ ﻪ ﺎـﻫ ﻪﺨـﺴﻧ ي
تارﻮـﺴﮐ لﻮﻤـﺸﻣ
ﺎﻫ نﺎﻣزﺎﺳ ي
ﺑ ﯿ ﻪﻤ ﻧ ﯿ ﺎـﻫوﺮ ي ﻣﺎـﺗ و ﺢﻠـﺴﻣ ﯿ
ﻦ ﻋﺎـﻤﺘﺟا ﯽ
ﺳرﺮﺑ درﻮﻣ ﯽ
راﺮﻗ ﺖﻓﺮﮔ . ﻬﺴﺗ ﺖﻬﺟ ﯿ
ﻞ و رﺎـﮐ مﺎـﺠﻧا رد
روآدﺮﮔ ي ﻪﺑ طﻮﺑﺮﻣ تﺎﻋﻼﻃا تارﻮﺴﮐ
ﺑ ﯿ ﻪﻤ ا ي اﺪﺘﺑا ﯾ ﮏ
روﺮﻣ ﻪﻌﻟﺎﻄﻣ ي
ﺮـﺘﻤﻬﻣ جاﺮﺨﺘـﺳا ﺖـﻬﺟ تﻻﺎـﻘﻣ رد ﯾ
ﻦ
وراد تارﻮﺴﮐ ﯽﯾ
ﺎـﻨﺒﻣ ﺮﺑ و ﺖﻓﺮﮔ ترﻮﺻ ﺎﻫ نآ ﻞﻠﻋ و ي
ﺎﻬﻧآ ﯾ ﮏ ﻟ ﮏﭼ ﯿ ﺖﺴ دراﺪﻧﺎﺘﺳا ﯽﺣاﺮﻃ
دﺮﮔ ﯾﺪ ﻞﻣﺎﺷ ﻪﮐ
ﺮﺘﻤﻬﻣ ﯾ ﻦ ﺖﻠﻋ ﻪﺑ طﻮﺑﺮﻣ تﻻاﻮﺳ تارﻮﺴﮐ
رد ﺴﻧ ﺦ ﺑﯿ ﻪﻤ
ﺮﻈﻧ و ﯽﺸﻫوﮋﭘ ﻖﺑاﻮﺳ و نﻮﺘﻣ روﺮﻣ زا هدﺎﻔﺘﺳا ﺎﺑ ﻪﮐ يا .دﻮــﺑ ﺮــﻣا نﺎــﺳﺎﻨﺷرﺎﮐ ﻪــﺑ ﻪــﻌﺟاﺮﻣ ﺎــﺑ ﺪــﻌﺑ ﻪــﻠﺣﺮﻣ رد
نﺎﻣزﺎﺳ ﺎﻫ ي ﺑ ﯿ ﻪﻤ ا ي ﺮـﺘﻤﻬﻣ ﯾ ﻦ ﺑ ﻞـﻠﻋ ﯿ ﻪـﻤ ا ي تارﻮـﺴﮐ
ﯽﯾوراد ﻪﻧﺎﺧوراد ﻪﺑ طﻮﺑﺮﻣ ﺪـﺷ ﺖـﻓﺎﯾرد ﯽـﻨﯿﻤﺧ مﺎـﻣا
تارﻮﺴﮐ ﺲﭙﺳ رد
ﯾ ﺘﻓﺎ ﯽ ـﺳرﺮﺑ درﻮﻣ ﺎﻫ ﻪﻧﺎﺧوراد ﯽ
راﺮـﻗ
ﺖﻓﺮﮔ . زا ﺲﭘ ﻤﺟ روآ ﻊ ي ﮏـﭼ زا هدﺎﻔﺘـﺳا ﺎﺑ تﺎﻋﻼﻃا
ﻟﯿ ﺖﺴ ﺎﻫ ي ﭘ زا ﯿ ﺶ ﺮﻌﺗ ﯾ ﻒ ﺰﺠﺗ ﻪـﺑ دراﺪﻧﺎﺘﺳا و هﺪﺷ ـﯾ
ﻪ
ﻠﺤﺗ ــﯿ ﻞ و ﺪــﺷ ﻪــﺘﺧادﺮﭘ ﺎــﻬﻧآ ﻞــﻠﻋ و تارﻮــﺴﮐ راﺪــﻘﻣ
ﻢﻬﻣ ﺮﺗ ﯾ ﻦ دﺮﮔ جاﺮﺨﺘﺳا ﺎﻬﻧآ راﺪﻘﻣ و تارﻮﺴﮐ ﻞﻠﻋ ﯾﺪ
. شور
ﺰﺠﺗ و ﺎﻫ ﯾ ﻪ ﻠﺤﺗ ﯿ ﻞ ﺎﻫ ي رﺎﻣآ ي
ﺮـﺗ ﻖﯿﻗد ﻞﯿﻠﺤﺗ ﻪﯾﺰﺠﺗ ﺖﻬﺟ
، هداد ﺎﻫ دراو ﺮﻧ م ا ﺰﻓ را
22 SPSS ﺪﻧﺪﺷ
و ﻮﻣ در ﻪﯾﺰﺠﺗ و ﻞﯿﻠﺤﺗ آ ﻣـ ﺎ ير ﻗ ــ ﺮ را
ﺪﻨﺘﻓﺮﮔ . ﺎﺑ ا ﺎﻔﺘﺳ هد آ زا ﺎﻣ ر ﯽﻔﯿﺻﻮﺗ ﺞﯾﺎﺘﻧ رد ﺐﻟﺎﻗ
ﺪﺟ لو ﺎﻫ ي آ ﺎﻣ ير ارا ﻪﺋ ﺪﺷ . رد ﻫﺮﯿﻐﺘﻣ ـﺎ ي ﻤﮐ ـ ﯽ ﻬﺟ ـ ﺖ
ﻒﯿﺻﻮﺗ ﺰﮐﺮﻣ هداد ﺎﻫ زا ﻦﯿﮕﻧﺎﯿﻣ و
ﺖﻬﺟ ﻒﯿﺻﻮﺗ
ﺮﭘ ا ﯽﮔﺪﻨﮐ هداد ﺎﻫ ا زا ﺮﺤﻧ فا ﺎﯿﻌﻣ ر ا ﺎﻔﺘﺳ هد ﺪﺷ . ﺎﻬﻧ ﯾ
ًﺎﺘ زا
آ نﻮﻣز رﺎﻣآ ي T-Test ﺖﻬﺟ
ﺎﻘﻣ ﯾ ﻪﺴ ﻐﺘﻣ ﯿﺮ درﻮـﻣ ﺮـﻈﻧ
رد ود هوﺮﮔ ﺑ ﯿ ﻪﻤ ﺪﺷ هدﺎﻔﺘﺳا .
ﺎﻫ ﻪﺘﻓﺎﯾ
ﺪﺟ لو 1 . ﺪﻌﺗ دا ﺦﺴﻧ ﯽﯾوراد ﻪﻧﺎﯿﻫﺎﻣ ﺎﮑﺷﺰﭘ ﮏﯿﮑﻔﺗ ﻪﺑ ن
ﯽﻋﺎﻤﺘﺟا ﻦﯿﻣﺎﺗ ﺦﺴﻧ ﻦﯿﮕﻧﺎﯿﻣ ﺢﻠﺴﻣ يﺎﻫوﺮﯿﻧ ﺦﺴﻧ ﻦﯿﮕﻧﺎﯿﻣ ﮏﺷﺰﭘ ﻒﯾدر
ﺪﺻرد داﺪﻌﺗ ﺪﺻرد داﺪﻌﺗ ﺺﺼﺨﺗ -
71 513 70 168 ﯽﻣﻮﻤﻋ 1
5 37 7 16 ﯽﻠﺧاد يﺎﻫيرﺎﻤﯿﺑ 2
4 30 5 12 بﺎﺼﻋا و ﺰﻐﻣ ﯽﺣاﺮﺟ 3
2 18 3 7 ﻦﯿﻐﻟﺎﺑ نﺎﻃﺮﺳ و نﻮﺧ يﺎﻫيرﺎﻤﯿﺑ 4
2 13 1 3 ﻞﺻﺎﻔﻣ و ناﻮﺨﺘﺳا ﯽﺣاﺮﺟ 5
4 28 4 9 سﺎﻨﺷﺎﻧ 6
1 6 2 4 قوﺮﻋ و ﺐﻠﻗ يﺎﻫيرﺎﻤﯿﺑ 7
1 6 0 1 (ﯽﭘاﺮﺗﻮﯾدار) ﯽﻧﺎﻣردﻮﺗﺮﭘ 8
1 5 0 1 ﺖﺳﻮﭘ يﺎﻫيرﺎﻤﯿﺑ 9
1 5 1 3 ﯽﻤﺴﯿﺗﺎﻣور يﺎﻫيرﺎﻤﯿﺑ 10
1 8 1 2 نﺎﻤﯾاز و نﺎﻧز يﺎﻫيرﺎﻤﯿﺑ 11
1 6 1 2 يراردا يرﺎﺠﻣ و ﻪﯿﻠﮐ ﯽﺣاﺮﺟ 12
2 14 1 3 بﺎﺼﻋا يﺎﻫيرﺎﻤﯿﺑ 13
0 2 0 0 ﻢﺸﭼ يﺎﻫيرﺎﻤﯿﺑ 14
1 10 0 1 بﺎﺼﻋا و ﺰﻐﻣ يﺎﻫيرﺎﻤﯿﺑ 15
0 1 0 0 نادازﻮﻧ يﺎﻫيرﺎﻤﯿﺑ 16
1 4 1 2 ﯽﻣﻮﻤﻋ ﯽﺣاﺮﺟ 17
0 1 0 0 ﯽﮑﺷﺰﭙﻧاﺪﻧد 18
0 0 0 1 يﺪﭘﻮﺗرا 19
1 8 0 1 نﺎﮐدﻮﮐ يﺎﻫيرﺎﻤﯿﺑ 20
1 4 0 1 (يژﻮﻟﻮﯾدار) ﯽﺼﯿﺨﺸﺗ ﯽﺳﺎﻨﺷﻮﺗﺮﭘ 21
0 0 0 0 ﯽﺸﺨﺒﻧاﻮﺗ و ﯽﮑﯾﺰﯿﻓ ﯽﮑﺷﺰﭘ 22
01
/0 P- value (T-Test)
ﻣ نﺎﺸﻧ قﻮﻓ لوﺪﺟ ﻪﮐ رﻮﻄﻧﺎﻤﻫ ﯽ
ﺪﻫد زﻮﺗ ﯾ ﻊ ﻧاواﺮﻓ ﯽ
وراد ﺦﺴﻧ ﯽﯾ
ﺎﻫ ﺺﺼﺨﺗ سﺎﺳا ﺮﺑ ي
ﮑﺷﺰﭘ ﯽ ﮐﺎﺣ ﯽ نآ زا
ﺑ ﻪﮐ ﺖﺳا ﯿ
ﺶ زا 70 ـﺷﺰﭘ ﻪـﺑ طﻮـﺑﺮﻣ ﺦـﺴﻧ ﺪـﺻرد نﺎﮑ
ﻣﻮﻤﻋ ﯽ اﺮﺑ ي ﺑ ود ﺮﻫ ﯿ ﻪﻤ ﻣ ﯽ نآ زا ﺪﻌﺑ و ﺪﺷﺎﺑ ﺗ
ﺺـﺼﺨ
ﺎﻫ ي ﻠﺧاد ﯽ ﺑ و ﯿ رﺎﻤ ي ﺎﻫ ي ﻧ بﺎﺼﻋا و ﺰﻐﻣ ﯿﺰ
اﺮـﺑ ي ﺮـﻫ ﺑ ود
ﯿ ﻪــﻤ ﻧ ﯿ ﺎــﻫوﺮ ي ﻣﺎــﺗ و ﺢﻠــﺴﻣ ﯿ
ﻦ ﻋﺎــﻤﺘﺟا ﯽ اراد ي
ﺑﯿ ﺮﺘﺸ ﯾ ﻦ ﻣ ﯿ ناﺰ ﻧاواﺮﻓ ﯽ ﻣ ﯽ ﻨﭽﻤﻫ .ﺪﺷﺎﺑ ﯿ
ﻦ رﻮﻄﻧﺎﻤﻫ ﻪﮐ
نﺎﺸﻧ لوﺪﺟ رد هﺪﻨﻫد
دﻮﺟو توﺎﻔﺗ رادﺎﻨﻌﻣ رﺎﻣا ي ـﺑ ﯿ ﻦ
داﺪﻌﺗ ﺦﺴﻧ ود عﻮﻧ ﺑ ﯿ ﻪﻤ ﺖﺳا . و ﻣﯿ ﮕﻧﺎ ﯿ ﻦ ﺦﺴﻧ رد ﺑ ﯿ ﻪـﻤ
ﻣﺎﺗ ﯿ ﻦ ﻋﺎﻤﺘﺟا ﯽ ﺑ ﯿ ﺮﺘﺸ ﺖﺳا .
ﺟ لوﺪ 2.
ﯽﻋﺎﻤﺘﺟا ﻦﯿﻣﺎﺗ و ﺢﻠﺴﻣ يﺎﻫوﺮﯿﻧ يﺎﻫ ﻪﻤﯿﺑ ﯽﯾوراد ﺦﺴﻧ ﻪﻨﯾﺰﻫ ﻦﯿﮕﻧﺎﯿﻣ ﻣﯿ
ﮕﻧﺎ ﯿ ﻦ ﻪﻧﺎﻫﺎﻣ ﺦﺴﻧ
ﯽﻋﺎﻤﺘﺟا ﻦﯿﻣﺎﺗ ﺢﻠﺴﻣيﺎﻫوﺮﯿﻧ ﻪﻧﺎﻫﺎﻣ ﺦﺴﻧﻦﯿﮕﻧﺎﻣﯿ
عﻮﻤﺠﻣ رﺎﯿﻌﻣ فاﺮﺤﻧا ﻦﯿﮕﻧﺎﻣﯿ عﻮﻤﺠﻣ رﺎﯿﻌﻣ فاﺮﺤﻧا ﻦﯿﮕﻧﺎﯿﻣ
8516593151 15381863 11748131 4184582763 107223344 17614128 ﺦﺴﻧ ﻞﮐ ﻪﻨﯾﺰﻫ
1137811371 2428005 1573816 ) 4/
13
(ﺪﺻرد 65286109 629886 272881
) 5/
1
(ﺪﺻرد ر ﺎﻤﯿﺑ ﻢﻬﺳ 7378781787 13645893 10174315
)6 / 86 (ﺪﺻرد
4121377990 107232218 1735077 ) 5/
98 (ﺪﺻرد
ﻢﻬﺳ ﻪﻤﯿﺑ
725 239 ﺦﺴﻧ داﺪﻌﺗ
002
/0 P-value
لوﺪﺟ رد ﻪﮐ رﻮﻄﻧﺎﻤﻫ 2
ﻣ نﺎﺸﻧ ﯽ ﺪـﻫد ﻦﯿﮕﻧﺎـﯿﻣ
ﻧ ﺦﺴﻧ داﺪﻌﺗ ﯿ
ﺎﻫوﺮ ي ﺢﻠـﺴﻣ 239 ﺦـﺴﻧ داﺪـﻌﺗ و دﺪـﻋ
ﻣﺎﺗ نﺎﻣزﺎﺳ ﯿ
ﻦ ﻋﺎﻤﺘﺟا ﯽ 725 هﺎـﻣ رد ـﻣ ﯽ ﻪـﺑ و ﺪـﺷﺎﺑ
رادﺎﻨﻌﻣ رﻮﻃ ي
رد ﺦﺴﻧ ﻣﺎﺗ نﺎﻣزﺎﺳ ﯿ
ﻦ ﻋﺎﻤﺘﺟا ﯽ ﺑ ﯿ ﺮﺘﺸ
.ﺖﺳا ﺰﻫ ﻞﮐ عﻮﻤﺠﻣ ﯾ
ﻪﻨ ﺎﻫ ﻪـﻧﺎﯿﻫﺎﻣ ي اﺮـﺑ
ي نﺎﻣزﺎـﺳ
ﻣﺎﺗ ﯿ ﻦ ﻋﺎﻤﺘﺟا ﯽ 8516593151 لﺎﯾر
اﺮﺑ و ي ﻧ ﯿ ﺎﻫوﺮ ي
ــﺴﻣ ﺢﻠ 4184582763 ر
ــﯾ لﺎ زا ﯽﮐﺎــﺣ ﺞﯾﺎــﺘﻧ .ﺖــﺳا
ود رد ﺦـﺴﻧ ﻪـﻨﯾﺰﻫ ﻦﯿﮕﻧﺎـﯿﻣ رد يرﺎﻣآ رادﺎﻨﻌﻣ توﺎﻔﺗ رد ﻪﮐ يرﻮﻄﺑ ﺖﺳا ﻪﻌﻟﺎﻄﻣ ﺖﺤﺗ ﻪﻤﯿﺑ ﻣﺎـﺗ نﺎﻣزﺎﺳ
ﯿ ﻦ
ﻋﺎﻤﺘﺟا ﯽ ﻣ ﯿ ﮕﻧﺎ ﯿ ﻦ ﺰﻫ ﯾ ﻪﻨ ﻪﺨﺴﻧ ﺮﻫ 11748131
لﺎﯾر و
اﺮــﺑ ي ﻧ ﯿ ﺎــﻫوﺮ ي ﻣ ﺢﻠــﺴﻣ ــﯿ ﮕﻧﺎ ﯿ ﻦ ﺰﻫ ﯾ ﻪــﻨ ﻪﺨــﺴﻧ ﺮــﻫ
17614128 .ﺖﺳا لﺎﯾر
ﻠﺤﺗ سﺎﺳا ﺮﺑ ﯿ
ﻞ ﻪﺘﻓﺮﮔ ترﻮﺻ
ﺑ ﻢﻬﺳ ﯿ رﺎﻤ اﺮﺑ ي ﺑ ﯿ ﻪﻤ ﻣﺎﺗ ﯿ ﻦ ﻋﺎـﻤﺘﺟا ﯽ 4/
13 و ﺪـﺻرد
اﺮﺑ ي ﺑ ﯿ ﻪﻤ ﻧ ﯿ ﺎﻫوﺮ ي ﺢﻠﺴﻣ 5/
1 ﻣ ﺪﺻرد ﯽ ﺪﺷﺎﺑ .
0 20 40 60 80 100
یﺎھورﯾﻧ
ﺢﻠﺳﻣ نﯾﻣﺎﺗ ﯽﻋﺎﻣﺗﺟا
1.5 13.4
98.5 86.6
ﯽﺗﺧادرﭘ دﺻرد
ﮫﻣﯾﺑ
ﺳﻧ یارﺑ رﺎﻣﯾﺑ ﯽﺗﺧادرﭘ نازﯾﻣ ﺦ ﺎھ ﮫﻣﯾﺑ ﯽﯾوراد
ﺎﻤﯿﺑ ﻢﮭﺳ ر ﮫﻤﯿﺑ ﻢﮭﺳ
رادﻮﻤﻧ 1 ﯽﯾوراد ﺦﺴﻧ ياﺮﺑ نارﺎﻤﯿﺑ و ﻪﻤﯿﺑ ﯽﺘﺧادﺮﭘ ﻢﻬﺳ .
رادﻮﻤﻧ 1 ﻣ نﺎﺸﻧ ﯽ ﻪﮐ ﺪﻫد ﺘﺧادﺮﭘ ﻢﻬﺳ ﯽ
ﺑ ﯿ نارﺎـﻤ
ﻧ ﺶﺷﻮﭘ ﺖﺤﺗ ﯿ
ﺎﻫوﺮ ي ـﺴﺑ ﺢﻠـﺴﻣ ﯿ
رﺎ ﺮـﺘﻤﮐ نﺎﻣزﺎـﺳ زا
ﻣﺎﺗ ﯿ ﻦ ﻋﺎﻤﺘﺟا ﯽ ﻣ ﯽ ﺪﺷﺎﺑ .
لوﺪﺟ 3 . ﺢﻠﺴﻣ يﺎﻫوﺮﯿﻧ و ﯽﻋﺎﻤﺘﺟا ﻦﯿﻣﺎﺗ يﺎﻫ ﻪﻤﯿﺑ ﯽﯾوراد ﺦﺴﻧ تارﻮﺴﮐ ﻞﻠﻋ ﻦﯾﺮﺘﻤﻬﻣ و ﻪﻧﺎﯿﻫﺎﻣ تارﻮﺴﮐ ناﺰﯿﻣ
ﺪﺻرد ﻎﻠﺒﻣ ﺪﺻرد داﺪﻌﺗﻦﯿﮕﻧﺎﻣﯿ ﻪﻤﯿ ﺑعﻮﻧ تارﻮﺴﮐﻞﻠﻋ ﻒﯾدر
3 241666 19 5 كﺮﺘﺸﻣ ﺖﻤﯿﻗﻪﻓﺎﺿا 1
0 14350 4 1 ﯽﻋﺎﻤﺘﺟاﻦﯿﻣﺎﺗ ﯽﺠﻨﺳﺖﺤﺻ زاﯽﺷﺎﻧر ﻮﺴﮐ 2
3 294000 6 15/ ﯽﻋﺎﻤﺘﺟاﻦﯿﻣﺎﺗ ياه ﺪﻧوﺮﭘيوراد 3
5 437500 4 1 كﺮﺘﺸﻣ ﺦﯾر ﺎﺗﺪﻗﺎﻓ 4
0 8750 4 1 كﺮﺘﺸﻣ ر ﺎﺒﺘﻋ اﺪﻗﺎﻓ 5
54 4617125 6 15/ ﯽﻋﺎﻤﺘﺟاﻦﯿﻣﺎﺗ ه ﺎﺒﺘﺷ اﯽﮑﺷﺰﭘم ﺎﻈﻧﺪﮐ 6
9 767468 4 1 ﺢﻠﺴﻣوﺮﻧﯿ ﻪﺘﺷﺬﮔﺦﯾرﺎﺗ 7
3 267868 4 1 ﯽﻋﺎﻤﺘﺟاﻦﯿﻣﺎﺗ ﯽﺘﻧﺮﺘﻨﯾ اﺪﯿﯾﺄﺗنوﺪﺑيﺎﻫﺪﻧوﺮﭘيوراد 8
3 253750 9 25/ ﯽﻋﺎﻤﺘﺟاﻦﯿﻣﺎﺗ ياﻪﻤﯿﺑﺮﯿﻏيوراد 9
20 1700606 42 11 ﺢﻠﺴﻣوﺮﻧﯿ ﺮﺘﻤﮐﯽﺘﺳاﻮﺧرد وﻞﯾﺪﻌﺗ 10
8603083 265/
ﺎﺘﻧ ﻪﮐ رﻮﻄﻧﺎﻤﻫ ﯾ
ﺞ لوﺪﺟ 3 ﻣ نﺎﺸﻧ ﯽ ﺪﻫد ﺑ ﯿ ﺮﺘـﺸ ﯾ ﻦ
ﻣﯿ اﺰ ن ﯽﻟﺎﯾر تارﻮﺴﮐ ﻪﻧﺎﻫﺎﻣ
ﻧﯿ ﺎﻫوﺮ ي ﺢﻠﺴﻣ ﺎﺑ ﺑﯿ ﺮﺘﺸ ﯾ ﻦ
ــﻧاواﺮﻓ ﯽ ﺪــﻌﺗ ﻪــﺑ طﻮــﺑﺮﻣ ﻞﯾ
ﯽــﺘﻤﯿﻗ ﺘــﺳاﻮﺧرد و
ﯽ ﺮﺘﻤﮐ
) 1،700،606 (
ﺑ ﺎﺑ طﺎﺒﺗرا رد و ﯿ
ﻪﻤ ﻣﺎﺗ ﯿ ﻦ ﻋﺎﻤﺘﺟا ﯽ
ﺑﯿ ﺮﺘﺸ ﯾ ﻦ ﻣ ﯿ ناﺰ ﻪـﺑ طﻮﺑﺮﻣ تارﻮﺴﮐ ﺪـﮐ
ﮑـﺷﺰﭘ مﺎـﻈﻧ ﯽ
هﺎﺒﺘﺷا ) 4،617،125 (
ﺖﺳا .
رادﻮﻤﻧ 2 . ﻠﺘﺨﻣ ﻞﻠﻋ ﻢﻬﺳ ﯽﯾوراد ﺦﺴﻧ تارﻮﺴﮐ ﻒ
رادﻮﻤﻧ ﻪﮐ رﻮﻄﻧﺎﻤﻫ 2
ﻣ نﺎﺸﻧ ﯽ ﺮـﺘﻤﻬﻣ ﺪـﻫد ﯾ
ﻦ ﻢﻬـﺳ
ﯽﻟﺎﯾر ﮑﺷﺰﭘ مﺎﻈﻧ ﺪﮐ ﻪﺑ تارﻮﺴﮐ ﯽ
ﺮﺘﻤﻬﻣ و هﺎﺒﺘﺷا ﯾ
ﻦ ﻢﻬﺳ
يدﺪﻋ ﺪﻌﺗ ﻪﺑ طﻮﺑﺮﻣ تارﻮﺴﮐ ﯾ
ﻞ ﺘﺳاﻮﺧرد و ﯽ
ﺖﺳا ﺮﺘﻤﮐ .
ﺚﺤﺑ ﺘﻧ و ﯿ ﻪﺠ ﮔ ﯿ ﺮ ي
ﻤﻫا ــﯿ ﺖ ﻮﻧ ﻪﺨــﺴﻧ تروﺮــﺿ و ﯾ
ــﺴ ﯽ ﺎــﺑ ﻖﺑﺎــﻄﻣ
ﺎﻫدراﺪﻧﺎﺘﺳا ﯾ
ﮏ ﺬﭘﺎﻧرﺎﮑﻧا تروﺮﺿ ﯾﺮ
ﺰﻓا رد اﯾ ﺶ ﺸﺨﺑﺮﺛا ﯽ
ﺰﻫ ﺶﻫﺎﮐ و نﺎﻣرد ﯾ
ﻪﻨ ﻣ بﻮﺴﺤﻣ ﺎﻫ ﯽ
دﻮﺷ ز ﯾ اﺮ ﻮـﺠﺗ ﯾﺰ
ﺐـﺳﺎﻨﻣﺎﻧ ﻏ و
ﯿ روﺮــﺿﺮ ي ﻪــﻧ ﺎـﻫوراد زوﺮــﺑ ﺐــﺟﻮﻣ ﺎـﻬﻨﺗ
ضراﻮﻋ بﻮﻠﻄﻣﺎﻧ وراد
ﯽﯾ ﻣ ﯽ
،دﻮﺷ ﺰﻫ ﻪﮑﻠﺑ ﯾ ﻪـﻨ تﺎﻣﺪـﺧ
ﺘﺷاﺪﻬﺑ ﯽ و وراد ﻧﺎﻣرد ﯽ ﻨﭽﻤﻫ و ﯿ ﻦ زوﺮﺑ ﺮﻄﺧ تﻼﺧاﺪﺗ
وراد ﯽﯾ ﻧ ار ﯿﺰ اﺰﻓا ﯾ ﺶ ﻣ ﯽ ﺪـﻫد ) 17 رد ﻪـﮐ رﻮﻄﻧﺎـﻤﻫ .(
اﯾ ﻦ ﻧ ﻪﻌﻟﺎﻄﻣ لوﺪﺟ) ﺪﺷ هداد نﺎﺸ 1
ﺑ ( ﯿ ﺮﺘـﺸ ﯾ ﻦ ﻣ ـﯿ ناﺰ ﺰﯾﻮــﺠﺗ
ﻣﻮــﻤﻋ نﺎﮑــﺷﺰﭘ ﻪــﺑ طﻮــﺑﺮﻣ ﯽ
نآ زا ﺪــﻌﺑ و
ﺼﺼﺨﺘﻣ ﯿ ﻦ ﻠﺧاد ﯽ ﺑ و ﯿ رﺎﻤ ي ﺎـﻫ ي دﻮـﺑ بﺎـﺼﻋا و ﺰـﻐﻣ
ﺎﺳ ﯾﺮ ﻧ تﺎﻌﻟﺎﻄﻣ ﯿﺰ
ﺪﻧور
ًﺎﺘﺒﺴﻧ ي ا ﻪﺑﺎﺸﻣ
ـﯾ ﻦ رد ﻪـﻌﻟﺎﻄﻣ
ﺎﻫ ﺺﺼﺨﺗ ي
ﻣﻮـﻤﻋ نﺎﮑﺷﺰﭘ و ﺖﺷاد دﻮﺟو ﻪﻃﻮﺑﺮﻣ ﯽ
و
ﻠﺧاد نﺎﺼﺼﺨﺘﻣ ﯽ
ﻧ ﯿﺰ ﺑ ﯿ ﺮﺘﺸ ﯾ ﻦ ﻮﺠﺗ ﯾﺰ وراد ﺦـﺴﻧ ﯽـﯾ
ار
) ﺪﻨﺘﺷاد 1
ﻣ ﺮﻈﻧ ﻪﺑ .(
ﯽ ﺪﺳر ﺑ داﺪـﻌﺗ ﻪـﺑ ﻪـﺟﻮﺗ ﺎﺑ ﯿ
ﺮﺘـﺸ
ﻣﻮﻤﻋ نﺎﮑﺷﺰﭘ ﯽ
ـﺼﺼﺨﺘﻣ ﻪـﺑ ﺖﺒﺴﻧ ﯿ
ﻦ ﺒﻃ ﯿ
ًﺎـﺘﻌ داﺪـﻌﺗ
وراد ﺦﺴﻧ ﯽﯾ
اﯾ ﻦ ﺑ نﺎﮑﺷﺰﭘ زا هوﺮﮔ ﯿ
ﺮﺘﺸ ﻪﺑ و دﻮﺑ ﺪﻫاﻮﺧ
ﻧ نآ ﻊﺒﺗ ﯿﺰ ﺷﺎﻧ تارﻮﺴﮐ ﯽ
ﺑ نآ زا ﯿ ﺮﺘـﺸ ﻣ ﯽ دﻮـﺷ ﺎـﺷ ﯾﺪ
ﯾﮑ ﯽ ﻻد زا ﯾ ﻞ ﻠﺻا ﯽ تارﻮﺴﮐ ا ﺦﺴﻧ
ﯾ ﻦ نﺎﮑـﺷﺰﭘ زا هوﺮﮔ
ﻃ ﯿ ﻒ ﺎﻫوراد هدﺮﺘﺴﮔ ي
ﻮﺠﺗ ﯾﺰ ي ﻮﺗ ﻂﺳ ﻣﻮﻤﻋ نﺎﮑﺷﺰﭘ ﯽ
ﺼﺼﺨﺘﻣ ﻪﺑ ﺖﺒﺴﻧ ﯿ
ﻦ ﺼﺼﺨﺘﻣ ﻪﮐ اﺮﭼ ﺪﺷﺎﺑ ﯿ
ﻦ ﯾ ﮏ هوﺮﮔ
ﺻﺎﺧ ﯽ ار ﺎﻫوراد زا ﺰﯾﻮﺠﺗ
ﻣ ﯽ ﻣﻮـﻤﻋ نﺎﮑﺷﺰﭘ ﺎﻣا ﺪﻨﻨﮐ ﯽ
ﺎﺑ عﻮﻨﺗ ﺴﺑ ﯿ رﺎ ز ﯾ دﺎ ي راد رﺎﮐوﺮﺳ ﺎﻫوراد زا ﻧ
اﺮﺑﺎﻨﺑ ﺪ ﯾ ﻦ ﻣ ﯽ
ﺎﻫﺎﻄﺧ ﺪﻧاﻮﺗ ي
ﺑ ﯿ ﺮﺘﺸ ي ﻮﻧ ﻪﺨﺴﻧ رد ﯾ
ـﺴ ﯽ ﺎـﺑ طﺎـﺒﺗرا رد
ا ـــﯾ ﻦ ﮔ ترﻮـــﺻ ﺎـــﻫوراد ـــﯿ
دﺮ ا زا ـــﯾ ﻦ ﻮـــﻣآ ور و شز
ﻨﻤﻧاﻮﺗ زﺎـﺳﺪ ﺖــﻬﺟ ﯽﻣﻮــﻤﻋ نﺎﮑـﺷﺰﭘ ﯽــﺴﯾﻮﻧ ﻪﺨــﺴﻧ ي
ﻦﯿﻧاﻮﻗ و ﺎﻫ دراﺪﻧﺎﺘﺳا ﺎﺑ ﻖﺑﺎﻄﻣ ﯽﺴﯾﻮﻧ ﻪﺨﺴﻧ ﻤﻫا زا
ـﯿ ﺖ
ﺻﺎﺧ ﯽ ﺖﺳا رادرﻮﺧﺮﺑ .
لوﺪﺟ ﻪﮐ رﻮﻄﻧﺎﻤﻫ 2
ـﻣ نﺎﺸﻧ ﯽ
ﺑ هراﻮﻤﻫ ﺪﻫد ﯿ
ﻪﻤ ﻧ ﯿ ﺎﻫوﺮ ي ﺑﻮـﺧ ﺶـﺷﻮﭘ ﺢﻠﺴﻣ ﯽ
اﺮـﺑ ي
ﺎﻀﻋا ي ﻣ و ﺖﺳا ﻞﺋﺎﻗ دﻮﺧ ﯿ
ناﺰ ﻬﺟﻮﺗ ﻞﺑﺎﻗ ﯽ
ﺰﻫ زا ﯾ ﻪﻨ ﺎﻫ
ﻣ ﺶﺷﻮﭘ ار ﯽ
ﺪﻫد ا و ﯾ ﻦ ﻫﺎﻣ ﻪﺑ ﯿ ﺖ ﺑ ﯿ ﻪﻤ ﻧ ﯿ ﺎﻫوﺮ ي ﺢﻠﺴﻣ
ﺎﻤﺣ ﺖﻬﺟ ﯾ
ﺖ ﺎـﻀﻋا زا ﻪـﺒﻧﺎﺟ ﻪـﻤﻫ و ﻞﻣﺎﮐ ي
ﺮـﺑ دﻮـﺧ
ﻣ ﯽ ددﺮﮔ رادﻮﻤﻧ) 1 ﺎﻣا ( اﯾ ﻦ ﻣ ـﯿ ناﺰ ـﻣ ﺶـﺷﻮﭘ ﯽ
ﺪـﻧاﻮﺗ
ﮕﻧا ﯿ هﺰ ﺎﻫ ي ز ﯾ دﺎ ي ﺑ فﺮﺼﻣ ﺖﻬﺟ ﯿ
ﺶ ﺎﺿﺎﻘﺗ و هزاﺪﻧا زا ي
ﺎﻘﻟا ﯽﯾ دﻮﺟو ﻪﺑ تﺎﻣﺪﺧ آ
درو ا زا ﯾ ﻦ لﺮﺘﻨﮐ ﺖﺳا مزﻻ ور
و ترﻮﺻ ﻪﺑ ﺦﺴﻧ ﯾ
هﮋ ا نﺎﺳﺎﻨﺷرﺎﮐ ﻂﺳﻮﺗ ﯾ
ﻦ ﻮﺣ هز ترﻮﺻ
ﮔﯿ دﺮ ﺎﺿﺎﻘﺗ ﻪﮐ ي ﺑ ﯽ ﮕﻧ ترﻮـﺻ دازﺎﻣ و درﻮﻣ ـﯿ
دﺮ . ﺎـﻣا و
رادﻮﻤﻧ ﻪﮐ رﻮﻄﻧﺎﻤﻫ 2
ـﻣ نﺎﺸﻧ ﯽ ﺑ ﺪـﻫد ﯿ ﺮﺘـﺸ ﯾ ﻦ ﻢﻬـﺳ
ﻗ ﻪﻓﺎﺿا ﻪﺑ تارﻮﺴﮐ داﺪﻌﺗ ﯿ
ﺖـﻤ ﺪـﻌﺗ و ﯾ ﻞ ﺘـﺳاﻮﺧرد و ﯽ
ﺮﺘﻤﮐ ﯽﻣ ﺮﺑ ﺮﺘﻤﮐ و ددﺮﮔ ﯾ
ﻦ ﻣ ﯿ ناﺰ نآ ﻞﻣﺎﺷ ﺎـﻫوراد ي
هﺪﻧوﺮﭘ ا ي ﺪﻗﺎﻓ و ﺦﯾرﺎﺗ ﺷﺎﻧ تارﺎﺴﺧ و ﯽ
ﺠﻨﺳ ﺖﺤﺻ زا ﯽ
ﺖﺳا ﻮﺳ زا ي د ﯾ ﺮﮕ ﻦﯾﺮﺘﺸﯿﺑ ر ﻢﻬﺳ
ﯾﻟﺎ ﯽ ﺪﮐ ﻪﺑ تارﻮﺴﮐ
ﮑﺷﺰﭘ مﺎﻈﻧ ﯽ
ﺒﺘﺷا هﺎ و و ﻞﯾﺪﻌﺗ ﺘﺳاﻮﺧرد
ﯽ طﻮﺑﺮﻣ ﺮﺘﻤﮐ
.دﻮﺷ ﯽﻣ ا ﻪﮐ رﻮﻄﻧﺎﻤﻫ ﯾ
ﻦ ﺎﺘﻧ ﯾ ﺞ ﻣ نﺎﺸﻧ ﯽ ﺪﻫد هﺪﻤﻋ ﻢﻬﺳ ا
ي
ا زا ــﯾ ﻦ ﺎﻨــﺷآﺎﻧ ﻪــﺑ تارﻮــﺴﮐ ﯽﯾ
نﺎــﺳﺎﻨﺷرﺎﮐ ﻞﻏﺎــﺷ
رد
ﺎﻨــﺷآ و ﺖــﺒﺛ رد ﺎــﻫ ﻪــﻧﺎﺧوراد ﯽﯾ
آ ﺎــﺑ ﯿــﯾ ﻦ و ﺎــﻫ ﻪــﻣﺎﻧ
ﺎﻫدادراﺮﻗ و ﺎﻫ بﻮﭼرﺎﭼ ي
ﻓ ﯽ ﺑﺎﻣ ﯿ ﻦ ﺑ ﯿ ﻪﻤ ﺮﺑ ﻪﻧﺎﺧ وراد و
ﻣ ﯽ ددﺮﮔ ﻪـﻌﻟﺎﻄﻣ رد .دﻮـﺷ ﯽـﻣ تارﻮـﺴﮐ ﻪﺑ ﺮﺠﻨﻣ ﻪﮐ
يرﺪﻔﺻ ﯽﺳرﺮﺑ رد ﻪﺑ هﺪﺷ لﺎﻤﻋا تارﻮﺴﮐ ﻞﻠﻋ و ناﺰﯿﻣ
ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد يﺎﻫ نﺎﺘﺳرﺎﻤﯿﺑ يﺎﻫ بﺎﺴﺤﺗرﻮﺻ ناﺮﻬﺗ دﻮﺑ هدرﻮﺧ رﻮﺴﮐ مﻼﻗا ﻦﯾﺮﺘﻤﻬﻣ زا ﯽﮑﯾ وراد ، ﻪﮐ
يزﺎﺳﺪﻨﺘﺴﻣ ﺺﻘﻧ زا ﯽﺷﺎﻧ نآ هﺪﻤﻋ ﺶﺨﺑ رد و
ﻪـﺠﯿﺘﻧ ﺎـﺑ ﯽﻧﺎﻣرد ردﺎﮐ ندﻮﺒﻧ ﺎﻨﺷآ ﺮﺛا رد تارﻮﺴﮐ هﺪﻤﻋ ﺶﺨﺑ
ﻪـﻤﯿﺑ يﺎﻫ نﺎﻣزﺎﺳ يزﺎﺳﺪﻨﺘﺴﻣ تﺎﻣاﺰﻟا دﺎـﺠﯾا يا
ﺪـﺷ
) 18 ( رد ﻦﯿﻨﭽﻤﻫ . ﺳرﺮﺑ
ﯽ ﻣ ﯿ ناﺰ وراد تارﻮﺴﮐ ﻞﻠﻋ و ﯽﯾ
رد ﯾ ﮏ ﺑ ﯿ نﺎﺘﺳرﺎﻤ ﻫﺎﮕـﺸﻧاد
ﯽ هﺎـﺸﻧﺎﻣﺮﮐ رد هداد نﺎـﺸﻧ
ﻪﮐ ﺪﺷ ﺑﯿ ﺮﺘﺸ ﯾ ﻦ وراد تارﻮﺴﮐ ﺖﻠﻋ ﯽـﯾ
ﺖﮐﺮـﺷ ﺮـﻈﻧ زا
ﻧاواﺮﻓ ﺎﺑ نﺎﮔﺪﻨﻨﮐ ﯽ
4/
44 ﺖـﺒﺛ مﺪـﻋ ﻪـﺑ طﻮـﺑﺮﻣ ﺪﺻرد
ﻗد و ﺖﺳرد ﯿ
،ﻖ ﻬﺠﺗ و وراد ـﯿ
تاﺰ ﻪـﮔﺮﺑ رد ي تارﻮﺘـﺳد
رﺎﺘـﺳﺮﭘ شراﺰﮔ و ﮏﺷﺰﭘ ي
ﺖـﺳا هدﻮـﺑ )
15 ( ﻦﯾاﺮﺑﺎـﻨﺑ .
ﺎﺑ ﻞﻨﺳﺮﭘ ﯾﺪ
زﺎـﺳﺪﻨﺘﺴﻣ رد ي
ﺑ ﻪـﺟﻮﺗ ﯿ ﺮﺘـﺸ ي و هدﻮـﻤﻧ
زﺎﺳﺪﻨﺘﺴﻣ تﺎﻫﺎﺒﺘﺷا دراﻮﻣ ي
ﻞﻗاﺪﺣ ﻪﺑ ار ﻦﮑﻤﻣ
ﺶﻫﺎﮐ
ـﻨﭽﻤﻫ .ﺪـﻨﻫد ﯿ
ﻦ هﺪــﻧوﺮﭘ تارﻮـﺴﮐ ﺶﻫﺎـﮐ رﻮـﻈﻨﻣ ﻪـﺑ
ﺑﯿ
،نارﺎﻤ ﻧﺎﻣرد ﻞﻨﺳﺮﭘ ﯽ
ﺮﻃ زا ار دﻮﺧ ﯾ
ﻖ راﺰﮔﺮﺑ ي سﻼﮐ
ﺎﻫ ي ﺷزﻮﻣآ ﯽ ﺎﻫ شور ﺎﺑ ي
ﺤﺻ ﯿ ﺢ زﺎـﺳﺪﻨﺘﺴﻣ ي
، ﺎﻨـﺷآ
ﺎﻤﻧ ﯾ ﺪــﻨ ) 9 .(
ﻪــﺘﺒﻟا داﺪــﻌﺗ ي ﻂــﺳﻮﺗ ﺺﺧﺎــﺷ WHO
ﺣاﺮﻃ ﯽ ﻣ :ﻪـﻠﻤﺟ زا ﺖـﺳا هﺪـﺷ ـﯿ
ﮕﻧﺎ ﯿ ﻦ ـﻗا ﻼ وراد م ﯽـﯾ
،
ناﺰﯿﻣ ﺑﯿ نارﺎﻤ رد ﯾ ﺖـﻓﺎ هﺪـﻨﻨﮐ وراد ي رﺰﺗ ﯾ ـﻘ ﯽ
، ﺎـﺑ ﻪـﮐ
ﺳرﺮﺑ ﯽ ﻣ نﺎﮑﺷﺰﭘ ﺦﺴﻧ ﯿ
ناﻮﺘ ﻪﺒﻨﺟ ﺎﻫ ي ﺗ ﻒﻠﺘﺨﻣ ﻮـﺠ ﯾﺰ
ﻘﻄﻨﻣ ﯽ ﻮﮕﻟا و وراد ي
ﻮﺠﺗ ﯾﺰ ي وراد رد زرا ار ﻪﻌﻣﺎﺟ ﯾﺑﺎ
ﯽ
ﺎﻬﻟﺎـﺳ رد ﻪﻧﺎﺘﺨﺒﺷﻮﺧ .دﺮﮐ ي
ﺧا ـﯿ ﺮ ا ﺎـﺑ ﯾ دﺎـﺠ ﺎـﻬﮑﻧﺎﺑ ي
ﯽﺗﺎﻋﻼﻃا زرا نﺎﮑﻣا ،رﻮﺸﮐ رد ﺦﺴﻧ
ﯾﺑﺎ ﯽ ﺎﭘ و ﯾ ﺶ مﺎﻈﻧ ﺪﻨﻣ
ﻃا ﻼ ﻮﺠﺗ ﺎﺑ ﻂﺒﺗﺮﻣ تﺎﻋ ﯾﺰ
و ﺎﻫرﺎﺘﻓر ،وراد فﺮﺼﻣ و ﻮﮕﻟا
ي
ﻪﺨﺴﻧ ﻮﻧ ﯾ ﺴ ﯽ ﻣ رد ﯿ نﺎ ﺺﺧﺎـﺷ و هﺪـﺷ ﻢﻫاﺮـﻓ نﺎﮑﺷﺰﭘ
ﺎﻫ ي ﺠﺗ ﻮﯾ ﺰ ﻘﻄﻨﻣ ﯽ ﮔ هزاﺪﻧا ﻞﺑﺎﻗ نﺎﻣز ﺮﻫ رد وراد ـﯿ
ﺮ ي
ــﻣ ﯽ ﺪﻨــﺷﺎﺑ ) 1 ، 14 ، 19 ( . هار ﻒــﻠﺘﺨﻣ تﺎــﻌﻟﺎﻄﻣ ﻪــﺘﺒﻟا
ﺎﻫرﺎﮐ ي ﻋﻮﻨﺘﻣ ﯽ ﻣ ﺖﻬﺟ ار ﯿ
ناﺰ ﻪـﺋارا تارﻮـﺴﮐ ﺶﻫﺎـﮐ
داد ﻧا ه ا هﺪﻤﻋ ﺖﻤﺴﻗ و ﺪ ي
ﮐﺮﺘـﺸﻣ تﺎـﮑﻧ ﻪـﺑ ﺎـﻬﻧآ زا ﯽ
ﺖﺳد ﯾ ﻪﺘﻓﺎ ﺪﻧا ﻪﮑﻨﯾا ﻪﻠﻤﺟ زا تارﻮـﺴﮐ ﺶﻫﺎـﮐ ﺖـﻬﺟ
ﻣﺎﺷ ﻪﺒﻧﺎﺟ ﺪﻨﭼ ﯽﻤﺴﯿﻧﺎﮑﻣ يﺮﯿﮔرﺎﮑﺑ لﻮـﺻا شزﻮـﻣآ ﻞ
ياﺮـﺟا ﻦـﺴﺣ ﺮـﺑ ترﺎﻈﻧ ،ﯽﻧﺎﻣرد ردﺎﮐ ﻪﺑ يزﺎﺳﺪﻨﺘﺴﻣ هﺪﻧوﺮﭘ لﺮﺘﻨﮐ ﻞﯿﮑـﺸﺗ و ﯽﮑـﺷﺰﭘ كراﺪـﻣ ﺪـﺣاو رد ﺎﻫ
ﻪﺘﯿﻤﮐ ياﺮـﺟا و ﻦﯿـﯿﺒﺗ رﻮـﻈﻨﻣ ﻪﺑ هﺎﮕﺸﻧاد يﻮﺳ زا يا
ﺖﯿﻟﺎﻌﻓ ﺮﻤﺘﺴﻣ ﯽﻣ يروﺮﺿ ﻪﻃﻮﺑﺮﻣ يﺎﻫ
ﺪﺷﺎﺑ ) 20،21 ( .
ﻦﯿﻨﭽﻤﻫ ﺑزﺎﺑ
ﯿﻨ ﯽ ﺎﻫ ﻪﮔﺮﺑ ي وراد ﺖﺳاﻮﺧرد ﯽـﯾ
ﻞﻗاﺪـﺣ
ﺮﻔﻧ ود ﻂﺳﻮﺗ ـﺳرزﺎﺑ ،نﺎﮑـﺷﺰﭘ ﻪـﺑ شزﻮﻣآ و ﺮﮐﺬﺗ ،
ﯽ زا
ﺑ ﻞﻨﺳﺮﭘ ﯿ ﻪﻤ ﻮﺸﺗ ،ﻢﻈﻨﻣ رﻮﻃ ﻪﺑ ﺪﻣآرد و ﯾ
ﻖ رد ﻞﻨـﺳﺮﭘ
ـﻘﻣ ﮏـﺷﺰﭘ زا هدﺎﻔﺘـﺳا ،تارﻮـﺴﮐ ﺶﻫﺎﮐ ترﻮﺻ ﯿ
ﻢ ﻪـﺑ
ﻓﺎﮐ داﺪﻌﺗ ﯽ
، ﻪﻠﺻﺎﻓ ﺶﻫﺎﮐ ي
ﻧﺎـﻣز ﯽ ـﺷ ﯿ ﺖﻔ و نﺎﮑـﺷﺰﭘ
رﺎﮑﻤﻫ ،نارﺎﺘﺳﺮﭘ ي
ﺑ ﯿ ﺮﺘﺸ ﺑ ﯿ ﻦ ﺑ ﻞﻨﺳﺮﭘ ﯿ ﻪﻤ ﺎـﺑ ﺪﻣآرد و
ﺶﺨﺑ ﺼﺼﺨﺘﻣ زا هدﺎﻔﺘﺳا و ﻪﻧﺎﺧوراد ﯿ
ﻦ ﺟﺮﺑ ﺖـﻬﺟ ﻪﺘﺴ
ﻧﺎﺳر زور ﻪﺑ ﯽ
ﻗ ﯿ ﺖﻤ ﻪـﻧﺎﺧوراد ﻪـﺑ دورو زا ﻞـﺒﻗ ﺎـﻫوراد
ﻣ ﯽ هار تارﻮـﺴﮐ ﺶﻫﺎـﮐ ﺖـﻬﺟ ﺪﻧاﻮﺗ ﺪـﺷﺎﺑ ﺎـﺸﮔ
) 15 ( .
ﻦﯿﻧاﻮـﻗ ﺎـﺑ رﺎﻤﯿﺑ نﺎﻣرد ﺪﻨﯾآﺮﻓ رد لﻮﺌﺴﻣ ردﺎﮐ ﯽﯾﺎﻨﺷآ ﯽﻧﺎﺘﺳرﺎﻤﯿﺑ تﺎﻋﻼﻃا يﺎﻫ ﻢﺘﺴﯿﺳ زا هدﺎﻔﺘﺳا و يا ﻪﻤﯿﺑ ﺪـﯾﺎﻤﻧ يﺮﯿﮔﻮـﻠﺟ يا ﻪـﻤﯿﺑ تارﻮـﺴﮐ دﺎﺠﯾا زا ﺪﻧاﻮﺗ ﯽﻣ ) 22 .(
ﻪﮐ ﺎﯾ راﺰﮔﺮﺑ ﺎﺑ ي ﺎﻫ هﺎﮔرﺎﮐ ي
ﺷزﻮﻣآ ﯽ اﺮﺑ ي ردﺎـﮐ
ﮔرﺎﮐ ﻪﺑ ،لﻮﺌﺴﻣ ﯿﺮ
ي ﻠﺤﺗ ،ﻪـﻃﻮﺑﺮﻣ نﺎﮕﺘﺧﻮﻣآ ﺶﻧاد ـﯿ
ﻞ
ﺎـﻫ نﺎﻣزﺎـﺳ ﻪـﺑ لﺎﺳرا زا ﻞﺒﻗ ﺎﻫ هﺪﻧوﺮﭘ ي
ﺑ ﯿ ﻪـﻤ زا ﺮـﮔ
اﯾ دﺎﺠ ﺑ تارﻮﺴﮐ ﯿ
ﻪﻤ ا ي ﮔﻮﻠﺟ ﯿﺮ ي دﺮﮐ ) 23 ( ﻪﻌﻟﺎﻄﻣ رد .
تارﻮـﺴﮐ ﻢـﻬﻣ رﻮﺘﮐﺎـﻓ ﮏـﯾ ﺖـﻤﯿﻗ ﻪﻓﺎـﺿا و ﻞﯾﺪﻌﺗ ﺎﻣ لوﺪـﺟ) ﺪﺷ ﯽﯾﺎﺳﺎﻨﺷ 3
رد و ( ﺮﺑ تارﻮـﺴﮐ ﺮﯿﺛﺎـﺗ ﯽـﺳر
ﯽﻟﺎﻣ قﻮﻘﺣ ﺮﺑ ﯽﻋﺎﻤﺘﺟا ﻦﯿﻣﺎﺗ ﻪﻤﯿﺑ يﻮﺳ زا هﺪﺷ لﺎﻤﻋا نﺎﺷﺎﮐ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد يﺎﻫ نﺎﺘﺳرﺎﻤﯿﺑ رد نارﺎﻤﯿﺑ ﺰﯾﺮﺒﺗ ﻪﻌﻟﺎﻄﻣ رد و ﺖﻤﯿﻗ ﻪﻓﺎﺿا
راﺬـﮔ ﺮﯿﺛﺎﺗ ﻞﻣاﻮﻋ زا ﺰﯿﻧ
دﻮــﺑ تارﻮــﺴﮐ )
16،24 (.
ﻦﯾاﺮﺑﺎــﻨﺑ ﺑﯿ
ﺮﺘــﺸ ﯾ ﻦ ﻣ ــﯿ ناﺰ
ـﺷﺎﻧ تارﻮـﺴﮐ ﯽ
ﮕﻨﻫﺎــﻤﻫﺎﻧ زا ﯽ
ﻧﺎــﺴﻧا ﻞـﻣﺎﻋ ﯽ
ﺰــﻟا ﺎـﺑ ما
زﺎﺳﺪﻨﺘﺴﻣ ي
دﻮﺑ ) 25،26 (.
يﺎـﻫ نﺎﻣزﺎـﺳ هﺪـﺷ لﺎـﻤﻋا تارﻮﺴﮐ ناﺰﯿﻣ ﻞﯿﻠﺤﺗ ﺪﺻرد ﻪﭼﺮﮔا ﯽﻟﺎﺳرا يﺎﻫ بﺎﺴﺣ ترﻮﺻ ﻪﺑ ﺖﺒﺴﻧ ﻪﻤﯿﺑ ﻢـﮐ راﺪﻘﻣ ﻦﯿﻤﻫ ﺎﻣا ،ﺪﻧدﻮﺑ هﺪﺷ تارﻮﺴﮐ لﻮﻤﺸﻣ ﯽﻤﮐ ﻪـﺑ ار ﯽﻬﺟﻮـﺗ ﻞﺑﺎﻗ ﯽﻟﺎﻣ رﺎﺑ ﺰﯿﻧ تارﻮﺴﮐ ﺎـﻫ ﻪـﻧﺎﺧوراد
ﻞﯿﻤﺤﺗ ﺪﻨﻨﮐ ﯽﻣ ﺑ ﺪـﺷ ﻪﺘﻔﮔ ﻪﮐ رﻮﻃ نﺎﻤﻫ و . ﯿ
ﺮﺘـﺸ ﯾ ﻦ
ﻞﻣﺎﻋ ﻧﺎـﺴﻧا ﻞـﻣاﻮﻋ ﻪـﺑ طﻮﺑﺮﻣ تارﻮﺴﮐ ﯽ
ﺖـﻗد مﺪـﻋ و
ﻓﺎﮐ دﺎﻨﺳا ﺖﺒﺛ رد ﯽ دﻮﺑ
اﺬـﻟ . ﺮـﺑ ﺪـﯿﮐﺎﺗ ﻪـﻨﯿﻣز ﻦـﯾا رد
شزﻮﻣآ و ﯽﻨﯿﻟﺎﺑ يﺎﻫﺎﻤﻨﻫار و نﺎﻨﮐرﺎﮐ
يروﺮﺿ نﺎﮑﺷﺰﭘ
هﺮﮐاﺬﻣ هوﻼﻋ ﻪﺑ .ﺪﺳر ﯽﻣ ﺮﻈﻧ ﻪﺑ ـﻫ ﺪﻨﺑ ﻖﯿﻗد ﻦﯿﯿﻌﺗ و
ﺎ
درﻮـﻣ يﺎـﻫ هﺮﺼﺒﺗ و ﻪـﻤﯿﺑ يﺎـﻫ نﺎﻣزﺎـﺳ ﺪـﻬﻌﺗ
ياﺮـﺑ
نﺎﻨﮐرﺎﮐ و ﺎﻫ ﻪﻧﺎﺧوراد ﺗ ﯽﻣ
يﺮﯿﮔﻮـﻠﺟ تارﻮـﺴﮐ زا ﺪﻧاﻮ
ﺪﯾﺎﻤﻧ .
ﯽﻧادرﺪﻗ و ﺮﮑﺸﺗ
ﻮﻧ ﯾ نﺎﮔﺪﻨﺴ ر زا ار ﺮﮑﺸﺗ لﺎﻤﮐ
ﯾ ﺖﺳﺎ ﻪـﻧﺎﺧوراد مﺎـﻣا
ﻤﺧ ﯿﻨ ﯽ ﮑـﺷﺰﭘ مﻮـﻠﻋ هﺎﮕـﺸﻧاد ﻪـﺑ ﻪﺘـﺴﺑاو ﯽ
و نﺎﺘـﺳﺮﻟ
ﺖﯾﺮﯾﺪﻣ ﺎـﻫ نﺎﻣزﺎﺳ ي
ﺑ ﯿ ﻪـﻤ ﺮـﮔ ، ﺑ نﺎﻣزﺎـﺳ ﯿ
ﻪـﻤ ﻣﺎـﺗ ﯿ ﻦ
ﻋﺎﻤﺘﺟا ﯽ ﻧ و ﯿ ﺎﻫوﺮ ي ﺢﻠـﺴﻣ ﻪﻧﺎﻤﯿﻤـﺻ يرﺎـﮑﻤﻫ ﺖـﻬﺟ
ﺪــــﻧراد . ﻦــــﯾا ﺮﻃ ح ﺎﺑ ﺪﯿﯾﺄﺗ ﻪﺘﯿﻤﮐ ا ﻼﺧ ق رد ﮋﭘ و ﺶﻫ
اد ﺎﮕﺸﻧ ه ﺎﺑ ﺪﮐ ا ﻼﺧ ق IR.LUMS.REC.1399.288
ا ﺎﺠﻧ م ﺪﺷ رد و ياﺮﺟا اﯾ ﻦ ﻠﮐ ﺶﻫوﮋﭘ ﯿ
ﻪ ﻗﻼﺧا رﻮﻣا ﯽ
ﺎـﺑ
ﮕﻧﺎﻣﺮﺤﻣ ﻆﻔﺣ ﯽ
ﺑ تﺎﻋﻼﻃا ﯿ
نارﺎﻤ ﻟﺎـﻣ دﺎﻨـﺳا و ﯽ
درﻮـﻣ
.ﺖﻓﺮﮔ راﺮﻗ ظﺎﺤﻟ
References
1. Sadeghi M, Rasti A, Salmani A, Naseri K, Kiani Z. Drug prescription patterns of physicians in South Khorasan Province in 2014. Journal of Birjand University of Medical Sciences. 2018; 25(1): 72-80(In Persian).
2. Sepehari Gram, Haj Akbari N, Mousavi A.
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Analysis of drug prescriptions and insurance deductions of the governmental pharmacy of Lorestan University of Medical Sciences
Hayati H1,2 *, Khalili Fard Ardali J3,4
1. Assistant Professor, Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
2. Assistant Professor, Department of Pharmacoeconomics and Management, School of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran, [email protected]
3. Assistant Professor, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
4. Assistant Professor, Pharmacology and Toxicology department, Faculty of Pharmacy, Tabriz University of Medical Sciences. Tabriz, Iran
Received: 2022/06/27 Accepted: 2022/12/6
Abstract
Background: Standards-based prescribing can increase the effectiveness of treatment and the optimal management of financial resources, including reducing the costs of insurance deductions.
Therefore, reducing insurance deductions is necessary for pharmacy management. So, this study aimed to analysis the prescriptions and insurance deductions of the governmental pharmacy of Lorestan University of Medical Sciences.
Materials and Methods: This study is a retrospective cross-sectional study that includes a review of all prescriptions of the Social Security and the Armed Forces insurances.The information was collected through the checklist. Then, they were statistically analyzed by SPSS22 and excel software’s.
Results: The results showed that the highest number of prescriptions is related to general practitioners and the highest monetary amounts of the monthly deductions related to the Armed Forces Insurance is “price adjustment and low demand” (1700606 Rials) and the highest monetary amounts of the deductions in connection with the Social Security Insurance is “wrong code of the medical system (4617125 Rials).
Conclusion: Based on the results, it can be concluded that the most important causes of the deductions are related to human errors. Hence to reduce the deductions, first be more coordination’s between the insurances and pharmacies for covered items and the regulations second monitoring and up-to-date training of individuals on the correct entry of information based on the standards and regulations.
Keywords: Drug prescriptions,Insurance deductions,Governmental pharmacy.
*Citation: Hayati H, Khalili Fard Ardali J. Analysis of drug prescriptions and insurance deductions of the governmental pharmacy of Lorestan University of Medical Sciences. Yafte. 2022; 24(3):24-33.
