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110

:يﺮﻬﺷ ناور ﺖﺷاﺪﻬﺑ تﺎﻣﺪﺧ

ﺖﺒﻗاﺮﻣ يﻮﮕﻟا ﯽﻋﺎﻤﺘﺟا ﺖﮐرﺎﺸﻣ ﺎﺑ هاﺮﻤﻫ ﻪﯿﻟوا ﯽﺘﺷاﺪﻬﺑ يﺎﻫ

يﺮﻬﻟاﻮﺑ ﺮﻔﻌﺟ ﺮﺘﮐد

،1

ﯽﺟﺎﺟز ﯽﻠﻋ ﺮﺘﮐد ﯽﻤﺴﯿﮐ ﯽﻤﯾﺮﮐ ﯽﺴﯿﻋ ،2

ﯽﻧاﺮﯿﺟ يﺮﻈﻧ ﻪﺑﻮﺒﺤﻣ ،3

ﯽﺋﺎﺒﻃ ﻪﻨﯿﮑﺳ ،4

5

Urban Mental Health Service:

Primary Health Care Model with Community Participation

Jafar Bolhari*, Ali Zojaji ^a, Issa Karimi-Kisomi ^b, Mahboobeh Nazari-Jeirani^c, Sakineh Tabaee ^d

هﺪﯿﮑﭼ

:فﺪﻫ ﺖـﺷاﺪﻬﺑشزﻮـﻣآﯽـﺸﺨﺑﺮﺛاناﺰﯿﻣﯽﺳرﺮﺑﺮﺿﺎﺣﺶﻫوﮋﭘفﺪﻫ

وﯽﺘﺷاﺪﻬﺑنﺎﺒﻠﻃوادﻪﺑناور ﺐـﻠﺟردﮏـﺷﺰﭙﻧاورﺮﯿﻏﺺﺼﺨﺘﻣنﺎﮑﺷﺰﭘ

ﺖـﺷاﺪﻬﺑتﺎﻣﺪـﺧﻪﯾاراوﯽﻣدﺮﻣﺖﮐرﺎﺸﻣ يﻮـﮕﻟاﮏـﯾﺐـﻟﺎﻗردناور

.دﻮﺑيﺮﻬﺷﯽﺘﮐرﺎﺸﻣ شور

: ﻪﻠﺤﻣﻪﺳنﺎﻨﮐﺎﺳ

،11 و16 18 ﺶـﺷﻪـﻘﻄﻨﻣ

.ﺪﻧﺪـﺷﻪﺘﻓﺮﮔﺮﻈﻧردﺶﺷﻮﭘﺮﯾزﺖﯿﻌﻤﺟناﻮﻨﻋﻪﺑناﺮﻬﺗﺮﻬﺷ 20

ﺐـﻠﻃواد

ﻪﺑ) ناورﺪﺷراسﺎﻨﺷرﺎﮐﺶﺷ،(ناورﺖﺷاﺪﻬﺑﻂﺑارناﻮﻨﻋ ﯽﻨﯿﻟﺎـﺑﯽـﺳﺎﻨﺷ

وﮏﺷﺰﭙﻧاورﻪﺳ،هروﺎﺸﻣﺎﯾ 15

ﮏﺷﺰﭙﻧاورﺮﯿﻏﺺﺼﺨﺘﻣﮏﺷﺰﭘ ﯽﮕﻤﻫ)

ﯽﻧدﻮﻣزآ (يرادﺮﻬﺷﺶﺷﻪﻘﻄﻨﻣﻦﮐﺎﺳ

ﻪـﮐﺪـﻧدﻮﺑﺮـﺿﺎﺣﺶﻫوﮋـﭘيﺎـﻫ

ﻪﺑوﻪﻧﺎﺒﻠﻃواد هداد .ﺪـﻧدﺮﮐﺖﮐﺮﺷحﺮﻃردﯽﻣﻮﻤﻋناﻮﺧاﺮﻓﻪﻠﯿﺳو

ﻪـﺑﺎـﻫ

ﺶﺳﺮﭘدﺮﺑرﺎﮐﺎﺑ) ﯽﻤﮐشورود ﻪﻣﺎﻧ

ﯽﮔﮋﯾويﺎﻫ ﺖـﯿﻌﻤﺟيﺎـﻫ

،ﯽﺘﺧﺎﻨـﺷ

ﯽﻔﯿﮐو (ناورﺖﺷاﺪﻬﺑنﺎﻄﺑارﯽﺠﻨﺳﺮﻈﻧوﺺﺼﺨﺘﻣنﺎﮑﺷﺰﭘﯽﺠﻨﺳﺮﻈﻧ ﺑﺮﺠﺗﺖﺒﺛﺎﺑ) ﻪ

هﺪﻫﺎﺸﻣوﺎﻫ .ﺪﻧﺪـﺷيروآدﺮﮔ (ﺎﻫ

هدادﻞـﯿﻠﺤﺗوﻪـﯾﺰﺠﺗ

ﺎـﻫ ^t يرﺎــﻣآنﻮــﻣزآشورﻪــﺑو^SPSS-15ﮏــﻤﮐﺎــﺑ .ﺪــﺷمﺎــﺠﻧاﻪﺘــﺴﺑاو

ﻪـﻣﺎﻧ ﺶـﺳﺮﭘودزاهﺪـﻣآﺖـﺳد ﻪـﺑيﺎـﻫ هﺮـﻤﻧدادنﺎـﺸﻧﺎـﻫﻪﺘﻓﺎﯾ :ﺎﻫﻪﺘﻓﺎﯾ

ﺶﯿـﭘردﺺـﺼﺨﺘﻣنﺎﮑﺷﺰﭘوناورﺖﺷاﺪﻬﺑنﺎﻄﺑارﯽﺠﻨﺳﺮﻈﻧ ونﻮـﻣزآ

توﺎـﻔﺗنﻮـﻣزآﺲـﭘ )دراد

002 /0

≤ .(p ﻢــﻫ ﻦﯿـﻨﭼ ناورﺖــﺷاﺪﻬﺑنﺎـﻄﺑار

ﻪـﺑارﺎـﻬﻧآ،ﻪـﺘﺧادﺮﭘﻪـﻠﺤﻣنارﺎـﻤﯿﺑﯽﯾﺎـﺳﺎﻨﺷﻪـﺑشزﻮـﻣآزاﺲﭘيﺮﻬﺷ .ﺪــﻧدادعﺎــﺟراﯽــﻠﺤﻣنﺎﺘــﺳرﺎﻤﯿﺑوﺺــﺼﺨﺘﻣنﺎﮑــﺷﺰﭘ،هروﺎــﺸﻣﺰــﮐاﺮﻣ ﻪــﺠﯿﺘﻧ يﺮــﯿﮔ : ونﺎــﻄﺑاريﺮــﯿﮔردوناورﺖــﺷاﺪﻬﺑﻢﯿﻫﺎــﻔﻣشزﻮــﻣآ

ﻪﻠﺤﻣردﯽﺘﮐرﺎﺸﻣيﻮﮕﻟاﮏﯾردﺺﺼﺨﺘﻣنﺎﮑﺷﺰﭘ ﯽـﻣ،ﺎﻫ

شورﺪـﻧاﻮﺗ

ﺖﺒﻗاﺮﻣتﺎﻣﺪﺧﻪﯾاراياﺮﺑيﺮﺛﺆﻣ يﺎﻫﺮﻬـﺷردﻪـﯿﻟواناورﺖـﺷاﺪﻬﺑيﺎﻫ

.ﺪﺷﺎﺑگرﺰﺑ

:هژاوﺪﯿﻠﮐ ﺖﺷاﺪﻬﺑ شزﻮﻣآ ؛ﯽﻋﺎﻤﺘﺟا ﺖﮐرﺎﺸﻣ يﻮﮕﻟا ؛ﯽﺘﺷاﺪﻬﺑ ﻂﺑار

ﺖﺒﻗاﺮﻣ ؛ناور ﺐﻠﻃواد ؛ﻪﯿﻟوا ﯽﺘﺷاﺪﻬﺑ يﺎﻫ

:ﻪﻟﺎﻘﻣ ﺖﻓﺎﯾرد] 12

/ 12 / 1388 :ﻪﻟﺎﻘﻣ شﺮﯾﺬﭘ ؛ 8/

6/

1389 [ Abstract

Objectives: The aim of the present study was to assess the degree of efficiency of mental health education for non-psychiatrist medical specialists in attracting public cooperation and the provision of mental health in the form of an urban cooperative model. Method: The residents of districts 11, 16, and 18 in municipality area 6 of Tehran were considered as the covered community. 20 volunteers (as mental health contact), three individuals with master degree in clinical psychology or consultation, three psychiatrists, and 15 non-psychiatrist specialists (all from municipality area 6) comprised the subjects of the present study and voluntarily participated in this research.

Data were gathered using quantitative (demographic questionnaires, specialists’ survey, and mental health contact survey) as well as qualitative (registering observations and experiences) methods. Data analysis was done via SPSS-15 and using dependent t-test. Results: The findings revealed that the scores of the volunteers and specialists changed from pretest to post-test (p≤0.002). Also, urban mental health contacts identified the districts’ patients subsequent to the training, and referred them to consultation centers, medical specialists, and district hospitals. Conclusion: Teaching mental health concepts to volunteers and medical professionals and involving them in a cooperative fashion in districts can be an efficient method of providing primary mental health services in large cities.

Key words: health contacts; social cooperation; mental health education; primary health services; volunteers [Received: 3 March 2010; Accepted: 30 August 2010]

_______________________________________

ـﺼﻨﻣ ﺪﯿﻬﺷ نﺎﺑﺎﯿﺧ ،ﺶﯾﺎﯿﻧ نﺎﺑﺎﯿﺧ ،نﺎﺧرﺎﺘﺳ نﺎﺑﺎﯿﺧ ،ناﺮﻬﺗ .ناﺮﻬﺗ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد دﺎﺘﺳا ،ﮏﺷﺰﭙﻧاور1

.ناﺮـﻬﺗ ﯽﮑـﺷﺰﭙﻧاور ﻮﺘﯿﺘـﺴﻧا ،ناور ﺖـﺷاﺪﻬﺑ تﺎـﻘﯿﻘﺤﺗ ﺰـﮐﺮﻣ ،يرﻮ

:رﺎﮕﻧرود 66506853 - 021 (لﻮﺌﺴﻣ هﺪﻨﺴﯾﻮﻧ) E-mail:[email protected]

2؛ ﮏﺷﺰﭙﻧاور

، ؛ناﺮﻬﺗ ﯽﮑﺷﺰﭙﻧاور ﻮﺘﯿﺘﺴﻧا 3

ﯽﮑـﺷﺰﭙﻧاور ﻮﺘﯿﺘﺴﻧا ؛ناﺮـﻬﺗ

ﺪـﺷرا سﺎﻨـﺷرﺎﮐ4

؛يرﺎﺘﺳﺮﭘ .ﯽﻠﻣ ﮏﻧﺎﺑ نﺎﺘﺳرﺎﻤﯿﺑ ،يرﺎﺘﺳﺮﭘ ﺪﺷرا سﺎﻨﺷرﺎﮐ5

* Corresponding author: Psychiatrist, Professor of Tehran University of Medical Sciences. Mental Health Research Center, Tehran Psychiatric Institute, Mansoori Alley, Niayesh St., Sattarkhan St., Tehran, Iran, IR. Fax: +9821-66506853. E-mail: [email protected];

a Psychiatrist, Tehran Psychiatric Institute; ^b Tehran Psychiatric Institute; ^c MS. in Nursing; ^d MS. in Nursing, Bank Melli Hospital.

Iranian Journal of Psychiatry and Clinical Psychology, Vol. 17, No. 2, Summer 2011, 110-115

لﺎﺳ ،ناﺮﯾا ﯽﻨﯿﻟﺎﺑ ﯽﺳﺎﻨﺸﻧاور و ﯽﮑﺷﺰﭙﻧاور ﻪﻠﺠﻣ ﻢﻫﺪﻔﻫ

هرﺎﻤﺷ ، 2 ، نﺎﺘﺴﺑﺎﺗ 1390

، 115 - 110

ﯽﺸﻫوﮋﭘ ﻪﻟﺎﻘﻣ ﻞﯿﺻا

Original Article

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يﺮﻬﻟاﻮﺑ ﺮﻔﻌﺟ نارﺎﮑﻤﻫ و

111

لﺎﺳﻔﻫـﺪﻢﻫﻤﺷ /ـرﺎه 2 / نﺎﺘﺴﺑﺎﺗ1390 Vol. 17 / No. 2 / Summer 2011

ﻪﻣﺪﻘﻣ لﻼﺘــﺧا يﻻﺎــﺑ عﻮﯿــﺷ و ﻮــﺳ ﮏــﯾ زا عﺮــﺻ و ﯽــﻧاور يﺎــﻫ

ﺮـﮕﯾد يﻮـﺳ زا ﺎـﻬﻧآ زا ﯽـﺷﺎﻧ راﺪﯾﺎﭘ و ﯽﻔﻨﻣ يﺎﻫﺪﻣﺎﯿﭘ

، ﻪـﺟﻮﺗ

ﯽﻣ ار تﻼﮑﺸﻣ ﻦﯾا ﻪﺑ يﺪﺟ ﯽﻧﺎـﻬﺟ نﺎﻣزﺎـﺳ شراﺰﮔ ﻪﺑ .ﺪﺒﻠﻃ

ﺖﺷاﺪﻬﺑ )1

ﺶﯿﺑ (WHO

زا 450 زا نﺎﻬﺟ ﺮﺳاﺮﺳ رد ﺮﻔﻧ نﻮﯿﻠﯿﻣ

ﻼﺘــﺧا ﯽــﻣ ﺞــﻧر يرﺎــﺘﻓر و ﯽــﻧاور يﺎــﻫ ﺟ نﺎﻣزﺎــﺳ) ﺪــﻧﺮﺑ

ﯽﻧﺎــﻬ

،ﺖﺷاﺪﻬﺑ 2003

لﻼﺘﺧا ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﯿﺑ زا يدﺎﯾز داﺪﻌﺗ .(

يﺎـﻫ

ﯽـﺳﺎﺳا ﯽﮔدﺮﺴﻓا ﺪﻨﻧﺎﻣ) ﯽﮑﺷﺰﭙﻧاور ﺎـﯿﻧﺎﻣ ،2

ﺎﯿﻧﺮﻓوﺰﯿﮑـﺳا و3

(4

ﻪﺑ ﺰﮔﺮﻫ ﻪـﺑ ﯽﻧﺎـﻣرد تﺎﻣﺪـﺧ ﺖـﻓﺎﯾرد ياﺮـﺑ ﻪﻧﺎﺒﻠﻃواد ترﻮﺻ

ﯽﺘــﺷاﺪﻬﺑ ﺰــﮐاﺮﻣ -

ﯽــﻤﻧ ﻪــﻌﺟاﺮﻣ ﯽﻧﺎــﻣرد ترﻮــﺻ رد ﺎــﯾ ﺪــﻨﻨﮐ

ﯽـﻤﻧ فﺮـﺼﻣ ار هﺪﺷﺰﯾﻮﺠﺗ يﺎﻫوراد ،ﻪﻌﺟاﺮﻣ

يرﻮـﺗ) ﺪـﻨﻨﮐ ،5

1999 .(

نآ ﺎــﺑ رد ناور ﺖــﺷاﺪﻬﺑ تﺎﻣﺪــﺧ شﺮﺘــﺴﮔ ﻪــﻨﯿﻣز رد ﻪــﮐ

مﺎﮔ نﺎﻣرﻮﺸﮐ ﯽﯾﺎﺘﺳور ﻪﻌﻣﺎﺟ ﺖـﺳا هﺪـﺷ ﻪﺘﺷادﺮﺑ يﺮﺛﺆﻣ يﺎﻫ

ﻦـــﺴﺣ) ،هداز 1992 هﺎـــﺷ ؛ ﮏـــﻠﻣ و يﺪـــﻤﺤﻣ ،ﯽﻠـــﻀﻓا

1990 ؛

،ﻂﯿﺤﻣ و يﺮﻬﻟاﻮﺑ 1995

،يﺮﻬﺒﻋ ؛ 1998

؛ ﺶﯿﭘ ﻞﮐ هرادا يﺮﯿﮔ

يرﺎـﻤﯿﺑ ﺎﺑ هزرﺎﺒﻣ و

6ﺎـﻫ ) 1999 (

، ﻦـﯾا د ﺮـﻣا

يﺮﻬـﺷ ﺖـﯿﻌﻤﺟ ر

ﻪــﺑ

ﯽﺑﺎــﯾرﺎﻤﯿﺑ ندﻮــﺑ راﻮــﺷد ،ﯽﯾﺎــﯿﻓاﺮﻐﺟ ﯽﮔدﺮﺘــﺴﮔ ﻞــﯿﻟد و

ﯽﭘ ﻪـﺑور ﯽﻧاواﺮﻓ يﺎﻫﺎﻨﮕﻨﺗ ﺎﺑ ،يﺮﯿﮔ ور ﻦـﯾا زا .ﺖـﺳا هدﻮـﺑ ور

ﻪــﺑ ﯽــﻣ ﺮــﻈﻧ ﻪــﺑ ﯽــﻣدﺮﻣ ﺖﮐرﺎــﺸﻣ ﺪــﺳر نﺎــﻄﺑار ﮏــﻤﮐ هاﺮــﻤﻫ

ﯽﻣ ﺎﻬﻨﺗ ﻪﻧ ،ﯽﺘﺷاﺪﻬﺑ نارﺎـﻤﯿﺑ زا يﺮﺘﺸﯿﺑ رﺎﻤﺷ ﯽﯾﺎﺳﺎﻨﺷ ﻪﺑ ﺪﻧاﻮﺗ

لﻼﺘـﺧا ﻪﺑ ﻼﺘﺒﻣ ناور يﺎـﻫ

ﺧﺎﻨـﺷ ﺪـﻣﺎﺠﻧﺎﯿﺑ ﻪـﻘﻄﻨﻣ ﯽﻋﺮـﺻ و ﯽﺘ

هﺎــﺷ ،ﻂﯿــﺤﻣ) ،يﺮﻬﻟاﻮــﺑ و يﺪــﻤﺤﻣ

1997 ﻒﻃﺎــﻋ ؛ ،ﺪــﯿﺣو

نﺎﺴﺣا ،ﯽﯾﺎﯿﺿ ،يﺮﻬﻟاﻮﺑ ﯽﻤﯾﺮﮐ و ﺶﻨﻣ

،ﯽﻤﺴﯿﮐ 2003 ﻦﻤﺠﻧا ؛

،هراوآ نﺎـﮐدﻮﮐ و نﺎﻧز زا ﺖﯾﺎﻤﺣ 2004

ﯽـﻣ ﻪـﮑﻠﺑ ،(

رد ﺪـﻧاﻮﺗ

لﻼﺘـﺧا ﻪـﺑ ﺖﺒـﺴﻧ مدﺮـﻣ شﺮـﮕﻧ ﺮﯿﯿﻐﺗ و ﯽﻫﺎﮔآ ندﺮﺑﻻﺎﺑ يﺎـﻫ

ناور

ﺎـﻧآ ﻖﯾﻮـﺸﺗ ﺰـﯿﻧ و ﯽﺘﺧﺎﻨـﺷ ﺰــﮐاﺮﻣ ﻪـﺑ ﺮﺛﺆـﻣ ﻪـﻌﺟاﺮﻣ ﻪــﺑ ن

) ﺪـﺷﺎﺑ ﻪﺘـﺷاد ﺶـﻘﻧ ﯽﻧﺎـﻣرد و ﯽﺘﺷاﺪﻬﺑ ﺰـﮐﺮﻣ

ﺶﯿـﭘ و يﺮـﯿﮔ

لﺮﺘﻨﮐ يرﺎﻤﯿﺑ ،ﺎﻫ 1999 .(

نآ زا ﻪﯿﻣﻼﻋا نﺎﮔﺪﻨﻨﮐﺎﻀﻣا زا ﯽﮑﯾ ناﺮﯾا ﻪﮐ ﺎﺟ آ

ﺎﻤﻟ

7ﺎـﺗآ

،ﺖــﺳا ﻪــﻤﻫ ياﺮــﺑ ﺖــﺷاﺪﻬﺑ ﻦﯿﻣﺄــﺗ فﺪــﻫ ﺎــﺑ ﻢــﻫ

ﻦﯿــﻨﭼ ﻖــﺣ

رد ناﺮـﯾا مدﺮﻣ ﻪﻤﻫ ياﺮﺑ ﺐﺳﺎﻨﻣ نﺎﻣرد و ﺖﺷاﺪﻬﺑ ﻪﺑ ﯽﺳﺮﺘﺳد ﺎﻗ ﻪـﺘﻓﺮﮔ راﺮـﻗ ﺪﯿﮐﺄﺗ درﻮﻣ ناﺮﯾا ﯽﻣﻼﺳا يرﻮﻬﻤﺟ ﯽﺳﺎﺳا نﻮﻧ رد ناور ﺖــﺷاﺪﻬﺑ ﻖــﯿﻔﻠﺗ ،فﺪــﻫ ﻦــﯾا ﻖــﻘﺤﺗ ياﺮــﺑ ،ﺖــﺳا

ﺖــﺒﻗاﺮﻣ ﻪــﯿﻟوا ﯽﺘــﺷاﺪﻬﺑ يﺎــﻫ )8

ﻪــﺑ (PHC

ماﺪــﻗا ﮏــﯾ ناﻮــﻨﻋ

ﻪـﻫد ﻞـﯾاوا زا ،هدﺮﺘـﺴﮔ و ﻪﺘـﺴﺟﺮﺑ 1370

ﺪــﺷ زﺎـﻏآ ناﺮـﯾا رد

هﺎﺷ) ،يﺪـﻤﺤﻣ 1990

ﻦـﺴﺣ ؛ ،هداز 1992 ،نارﺎـﮑﻤﻫ و ﻂﯿـﺤﻣ ؛

1997 و ( ﻪــﯾارا رد مدﺮــﻣ ﺮﺘــﺸﯿﺑ ﻪــﭼﺮﻫ و ﻪــﻧﻻﺎﻌﻓ ﺖﮐرﺎــﺸﻣ

هﺎـﺷ) ناور ﺖﺷاﺪﻬﺑ تﺎﻣﺪﺧ

ﮏـﻠﻣ و يﺪـﻤﺤﻣ ،ﯽﻠـﻀﻓا

1990 ؛

،يوﺮـــﺴﺧ و ﯽـــﺴﯿﺋر 1998

؛ ﺰـــﮐﺮﻣ ﺶﯿـــﭘ و يﺮـــﯿﮔ لﺮـــﺘﻨﮐ

يرﺎﻤﯿﺑ ،ﺎﻫ 1999

؛ خﺮﻓ ،ﯽﻤﺸﯾﺮﺑا و ﯽﻣﺎﻤﺳ ﯽﭘ 2000

ﻖﻃﺎﻨﻣ رد (

ﻪﻣﺎﻧﺮﺑ رﺎﮐ رﻮﺘﺳد رد ﯽﺻﺎﺧ .ﺖﻓﺮﮔ راﺮﻗ رﻮﺸﮐ ﯽﺘﺷاﺪﻬﺑ ناﺰﯾر

نﺎــﯿﻣ ﻦــﯾا رد ﺖﮐرﺎــﺸﻣ

نﺎــﻄﺑار و ﺐــﻠﻃواد يﺎــﻫوﺮﯿﻧ نداد

ﻪـﯾارا شﺮﺘـﺴﮔ ياﺮﺑ ﻪﺟﻮﺗ درﻮﻣ يﺎﻫرﺎﮑﻫار زا ﯽﮑﯾ ﯽﺘﺷاﺪﻬﺑ نﺎﻣزﺎـﺳ) ﺖـﻓﺮﮔ راﺮـﻗ ﻪﺟﻮﺗ درﻮﻣ ﻪﻌﻣﺎﺟ رد ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ ،ﺖــﺷاﺪﻬﺑ ﯽﻧﺎــﻬﺟ 1988

وa

ﻪــﯿﻣﻼﻋا ﺪــﯿﮐﺄﺗ .(b

ﺎــﻤﻟآ ﺮــﺑ ﺎــﺗآ

ﻪﺑ ،نﺎﮕﻤﻫ ﺖﮐﺮﺷ تروﺮﺿ هداﻮﻧﺎﺧ هﮋﯾو

تﺎﻣﺪـﺧ ﻪـﯾارا رد ﺎﻫ

ﻟوا ﯽﺘﺷاﺪﻬﺑ ﻪـﻣﺎﻧﺮﺑ رد مدﺮﻣ يرﺎﮑﻤﻫ موﺰﻟ و ﻪﯿ

ﯽﺘـﺷاﺪﻬﺑ يﺎـﻫ

ﺎﻫرﻮـــﺸﮐ ﺮﻈﻧدرﻮـــﻣ ،ﺖـــﺷاﺪﻬﺑ ﯽﻧﺎـــﻬﺟ نﺎﻣزﺎـــﺳ)

1978 ،(

نﺎﺸﻧ نوﺮـﺑ رد دﺮﮑﯾور ﻦﯾا ﯽﺸﺨﺑﺮﺛا هﺪﻨﻫد يﺎـﻫﺎﻨﮕﻨﺗ زا ﺖـﻓر

ﻪــﺑور يﺎﻫرﻮــﺸﮐ زا يرﺎﯿــﺴﺑ رد دﻮــﺟﻮﻣ ﻪــﯾارا ﻪــﻨﯿﻣز رد ﺪــﺷر

هوﺮﮔ ﻪﺑ ناور ﺖﺷاﺪﻬﺑ تﺎﻣﺪﺧ ﯽﺳﺮﺘﺳد نﺎﮑﻣا ﻪﮐ ﺖﺳا ﯽﯾﺎﻫ

ﻣﺪﺧ ﻪﺑ يﺮﺘﻤﮐ

ﻢـﮐ داﺮـﻓا ﺪـﻨﻧﺎﻣ) ﺪـﻧراد ﯽﺘـﺷاﺪﻬﺑ تﺎ ،ﺪـﻣآرد

ﯽــﺑ نﺎــﻤﻧﺎﺧ فﺮــﺼﻣ ،ﯽﻧﺎــﺑﺎﯿﺧ نﺎــﮐدﻮﮐ ،ﺎــﻫ داﻮــﻣ نﺎﮔﺪــﻨﻨﮐ

ﻪﯿﺷﺎﺣ و ناﺮﺟﺎﻬﻣ ،روآدﺎﯿﺘﻋا نﺎﻣزﺎﺳ) (نﺎﻨﯿﺸﻧ

،ﺖﺷاﺪﻬﺑ ﯽﻧﺎﻬﺟ

2000 ﻢﻫ .(

هﺮـﻬﺑ ﻦﯿﻨﭼ يﺎـﻫوﺮﯿﻧ و ﯽـﻣدﺮﻣ ﺖﮐرﺎـﺸﻣ زا يﺮـﯿﮔ

ﻪﺑ ،ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ ﻪﯾارا ياﺮﺑ ﺐﻠﻃواد ،ناور ﺖـﺷاﺪﻬﺑ هﮋـﯾو

ﻮﺸﮐ رد

هروﺎـﺸﻣ ﺰـﮐﺮﻣ) ﺎﮑﯾﺮﻣآ ﻪﻠﻤﺟ زا ،نﻮﮔﺎﻧﻮﮔ يﺎﻫر و يا

ﻪﻌﻣﺎﺟ و ﯽﻧﻮﻧﺎﻗ تﺎﻣﺪﺧ

9ﺮﮕﻧ ، 2002 ﻪـﺘﻓﺮﮔ راﺮـﻗ ﺪﯿﮐﺄﺗ درﻮﻣ (

ﯽﺳرﺮﺑ .ﺖﺳا هداد نﺎﺸﻧ ﺎﻫ

يﺮﺛﺆـﻣ ﺶـﻘﻧ ﺐـﻠﻃواد يﺎﻫوﺮﯿﻧ ﺪﻧا

ﺶﯿﭘ رد

ﯽﻫﺎـﮔآ ناﺰـﯿﻣ ندﺮﺑﻻﺎـﺑ و شﺮﮕﻧ ﺮﯿﯿﻐﺗ ،نﺎﻣرد ،يﺮﯿﮔ

؛ﺪﻧراد ناور ﺖﺷاﺪﻬﺑ درﻮﻣ رد مدﺮﻣ

ﯽـﻣ ﻪـﻧﻮﻤﻧ ياﺮـﺑ ـﺗ

ﻪـﺑ ناﻮ

) يوﺮـﺴﺧ و ﯽـﺴﯿﺋر ﯽﺳرﺮﺑ 1998

( عﻮـﺿﻮﻣ ﺎـﺑ

» نﺎـﻄﺑار ﺮﯿﺛﺄـﺗ

يﺮﻬــﺷ يﺎــﻫراﻮﻧﺎﺧ دﺮــﮑﻠﻤﻋ و ﯽﻫﺎــﮔآ ﺮــﯿﯿﻐﺗ ﺮــﺑ ﺖــﺷاﺪﻬﺑ ﯽﺘﺷاﺪﻬﺑ ﺰﮐاﺮﻣ ﺶﺷﻮﭘﺮﯾز -

و جﺪﻨﻨﺳ ،ناﺮﻬﺗ يﺎﻫﺮﻬﺷ ﯽﻧﺎﻣرد

دﺮﮐﺮﻬﺷ

« و ﺰﮐﺮﻣ ﺶﯿﭘ و يﺮـﯿﮔ لﺮـﺘﻨﮐ يرﺎـﻤﯿﺑ ﺎـﻫ ) 1999 ( ﺎـﺑ

عﻮــﺿﻮﻣ

» نﺎﺘــﺳﺮﻬﺷ يﺮﻬــﺷ ﻖﻃﺎــﻨﻣ رد ناور ﺖــﺷاﺪﻬﺑ دﻮــﺒﻬﺑ

ﺮــﺑ هﺮــﻬﺑ ﺎــﺑ ﻦﺟو نﺎﺘــﺳا ﺐــﻠﻃواد ﯽﺘــﺷاﺪﻬﺑ نﺎــﻄﺑار زا يﺮــﯿﮔ

لﺎﺤﻣرﺎﻬﭼ و

يرﺎﯿﺘﺨﺑ

« .دﺮﮐ هرﺎﺷا 1

شزﻮـﻣآ ﯽـﺸﺨﺑﺮﺛا ناﺰـﯿﻣ ﯽﺳرﺮﺑ فﺪﻫ ﺎﺑ ﺮﺿﺎﺣ ﺶﻫوﮋﭘ و ﯽﺘــﺷاﺪﻬﺑ نﺎــﺒﻠﻃواد ﻪــﺑ ناور ﺖــﺷاﺪﻬﺑ ﺺــﺼﺨﺘﻣ نﺎﮑــﺷﺰﭘ

تﺎﻣﺪــﺧ ﻪــﯾارا و ﯽــﻣدﺮﻣ ﺖﮐرﺎــﺸﻣ ﺐــﻠﺟ رد ﮏــﺷﺰﭙﻧاورﺮﯿﻏ

ـﺷ ﯽﺘﮐرﺎـﺸﻣ يﻮـﮕﻟا ﮏﯾ ﺐﻟﺎﻗ رد ناور ﺖﺷاﺪﻬﺑ مﺎـﺠﻧا يﺮﻬ

.ﺪﺷ

_______________________________________

1- World Health Organization 2- major depression 3- mania 4- schizophrenia 5- Torrey 6- Center for Diseases Control and Prevention 7- Alma Ata 8- primary health care 9- Community Legal Services and Counseling Center

(3)

يﺮﻬﺷ ناور ﺖﺷاﺪﻬﺑ تﺎﻣﺪﺧ

112

لﺎﺳﻔﻫـﻢﻫﺪﻤﺷ /ـرﺎه 2 / نﺎﺘﺴﺑﺎﺗ1390

Vol. 17 / No. 2 / Summer 2011

شور ﯽﻧدﻮـﻣزآ

ﯽﻧاﺪـﯿﻣ ﺶﻫوﮋــﭘ يﺎـﻫ -

ﻪـﻠﺧاﺪﻣ يدﺮﺑرﺎــﮐ و يا

هﺪﻧﺮﯿﮔﺮﺑرد ،ﺮﺿﺎﺣ 20

ﻪﺑ) ﺐﻠﻃواد (ناور ﺖﺷاﺪﻬﺑ ﻂﺑار ناﻮﻨﻋ

ﺪـﺷرا سﺎﻨـﺷرﺎﮐ ﺶـﺷ ،ناﺮـﻬﺗ يرادﺮﻬـﺷ ﺶﺷ ﻪﻘﻄﻨﻣ ﻦﮐﺎﺳ ناور و ﮏـﺷﺰﭙﻧاور ﻪـﺳ ،هروﺎـﺸﻣ ﺎـﯾ ﯽﻨﯿﻟﺎﺑ ﯽﺳﺎﻨﺷ 15

ﮏـﺷﺰﭘ

ﻪﺑ ﯽﮕﻤﻫ ﻪﮐ ،دﻮﺑ ﮏﺷﺰﭙﻧاورﺮﯿﻏ ﺺﺼﺨﺘﻣ ترﻮﺻ

ﻪـﺑ نﺎﮕﯾار

حﺮــﻃ رد ﺖﮐﺮــﺷ ياﺮــﺑ ﯽﺗﺎﻣﺪــﻘﻣ ﯽــﺳرﺮﺑ و ﻪــﯿﻟوا ناﻮــﺧاﺮﻓ .ﺪﻧدﻮﺑ هدﺮﮐ ﯽﮔدﺎﻣآ مﻼﻋا ﻪﻘﻄﻨﻣ ناور ﺖﺷاﺪﻬﺑ

لﺎﺳ رد ﺖﺳا ﯽﻨﺘﻔﮔ 1381

ﻪـﺑ ﺶـﺷ ﻪﻘﻄﻨﻣ زا ﯽـﮑﯾ ناﻮـﻨﻋ

رد ناور ﺖـﺷاﺪﻬﺑ شﺮﺘﺴﮔ حﺮﻃ ياﺮﺟا ياﺮﺑ ﯽﺸﯾﺎﻣزآ ﻖﻃﺎﻨﻣ ﯽـﺳرﺮﺑ نآ رد .دﻮـﺑ هﺪـﺷ بﺎﺨﺘﻧا ﯽﻣدﺮﻣ ﺖﮐرﺎﺸﻣ بﻮﭼرﺎﭼ 5909 اﻮﻧﺎــﺧ ﻪــﺑ ر زا ﯽﻓدﺎــﺼﺗ ترﻮــﺻ 18

ﺶــﺷ ﻪــﻘﻄﻨﻣ ﻪــﻠﺤﻣ

نﺎﯿﻣ ﻦﯾا زا و ﺪﻧﺪﺷ بﺎﺨﺘﻧا 1830

ﺶﺳﺮﭘ دﺮﺑرﺎﮐ ﺎﺑ ﺮﻔﻧ ﻪﻣﺎﻧ

يﺎﻫ

ﺖــﯿﻌﻤﺟ ﻪﺨــﺴﻧ و شﺮــﮕﻧ ،ﯽﻫﺎــﮔآ ،ﯽﺘﺧﺎﻨــﺷ 90

ﻪــﯾﻮﮔ يا

ﻪﻧﺎﺸﻧ ﻪﻫﺎﯿﺳ هﺪﺷﺮﻈﻧﺪﯾﺪﺠﺗ

1ﺎـﻫ )

SCL-90-R

.ﺪﻧﺪـﺷ ﯽﺑﺎـﯾزرا (

ﻪــﺘﻓﺎﯾ نﺎــﺸﻧ ﺎــﻫ ﯽﮑــﺷﺰﭙﻧاور تﻼﮑــﺸﻣ يﻻﺎــﺑ ًﺎﺘﺒــﺴﻧ عﻮﯿــﺷ ﺮــﮔ

) 2/

29 (%

ﺑ و اﺮﺑﺎﻨ ﯾ ﺶﯿﭘ ﻪﺑ ﺮﺘﺸﯿﺑ ﻪﺟﻮﺗ موﺰﻟ ﻦ ﻦﯾا نﺎﻣرد و يﺮﯿﮔ

ﻒﻃﺎﻋ) دﻮﺑ تﻼﮑﺸﻣ ،نارﺎﮑﻤﻫ و ﺪﯿﺣو

2003 .(

زا 18 ﻪـﻠﺤﻣ ﻪـﺳ ،ﺶﺷ ﻪﻘﻄﻨﻣ ﻪﻠﺤﻣ 11

، 16 و 18 ﯽﻟاﻮـﺣ)

نﺎﺑﺎﯿﺧ ﻢﯾﺮﮐ يﺎﻫ ،ﺪﻨﻣدﺮﺧ ،لﺎﺻو ،بﺎﺠﺣ ،ﺪﻧز نﺎﺧ

16 و رذآ

ﻪﺑ (ﺮﯿﺗ ﺖﻔﻫ ناﺪﯿﻣ زا .ﺪﻧﺪﺷ بﺎﺨﺘﻧا ﯽﻓدﺎﺼﺗ ترﻮﺻ

216921

ﺮﻣ) ﺖﯿﻌﻤﺟ ﺮﻔﻧ ،ناﺮـﯾا رﺎﻣآ ﺰﮐ

1999

ﻪـﺑ ،ﻪـﻘﻄﻨﻣ ﻦـﯾا ( ﺐـﯿﺗﺮﺗ

4630 ، 9178 و 7958 يﻻﺎﺑ ﺖﯿﻌﻤﺟ زا ﺮﻔﻧ 15

ﻦـﯾا ﻦﮐﺎﺳ لﺎﺳ

.ﺪﻧﺪـﺷ ﻪـﺘﻓﺮﮔ ﺮـﻈﻧرد ﺶـﺷﻮﭘﺮﯾز ﺖﯿﻌﻤﺟ ناﻮﻨﻋ ﻪﺑ ،ﻪﻠﺤﻣ ﻪﺳ تﺎﻣﺪــﺧ ﺰــﮐاﺮﻣ ،ﮏــﺷﺰﭙﻧاورﺮﯿﻏ و ﮏــﺷﺰﭙﻧاور نﺎــﺼﺼﺨﺘﻣ نﺎﺘﺳرﺎﻤﯿﺑ ،هروﺎﺸﻣ ﻦـﯾا رد ﻦﮐﺎـﺳ يﺎـﻫراﻮﻧﺎﺧ و ﺎـﻫ

ﻪـﺳ ﻪـﻠﺤﻣ

ﻪــﺑ ،هﺪــﺷ ﯽﯾﺎــﺳﺎﻨﺷ تﻮــﻋد ﻪﻠﯿــﺳو

ياﺮــﺑ نﺎــﺸﯾا زا ،ﯽــﺒﺘﮐ ﻪــﻣﺎﻧ

ترﻮـﺻ ناﻮـﺧاﺮﻓ ﯽـﺷزﻮﻣآ هﺎـﮔرﺎﮐ و رﺎﻨﯿﻤـﺳ ﺪﻨﭼ يراﺰﮔﺮﺑ رد ،ﺐـﻠﻃواد ﺪـﺷرا نﺎـﺳﺎﻨﺷرﺎﮐ و نﺎـﯿﺑﺮﻣ نآ زا ﺲـﭘ .ﺖﻓﺮﮔ ﻪﺴﻠﺟ داﺮـﻓا ﻪﺑ ناور ﺖﺷاﺪﻬﺑ شزﻮﻣآ ﻪﺑ ﮏﭼﻮﮐ ﯽﻫوﺮﮔ يﺎﻫ

ﺖﮐﺮﺷ ﯽﺘﺷاﺪﻬﺑ نﺎﺒﻠﻃواد .ﺪﻨﺘﺧادﺮﭘ ﯽﻣﻮﻤﻋ ناﻮﺧاﺮﻓ رد هﺪﻨﻨﮐ

ﻪﺑ ﺸﻣ ﺰﮐاﺮﻣ ﻪﻠﯿﺳو ﻪـﻠﺤﻣ رد ﺮﻘﺘﺴﻣ هروﺎ

،ﯽﯾﺎـﺳﺎﻨﺷ درﻮـﻣ رد ﺎـﻫ

ﺐﻘﻋ ،عﺮﺻ ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﯿﺑ زا ﺖﯾﺎﻤﺣ و عﺎﺟرا ﯽـﻨﻫذ ﯽﮔﺪﻧﺎﻣ

لﻼﺘــﺧا و راﺮــﻗ شزﻮــﻣآ درﻮــﻣ ﯽــﻧاور ﺪﯾﺪــﺷ و ﻒــﯿﻔﺧ يﺎــﻫ

ﻪﻧﺎﺧ ﻪﺑ ﻪﻧﺎﺧ ﯽﺳرﺮﺑ ﻪﺑ ،دﻮﺧ ﯽﺘﻧﻮﮑﺳ ﻪﻠﺤﻣ رد ﺲﭙﺳ و ﺪﻨﺘﻓﺮﮔ ﮏـﺷﺰﭙﻧاورﺮﯿﻏ ﺺـﺼﺨﺘﻣ نﺎﮑـﺷﺰﭘ ﺮـﮕﯾد يﻮـﺳ زا .ﺪﻨﺘﺧادﺮﭘ ﺳ ﻦﯾا رد ﻞﻏﺎﺷ ﻪﺑ ،ﻪﻠﺤﻣ ﻪ

ﻞﻏﺎـﺷ ﺐـﻠﻃواد نﺎﮑـﺷﺰﭙﻧاور ﻪﻠﯿﺳو

ﻪــﻠﺤﻣ ﻦﯿــﻤﻫ رد ﺎــﻫ

، ود ياﻮــﺘﺤﻣ .ﺪﻧﺪــﺷ هداد شزﻮــﻣآ ﻪــﺴﻠﺟ

لﻼﺘـﺧا ﺖﺧﺎﻨـﺷ هﺪﻧﺮﯿﮔﺮﺑرد هوﺮﮔ ﻦﯾا ﯽﺷزﻮﻣآ ،ﯽـﻧاور يﺎـﻫ

ﻪــﺑ لﻼﺘــﺧا هﮋــﯾو ﮏــﯿﺗ لﻼﺘــﺧا ،نﺎــﮐدﻮﮐ ﻪــﺑ طﻮــﺑﺮﻣ يﺎــﻫ

،2

لﻼﺘــﺧا ﯽــﻧاور يﺎــﻫ -

نآ .دﻮــﺑ دﺎــﯿﺘﻋا و ﯽــﺴﻨﺟ دراﻮــﻣ هﺎــﮔ

ﯽﯾﺎﺳﺎﻨﺷ ﻪﺑ هﺪﺷ ﺳو

ﺐـﻄﻣ ﻪـﺑ ،ﯽﺘﺷاﺪﻬﺑ نﺎﺒﻠﻃواد ﻪﻠﯿ ﺰـﮐاﺮﻣ ،ﺎـﻫ

هروﺎﺸﻣ تﺎﻣﺪﺧ ﻪـﻘﻄﻨﻣ ﻦـﯾا رد ﻊـﻗاو ﺮـﮔزوﺮﯿﻓ نﺎﺘﺳرﺎﻤﯿﺑ و يا

ﻪﺘﻔﻫ ﺮﮔزوﺮﯿﻓ نﺎﺘﺳرﺎﻤﯿﺑ رﻮﻈﻨﻣ ﻦﯾﺪﺑ .ﺪﻧﺪﺷ هداد عﺎﺟرا يا

1 ﺎﺗ

2 ﺖﺷاﺪﻬﺑ و ﯽﮑﺷﺰﭙﻧاور لﺎﻌﻓ هﺎﮕﻧﺎﻣرد زور هار ار ناور

يزاﺪﻧا

.دﺮﮐ هداد ،ﯽﻗﻼﺧا تﺎﮑﻧ ﺖﯾﺎﻋر رﻮﻈﻨﻣ ﻪﺑ ﻪﺑ يﺎﻫ

ﺖﺳد زا هﺪـﻣآ

هداﻮﻧﺎﺧ

ﻪـﺑ ﺶﻫوﮋـﭘ رد ﺎـﻬﻨﺗ ،هﺪﻧﺎﻣ ﻪﻧﺎﻣﺮﺤﻣ نﺎﺒﻠﻃواد و ﺎﻫ رﺎـﮐ

.ﺪـﺷ هداد نﺎــﻨﯿﻤﻃا نﺎـﺸﯾا ﻪــﺑ عﻮـﺿﻮﻣ ﻦــﯾا و ﺖـﻓر ﻢــﻫ

ﻦﯿــﻨﭼ

هداﻮﻧﺎﺧ و نﺎﺒﻠﻃواد ﺪـﻨﻨﮑﻧ ﺖﮐﺮﺷ ﺶﻫوﮋﭘ رد ﺪﻨﺘﺷاد رﺎﯿﺘﺧا ﺎﻫ

ﻪﻠﺣﺮﻣ رد رﻮﻀﺣ ﻪﻣادا ﺎﺑ ار دﻮﺧ ﺖﻔﻟﺎﺨﻣ و مﻼـﻋا ﻦﯿـﺴﭘ يﺎـﻫ

.ﺪﻨﯾﺎﻤﻧ هداد يروآدﺮﮔ ياﺮﺑ ﻪﺑ ﺎﻫراﺰﺑا ﻦﯾا ﺎﻫ

:ﺪﺷ هدﺮﺑ رﺎﮐ

ﺶﺳﺮﭘ ﯽﮔﮋﯾو ﻪﻣﺎﻧ ﺖـﯿﻌﻤﺟ يﺎﻫ

ﯽﺘﺧﺎﻨـﺷ

هﺪـﻧﺮﯿﮔﺮﺑرد ﻪـﮐ

.دﻮﺑ ﻞﻐﺷ و ﻞﯿﺼﺤﺗ ناﺰﯿﻣ ،ﺖﯿﺴﻨﺟ ،ﻦﺳ

ﺶﺳﺮﭘ ناور ﺖـﺷاﺪﻬﺑ نﺎﻄﺑار ﯽﺠﻨﺳﺮﻈﻧ ﻪﻣﺎﻧ

هﺪـﻧﺮﯿﮔﺮﺑرد ،

15 ﻪﻨﯾﺰﮔرﺎﻬﭼ ﻪﯾﻮﮔ نﺎﻄﺑار شﺮﮕﻧ و ﯽﻫﺎﮔآ ﯽﺑﺎﯾزرا ياﺮﺑ ،يا

.ﺪﺷ ﻢﯿﻈﻨﺗ

ﺶﺳﺮﭘ ﺨﺘﻣ نﺎﮑـﺷﺰﭘ ﯽﺠﻨﺳﺮﻈﻧ ﻪﻣﺎﻧ

هﺪـﻧﺮﯿﮔﺮﺑرد ،ﺺـﺼ

25

ﻪﻨﯾﺰﮔرﺎﻬﭼ ﻪﯾﻮﮔ هرﺎﺑرد نﺎﮑﺷﺰﭘ شﺮﮕﻧ و ﯽﻫﺎﮔآ درﻮﻣ رد يا

يرﻮﺻ رﺎﺒﺘﻋا .ناور ﺖﺷاﺪﻬﺑ ﯽﯾاﻮﺘﺤﻣ و3

ﺶـﺳﺮﭘ ﻪﺳ ﺮﻫ4

ﻪـﻣﺎﻧ

ﺶﯿﭘ و ﻪﯿﻟوا ﯽﺳرﺮﺑ رد ﺶﻫوﮋﭘ

ﻪﺑ ﺐﺳﺎﻨﻣ5

.ﺪﻣآ ﺖﺳد

هداد ﻞﯿﻠﺤﺗ و ﻪﯾﺰﺠﺗ ﺎـﻫ

ﮏـﻤﮐ ﺎـﺑ

SPSS-15

شور ﻪـﺑ و6

يرﺎــﻣآ نﻮــﻣزآ ﻪﺘــﺴﺑاوt

.ﺪــﺷ مﺎــﺠﻧا ﻢــﻫ

ﻦﯿــﻨﭼ ﻪــﺑﺮﺠﺗ و ﺎــﻫ

هﺪﻫﺎﺸﻣ

ﻪـﺴﻠﺟ رد ناﺮﮕـﺸﻫوﮋﭘ يﺎـﻫ شور ﻪـﺑ نﻮﮔﺎـﻧﻮﮔ يﺎـﻫ

ﻊﻤﺟ ﯽﻔﯿﮐ .ﺪﺷ شراﺰﮔ و يﺪﻨﺑ

ﻪﺘﻓﺎﯾ ﺎﻫ ﯽﻧدﻮﻣزآ ﯽﻣﺎﻤﺗ ﯽﺘـﺷاﺪﻬﺑ نﺎـﺒﻠﻃواد .ﺪـﻧدﻮﺑ نز ﺎﻫ

50 - 30

،ﺪﻨﺘــﺷاد لﺎــﺳ 60

و ﻢﻠﭙــﯾد % 40

و ﯽــﺳﺎﻨﺷرﺎﮐ % 85

ﻪــﻧﺎﺧ % راد

.ﺪﻧدﻮﺑ 71 يﻻﺎـﺑ ﮏـﺷﺰﭙﻧاورﺮﯿﻏ ﺺﺼﺨﺘﻣ نﺎﮑﺷﺰﭘ % 50

لﺎـﺳ

.ﺪﻧدﻮﺑ 1

_______________________________________

1- Symptom Checklist-90-Revised 2- tic disorder 3- face validity 4- content 5- pilot study

6- Statistical Package for the Social Science- version 15

(4)

113

ﻣ هﺮــﻤﻧ (رﺎــﯿﻌﻣ فاﺮــﺤﻧا و) ﻦﯿﮕﻧﺎــﯿ ﻪــﺑ يﺎــﻫ

ﺖــﺳد زا هﺪــﻣآ

ﺶﺳﺮﭘ زا ﺲـﭘ و ﺶﯿـﭘ ،ناور ﺖـﺷاﺪﻬﺑ نﺎـﻄﺑار ﯽﺠﻨﺳﺮﻈﻧ ﻪﻣﺎﻧ

ﻪﺑ شزﻮﻣآ ﺐﯿﺗﺮﺗ

5/

8 ) 06 /3 و ( 10 ) 01 /3 نﻮﻣزآ دﺮﺑرﺎﮐ .دﻮﺑ (

ﺎﻨﻌﻣ توﺎﻔﺗ هﺮﻤﻧ ود ﻦﯾا نﺎﯿﻣ ﻪﺘﺴﺑاوt

) داد نﺎﺸﻧ راد 002

/0

≤

،p

19

= ،df

5/

3 -

= .(t

ﻧ (رﺎــﯿﻌﻣ فاﺮــﺤﻧا و) ﻦﯿﮕﻧﺎــﯿﻣ هﺮــﻤ

ﻪــﺑ يﺎــﻫ ﺖــﺳد زا هﺪــﻣآ

ﺶــﺳﺮﭘ زا ﺲــﭘ و ﺶﯿــﭘ ،ﺺــﺼﺨﺘﻣ نﺎﮑــﺷﺰﭘ ﯽﺠﻨــﺳﺮﻈﻧ ﻪــﻣﺎﻧ

ﻪﺑ شزﻮﻣآ ﺐﯿﺗﺮﺗ

3/

8 ) 4/

2 و ( 4/

12 ) 3/

3 نﻮﻣزآ دﺮﺑرﺎﮐ .دﻮﺑ (

ﺎﻨﻌﻣ توﺎﻔﺗ هﺮﻤﻧ ود ﻦﯾا نﺎﯿﻣ ﻪﺘﺴﺑاوt

) داد نﺎﺸﻧ راد 001

/0

≤

،p

14

= ،df

8/

4 -

= .(t

ﺖﯾدوﺪﺤﻣ ﻪﮐ ﺎﺠﻧآ زا

ﻪـﺘﻓﺎﯾ ﺪـﺷ ﺐﺟﻮﻣ دﻮﺟﻮﻣ يﺎﻫ يﺎـﻫ

ﻪﺑ ﯽﻤﮐ ﺖﺳد ﻪﺘـﺷاﺪﻧ يﺪﻨﻤـﺷزرا يرﺎـﻣآ ﻢﯿـﻤﻌﺗ شزرا هﺪـﻣآ

هﺮﻬﺑ ،ﺪﺷﺎﺑ ﻪﺘﻓﺎﯾ زا يﺮﯿﮔ

ﻪﺑ) ﯽﻔﯿﮐ يﺎﻫ ،هﺪﻫﺎـﺸﻣ زا هﺪﻣآ ﺖﺳد

ﻪــﺴﻠﺟ ﺎــﺑ يداﺮــﻔﻧا ﻪﺒﺣﺎــﺼﻣ و دﺎﻨــﺳا ﯽــﺳرﺮﺑ ،ﯽــﻫوﺮﮔ يﺎــﻫ

ﺖﮐﺮﺷ ؛ﺖـﻓﺎﯾ يﺮﺘـﺸﯿﺑ تروﺮـﺿ (نﺎﮔﺪﻨﻨﮐ 1

- هداﻮﻧﺎـﺧ و ﺎـﻫ

ﺖﮐﺮـﺷ نﺎﺒﻠﻃواد خرﻮـﻣ ﺶﯾﺎـﻤﻫ رد هﺪـﻨﻨﮐ

11 رذآ 1383 ﻪـﺑ

د و زﺎﯿﻧ ﻞﯿﻟد هﺮـﻬﺑ تروﺮﺿ كر

ﺖـﺷاﺪﻬﺑ تﺎﻣﺪـﺧ زا يﺮـﯿﮔ

ﻪﺑ ،ناور ﻢـﻫ دﺮـﮔ ﺖـﮐﺮﺣ گرﺰـﺑ رﻻﺎـﺗ رد هدﺮﺘـﺴﮔ ترﻮﺻ

ﻪـﺑ حﺮـﻃ رد يرﺎﮑﻤﻫ ياﺮﺑ و ﺪﻧﺪﻣآ ﻂـﺑار ﺎـﯾ ﺐـﻠﻃواد ناﻮـﻨﻋ

ﻪــﺑ ﻞــﯾﺎﻤﺗ و قﺎﯿﺘــﺷا ﻦــﯾا .ﺪــﻧدﺮﮐ ﯽﮔدﺎــﻣآ مﻼــﻋا ،ﯽﺘــﺷاﺪﻬﺑ هروﺎـﺸﻣ تﺎﻣﺪﺧ ﺰﮐاﺮﻣ ناروﺎﺸﻣ و نﺎﺳﺎﻨﺸﻧاور رد يرﺎﮑﻤﻫ يا

ـﮐ ﺪﺷ هﺪﯾد ﺰﯿﻧ ﻪﻘﻄﻨﻣ

ﻪـﺑ ﺪﻧﺪـﺷ ﺮـﺿﺎﺣ ﻪ تﺎﻣﺪـﺧ ﻪـﯾارا يﺎـﺟ

ﻪـﺑ ﻪﻧﺎﺒﻠﻃواد و نﺎﮕﯾار ،هروﺎﺸﻣ ﺰﮐاﺮﻣ رد يدﺮﻓ و ﯽـﺑﺮﻣ ناﻮـﻨﻋ

هداﻮﻧﺎﺧ روﺎﺸﻣ رد ﻞﻏﺎﺷ ﺺﺼﺨﺘﻣ نﺎﮑﺷﺰﭘ .ﺪﻨﯾﺎﻤﻧ يرﺎﮑﻤﻫ ﺎﻫ

ﺐﻄﻣ ﺎـﺑ) ﯽﯾﺎﻤﻫدﺮﮔ ود رد رﻮﻀﺣ ﺎﺑ ﻪﻘﻄﻨﻣ ﻦﯾا ﯽﺻﻮﺼﺧ يﺎﻫ

نآ شزﻮﻣآ ﻦﯾا ﻪﮐ

ﻮﻣآزﺎـﺑ زﺎـﯿﺘﻣا ﺎـﻫ ز

ﻪـﺑ ﻪﻧﺎﻗﺎﺘـﺸﻣ (ﺖـﺷاﺪﻧ ي

و يﺮﯿﮔاﺮﻓ ﻪـﺑ

ترﻮـﺸﻣ رد ناور ﺖـﺷاﺪﻬﺑ تﻼﮑـﺸﻣ ﻦﺘـﺷاﺬﮔ

هداﻮﻧﺎﺧ و نﺎﻌﺟاﺮﻣ ﻪﺑ و ﺪﻨﺘﺧادﺮﭘ ﺎﻫ

شزﻮﻣآ ﺮﻤﺘﺴﻣ ترﻮﺻ و ﺎﻫ

ﻪﯿﺻﻮﺗ ﯽﭘ ار ﻪﻣﺎﻧﺮﺑ ﻦﯾا يﺎﻫ ﻞﻏﺎـﺷ نﺎﮑـﺷﺰﭙﻧاور .ﺪﻧدﺮﮐ يﺮﯿﮔ

ﻪـﺑ ﻪـﻘﻄﻨﻣ ﯽﺘﻟود ﺰﮐاﺮﻣ ﺎﯾ ﺐﻄﻣ رد شزﻮـﻣآ رد لﺎـﻌﻓ ترﻮـﺻ

ﻦﯾاﺮﺑﺎـﻨﺑ ،ﺪﻨﺘﺷاد ﺖﮐﺮﺷ ﯽﺘﺷاﺪﻬﺑ نﺎﻄﺑار و نﺎﯿﺑﺮﻣ ،نﺎﺼﺼﺨﺘﻣ ﺷ هداد لدﺎﺒﺗ ،ﯽﯾﺎﺳﺎﻨ ﯾ ﻪﺑ نﺎﻌﺟاﺮﻣ عﺎﺟرا و ﺎﻫ

ﮑ ﺢﻄـﺳ رد ﺮﮕﯾﺪ

.ﺪﺷ مﺎﺠﻧا ﯽﺑﻮﺧ ﻪﺑ ﻪﻠﺤﻣ 2

- ﻞﯿﮑـﺸﺗ ياﺮـﺑ نﺎـﯿﺑﺮﻣ و نﺎﺒﻠﻃواد

ﺖﺴﺸﻧ هداد لدﺎﺒﺗ ،ﯽﮕﺘﻔﻫ يﺎﻫ و نﺎـﻌﺟاﺮﻣ تﻼﮑـﺸﻣ نﺎـﯿﺑ ،ﺎﻫ

هداﻮﻧﺎﺧ تﺎﻣﺪـﺧ ﺰﮐاﺮﻣ زا ﻞﻘﺘﺴﻣ ﯽﻧﺎﮑﻣ صﺎﺼﺘﺧا رﺎﺘﺳاﻮﺧ ﺎﻫ

ﺮــﮔزوﺮﯿﻓ نﺎﺘــﺳرﺎﻤﯿﺑ و ﯽــﻠﺤﻣ هروﺎــﺸﻣ -

ﯽــﺼﺼﺨﺗ ﺰــﮐﺮﻣ ﻪــﮐ

دﻮـﺑ دراﻮﻣ عﺎﺟرا -

.ﺪـﻧدﻮﺑ 3 - ﺖـﺷاﺪﻬﺑ نﺎـﺒﻠﻃواد زا يرﺎﻤـﺷ

ﻪﺑ ناور ﺎـﺑ ﺮـﯿﮔرد داﺮﻓا ﯽﯾﺎﺳﺎﻨﺷ ﻪﺑ ،ﻪﻧﺎﺧ ﻪﺑ ﻪﻧﺎﺧ ،لﺎﻌﻓ ترﻮﺻ ﺘﺒﻣ داﺮﻓا زا يدﺎﯾز رﺎﻤﺷ و ﺪﻨﺘﺧادﺮﭘ ناور ﺖﺷاﺪﻬﺑ تﻼﮑﺸﻣ

ﻼ

لﻼﺘــﺧا ﻪــﺑ تﻼﮑــﺸﻣ ﺎــﺑ ﺮــﯿﮔرد و دﺎــﯿﺘﻋا و ﯽﮑــﺷﺰﭙﻧاور يﺎــﻫ

ﯽﻧاور - ﻪﺑ ﯽﻋﺎﻤﺘﺟا ،هروﺎـﺸﻣ ﺰـﮐاﺮﻣ ﻪـﺑ و ﯽﯾﺎﺳﺎﻨﺷ نﺎﻧآ ﻪﻠﯿﺳو

ﺐﻄﻣ .ﺪﻧﺪـﺷ عﺎﺟرا ﺮﮔزوﺮﯿﻓ نﺎﺘﺳرﺎﻤﯿﺑ و ﻞﺤﻣ ﯽﺻﻮﺼﺧ يﺎﻫ

4 - ﺮـﺧاوا زا ناور ﺖﺷاﺪﻬﺑ ﯽﺼﺼﺨﺗ و مﻮﺳ ﺢﻄﺳ دﺎﺠﯾا ياﺮﺑ

لﺎﺳ 1384

ﺑ) ﯽﻋﺎـﻤﺘﺟا ﯽﮑـﺷﺰﭙﻧاور ﯽﯾﺎﭘﺮﺳ هﺎﮕﻧﺎﻣرد ﺖـﺷاﺪﻬ

هﺎــﮕﻧﺎﻣرد رد (ناور ﺎــﺑ ،هﺪــﺷ لﺎــﻌﻓ ﺮــﮔزوﺮﯿﻓ نﺎﺘــﺳرﺎﻤﯿﺑ يﺎــﻫ

رﺎﯿﺘـﺳد ،ﮏﺷﺰﭙﻧاور ،ﯽﻨﯿﻟﺎﺑ سﺎﻨﺸﻧاور ،رﺎﮐدﺪﻣ ﯽﮕﺘﻔﻫ رﻮﻀﺣ يﺎــﻫزور رد ﯽﮑــﺷﺰﭙﻧاور ﯽــﻤﻠﻋ تﺄــﯿﻫ ﻮــﻀﻋ و ﯽﮑــﺷﺰﭙﻧاور ﻪﺑ ﮏﯾدﺰﻧ ﻪﻧازور ،ﻪﺒﻨﺷرﺎﻬﭼ 15

ﻪﻠﺤﻣ ،ﺮﻬﺷ ﺢﻄﺳ زا رﺎﻤﯿﺑ يﺎﻫ

ﺶـﺨﺑ و حﺮﻃ ياﺮﺟا

د درﻮـﻣ نﺎﺘـﺳرﺎﻤﯿﺑ يﺮﺘـﺴﺑ يﺎـﻫ و نﺎـﻣر

ﯽﻣ راﺮﻗ هروﺎﺸﻣ .ﺪﻧﺮﯿﮔ

ﺚﺤﺑ شزﻮـﻣآ ﯽـﺸﺨﺑﺮﺛا ناﺰـﯿﻣ ﯽﺑﺎـﯾزرا فﺪـﻫ ﺎـﺑ ﯽـﺳرﺮﺑ ﻦﯾا

ﻪﺑ) ناور ﺖﺷاﺪﻬﺑ نﺎﻄﺑار ﺮﯿﯿﻐﺗ رد (ناور ﺖﺷاﺪﻬﺑ نﺎﯿﺑﺮﻣ ﻪﻠﯿﺳو

ﺖﮐرﺎـﺸﻣ ﺐـﻠﺟ و ناور ﺖـﺷاﺪﻬﺑ ﻪـﺑ ﺖﺒﺴﻧ شﺮﮕﻧ و ﯽﻫﺎﮔآ هداﻮﻧﺎـﺧ هﺪﻧﺮﯿﮔﺮﺑرد) ﯽﻣدﺮﻣ

هروﺎـﺸﻣ تﺎﻣﺪـﺧ ﺰـﮐاﺮﻣ ،ﺎـﻫ ،يا

نﺎﺼﺼﺨﺘﻣ و ناروﺎﺸﻣ ﺮﻬـﺷ ﺶـﺷ ﻪـﻘﻄﻨﻣ ﻪـﻠﺤﻣ ﻪـﺳ رد ﻞﻏﺎﺷ

ﻒﻃﺎﻋ .ﺪﺷ مﺎﺠﻧا (ناﺮﻬﺗ ) نارﺎـﮑﻤﻫ و ﺪـﯿﺣو

2003 حﺮـﻃ رد (

ﺶﯿـﭘ و ناور ﺖﺷاﺪﻬﺑ ﻪﻌﺳﻮﺗ ﻪﻧﻮﻤﻧ ﻪـﻘﻄﻨﻣ رد دﺎـﯿﺘﻋا زا يﺮـﯿﮔ

لﺎــﺳ رد ناﺮـﻬﺗ ﺮﻬــﺷ ﺶـﺷ 1382

) نارﺎــﮑﻤﻫ و ﺮـﺼﻧ ، 2004

،(

يﺮﻗﺎﺑ و ﺪﻤﺤﻣ ،ﻻﺎﺑرﻮﻧ ) يدﺰـﯾ

1999 نارﺎـﮑﻤﻫ و يﺪـﻤﺤﻣ و (

) 2003 ﯽﺳرﺮﺑ ﯽﻃ ( ﻧا يﺎﻫ

مﺎﺠ ﻪﺘﻓﺎﯾ ﻦﯾا ناﺮﻬﺗ ﺮﻬﺷ رد هﺪﺷ ار ﺎﻫ

ﻪﺑ لﻼﺘﺧا يﻻﺎﺑ عﻮﯿﺷ :ﺪﻧداد ﺖﺳد فﺮـﺼﻣ ،ﯽﮑـﺷﺰﭙﻧاور يﺎـﻫ

ﺖـﺷاﺪﻬﺑ ﻪـﺑ ﺖﺒـﺴﻧ شﺮـﮕﻧ و ﯽﻫﺎﮔآ رد ﻞﮑﺸﻣ ،داﻮﻣ و ﻞﮑﻟا هداﻮﻧﺎﺧ ﯽﻧاور ﯽـﺼﺼﺨﺗ ﺰـﮐﺮﻣ و ﻊﺑﺎﻨﻣ زا ﻦﺘﺷاﺪﻧ ﯽﻫﺎﮔآ و ﺎﻫ

ﻪـﺑﺮﺠﺗ ﺎـﺑ ﺪﺷ شﻼﺗ ﺮﺿﺎﺣ ﺶﻫوﮋﭘ رد ﻦﯾاﺮﺑﺎﻨﺑ .ناور ﺖﺷاﺪﻬﺑ ﺗ زا دﻮــﺟﻮﻣ رد ناور ﺖــﺷاﺪﻬﺑ ﻖــﯿﻔﻠ

هﺮــﻬﺑ ﺎــﺑ ،PHC

زا يﺮــﯿﮔ

ﻦﯿﺘـﺴﺨﻧ ياﺮـﺑ و ﯽﺘـﺷاﺪﻬﺑ نﺎـﻄﺑار و ﺐﻠﻃواد يﺎﻫوﺮﯿﻧ ﺎـﺑ رﺎـﺑ

ﻪﺑ

هروﺎـﺸﻣ تﺎﻣﺪـﺧ ﺰـﮐاﺮﻣ ﻪـﻧﺎﺒﻠﻃواد يرﺎﮑﻤﻫ يﺮﯿﮔرﺎﮐ و يا

ناﺮــﻬﺗ ﺮﻬــﺷ ﮏــﺷﺰﭙﻧاورﺮﯿﻏ ﺺــﺼﺨﺘﻣ نﺎﮑــﺷﺰﭘ ﺐــﻄﻣ -

ﻪــﮐ

ﺖﺒﻗاﺮﻣ تﺎﻣﺪﺧ ﻪﯾارا ﻪﻣﺎﻧﺮﺑ ﮏﯾ زا ﻪﺸﯿﻤﻫ ﺖـﺷاﺪﻬﺑ ﻪﯿﻟوا يﺎﻫ

ﺑ موﺮﺤﻣ ناور ﺖﺳا هدﻮ

- تﺎﻣﺪﺧ ﻪﯾارا ياﺮﺑ ﯽﺘﮐرﺎﺸﻣ ﯽﯾﻮﮕﻟا

.دﻮﺷ ﻪﯾارا و ﯽﺣاﺮﻃ ناور ﺖﺷاﺪﻬﺑ

ﻪﺘﻓﺎﯾ و ﯽﻫﺎـﮔآ رد ،ﯽﺘـﺷاﺪﻬﺑ نﺎـﻄﺑار شزﻮﻣآ داد نﺎﺸﻧ ﺎﻫ

ﺖﺳا هدﻮﺑ ﺮﺛﺆﻣ ناور ﺖﺷاﺪﻬﺑ ﻪﺑ ﺖﺒﺴﻧ نﺎﻧآ شﺮﮕﻧ .

ﺮـﺑ نوﺰﻓا

عﻮــﺿﻮﻣ زا نﺎــﺼﺼﺨﺘﻣ ﯽﻫﺎــﮔآ نآ ناور ﺖــﺷاﺪﻬﺑ يﺎــﻫ

ﺰــﯿﻧ

(5)

يﺮﻬﺷ ناور ﺖﺷاﺪﻬﺑ تﺎﻣﺪﺧ

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لﺎﺳﻔﻫـﻢﻫﺪﻤﺷ /ـرﺎه 2 / نﺎﺘﺴﺑﺎﺗ1390

Vol. 17 / No. 2 / Summer 2011

ﺎﻄﺑار ﺖﮐرﺎﺸﻣ .ﺖﺷاد رادﺎﻨﻌﻣ ﺶﯾاﺰﻓا ندﻮـﺑﺮﺛﺆﻣ و ﯽﺘﺷاﺪﻬﺑ ن

شزﻮﻣآ ،يوﺮﺴﺧ و ﯽﺴﯿﺋر) نﺎﻧآ ﻪﺑ 1998

ﺰﮐﺮﻣ ؛ ﺶﯿﭘ و يﺮﯿﮔ

لﺮﺘﻨﮐ يرﺎﻤﯿﺑ ،ﺎﻫ 1999 و زروﺎﺸﮐ ،ﻪﯾﺪﻧز ،يوﺎﺸﯿﻠﮐ ،ﯽﺤﻟﺎﺻ ؛

يﺮﻗﺎﺑ ،يدﺰﯾ 2005 ﯽﺳرﺮﺑ رد ( .دﻮـﺑ هﺪـﺷ ﺪﯿﯾﺄﺗ ﺰﯿﻧ ﻦﯿﺸﯿﭘ يﺎﻫ

هداﻮﻧﺎــﺧ ﺎــﺑ نﺎــﻧآ طﺎــﺒﺗرا ،ﺮــﺿﺎﺣ ﺶﻫوﮋــﭘ ﯽﻠــﺻا فﺪــﻫ ،ﺎــﻫ

ﭙﻧاور و ناروﺎــﺸﻣ ،نﺎــﺼﺼﺨﺘﻣ زا يرادرﻮــﺧﺮﺑ ﺰــﯿﻧ و نﺎﮑــﺷﺰ

ﺮـﯿﯿﻐﺗ .دﻮـﺑ ﻪـﻠﺤﻣ رد ﻞﻏﺎﺷ نﺎﺳﺎﻨﺸﻧاور و نﺎﮑﺷﺰﭙﻧاور شزﻮﻣآ رد نﺎــﻧآ ﺖﮐﺮــﺷ ،ﯽﺘــﺷاﺪﻬﺑ نﺎــﻄﺑار شﺮــﮕﻧ و ﯽﻫﺎــﮔآ رد ﻪﺴﻠﺟ ﻪﻌﺟاﺮﻣ و ﯽﺷزﻮﻣآ يﺎﻫ هداﻮﻧﺎﺧ نداد

ﻪـﺑ داﺮﻓا و ﺎﻫ ﻪﻠﯿـﺳو

نﺎﺸﻧ نﺎﻧآ

لﺎـﻌﻓ .دﻮـﺑ حﺮﻃ ﺖﯿﻘﻓﻮﻣ ﺮﮔ ﯽـﺼﺼﺨﺗ هوﺮـﮔ نﺪـﺷ

زﻮـﺣ رد ﯽﻣﻮــﻤﻋ نﺎﺘـﺳرﺎﻤﯿﺑ ﮏـﯾ نﺪــﺷزﺎﺑ و ناور ﺖـﺷاﺪﻬﺑ ه

هﺎﮕﻧﺎﻣرد و ﺲﻧاژروا يﺎﻫرد ناﺪﻨﻣزﺎﯿﻧ ياﺮﺑ نﺎﺘﺳرﺎﻤﯿﺑ ﻦﯾا يﺎﻫ

.دﻮﺑ ﺮﺿﺎﺣ ﺶﻫوﮋﭘ يﺎﻫدروﺎﺘﺳد زا ﻪﻘﻄﻨﻣ ناور ﺖﺷاﺪﻬﺑ

ﻢـﮐ ،ﺮﺿﺎﺣ ﺶﻫوﮋﭘ ﯽﻠﺻا ﺖﯾدوﺪﺤﻣ ﻪـﻧﻮﻤﻧ رﺎﻤـﺷ ندﻮـﺑ

ﻢﯿـﻤﻌﺗ و ﯽﺑﺎـﯾزرا رد دﺎﻤﺘﻋا ﻞﺑﺎﻗ يرﺎﻣآ ﻞﯿﻠﺤﺗ نﺎﮑﻣا ﻪﮐ ،دﻮﺑ ﻪﺘﻓﺎﯾ

ﻪـﺟاﻮﻣ ﻞﮑـﺸﻣ ﺎـﺑ ار ﺎﻫ

ﻪـﺑﺮﺠﺗ ،ﺮﺘـﺸﯿﺑ ﻦﯾاﺮﺑﺎـﻨﺑ ،دﺮـﮐ ،ﺎـﻫ

هﺪﻫﺎــﺸﻣ ﻪــﺘﻓﺎﯾ و ﺎــﻫ .ﺖــﻓﺮﮔ راﺮــﻗ دﺎﻨﺘــﺳا درﻮــﻣ ﯽــﻔﯿﮐ يﺎــﻫ

ﺖﮐرﺎﺸﻣ ﺮـﮕﯾد و ناروﺎـﺸﻣ ،هروﺎـﺸﻣ ﺰـﮐاﺮﻣ زا ﯽـﺧﺮﺑ ندﺮـﮑﻧ ،دﺎﯾز لﺎﻐﺘﺷا ﻞﯾﻻد ﻪﺑ ،ﯽﺘﺷاﺪﻬﺑ و ﯽﮑﺷﺰﭘ تﺎﻣﺪﺧ ﻪﯾارا ﺰﮐاﺮﻣ

ﻪﻧﺎﺒﻠﻃواد و نﺎﮕﯾار و ﯽﻧﺎﻣزﺎـﺳ ﻪـﻔﯿﻇو دﻮـﺒﻧ و ﺖﮐرﺎـﺸﻣ ندﻮـﺑ

،ﯽﻤﺳر ﻢﻫ ﻦﯿﻨﭼ ﻢـﻫ زﺎـﺑ) نﺎـﺒﻠﻃواد و نﺎـﯿﺑﺮﻣ ﯽﺠﯾرﺪﺗ شﺰﯾر

ﻪﺑ ﻪﻧﺎﺒﻠﻃواد و نﺎﮕﯾار ﻞﯿﻟد (ﯽﻧﺎﻣزﺎﺳ ﺪﻬﻌﺗ ﻦﺘﺷاﺪﻧ و حﺮﻃ ندﻮﺑ

،رﻮــﺷوﺮﺑ ﻦﯾوﺪــﺗ نﺎــﮑﻣا دﻮــﺒﻧ .دﻮــﺑ ﺶﻫوﮋــﭘ ﺮــﮕﯾد ﻞﮑــﺸﻣ زﺎـﯿﻧ درﻮﻣ ﻪﻧﺎﺨﺑﺎﺘﮐ ﻦﺘﺷاﺪﻧرﺎﯿﺘﺧارد و بﺎﺘﮐ و ﺮﺘﺳﻮﭘ ،ﻪﯿﻋﻼﻃا و ﯽﯾﺎــﻤﻫدﺮﮔ يراﺰــﮔﺮﺑ نﺎــﮑﻣا دﻮــﺒﻧ ،نﺎــﺒﻠﻃواد و نﺎــﯿﺑﺮﻣ ﺖﺴﺸﻧ هداﻮﻧﺎﺧ ﯽﻣﺎﻤﺗ ياﺮﺑ ﺮﻤﺘﺴﻣ ﯽﺗرﺎﻈﻧ و ﯽﺷزﻮﻣآ يﺎﻫ و ﺎﻫ

هرود ﺰﯿﻧ ،نﺎﺒﻠﻃواد ﺎـﺑ نﺎﮑـﺷﺰﭘ و نﺎـﯿﺑﺮﻣ ياﺮـﺑ ﯽـﺷزﻮﻣآ يﺎـﻫ

ﻦﯿﻣﺄـﺗ ،حﺮـﻃ ﯽﯾارﺎـﮐ ندﺮﺑﻻﺎـﺑ و ﺮﺘـﺸﯿﺑ شﺰﯿﮕﻧا فﺪﻫ نﺪـﺸﻧ

ﻦﯿﺑزا نﺎﯾﺎﭘ رد و حﺮﻃ ﻪﺟدﻮﺑ مﺮﻓ ﻦﺘﻓر

هﺪﻧوﺮﭘ ،ﺎﻫ تﺎﻋﻼﻃا و ﺎﻫ

ﻪــﺑ نﺎــﻌﺟاﺮﻣ ارا ﻪــﻣادا ياﺮــﺑ ﯽﻧﺎــﮑﻣ دﻮــﺒﻧ ﻞــﯿﻟد

،تﺎﻣﺪــﺧ ﻪــﯾ

ﻞــﯿﻄﻌﺗ

ﻪــﺑﺎﺟ ،هروﺎــﺸﻣ ﺰــﮐاﺮﻣ ﯽــﺧﺮﺑ نﺪــﺷ ﻮﺘﯿﺘــﺴﻧا ﯽﯾﺎــﺟ

ﯽﮑﺷﺰﭙﻧاور ناﺮﻬﺗ

زا ﯽـﮕﻤﻫ ،ﺮـﮔزوﺮﯿﻓ نﺎﺘـﺳرﺎﻤﯿﺑ هﺎﮕﻧﺎﻣرد و

ﺖﯾدوﺪﺤﻣ فاﺪـﻫا ﻪـﺑ ﻪـﻨﯿﻬﺑ ﯽـﺳﺮﺘﺳد ﻪـﮐ دﻮﺑ ﯽﺗﻼﮑﺸﻣ و ﺎﻫ

ﯽــﻣ دﺎﻬﻨــﺸﯿﭘ ﻦﯾاﺮﺑﺎــﻨﺑ .ﺖﺧﺎــﺳ ﻦﮑﻤﻣﺎــﻧ ار ﺶﻫوﮋــﭘ ﻪــﺑ دﻮــﺷ

ﻦﯾا حﺮﻃ ﻪﻧﻮﮔ ﻪﺑ ﺎﻫ

ﻪﻧﺎﻣﺎﺳ ﯽﺸﻫوﮋﭘ حﺮﻃ ناﻮﻨﻋ ﺪﻬﺑ

ﯽﺘﺷا - ﻪـﻧ و

ﯽﺸﻫوﮋﭘ حﺮﻃ ﻂﻘﻓ -

ﺖـﺴﺨﻧ ،نآ مﺎـﺠﻧا ياﺮـﺑ ﻪﮐ ،دﻮﺷ ﻪﺟﻮﺗ

ياﺮﺟا .دﻮﺷ ﻦﯿﻣﺄﺗ زﺎﯿﻧ درﻮﻣ ﯽﻧﺎﻣزﺎﺳ ﺪﻬﻌﺗ و يرﺎﮑﻤﻫ ،ﻪﺟدﻮﺑ ﮏـﯾدﺰﻧ ،ﺐـﺳﺎﻨﻣ ﻪـﺟدﻮﺑ ﻦﯿﻣﺄـﺗ ﺪﻨﻣزﺎﯿﻧ ﯽﺗﻼﺧاﺪﻣ حﺮﻃ ﻦﯿﻨﭼ 100

ﺎﺗ 150

ﻢـﻫ ،لﺎـﺳ رد نﺎـﻣﻮﺗ نﻮـﯿﻠﯿﻣ

هﺮـﻬﺑ ﻦﯿـﻨﭼ زا يﺮـﯿﮔ

ﺐﺣﺎﺻ و نادﺎﺘﺳا و ﺖﺷاﺪﻬﺑ ترازو ناﺮﻈﻧ

هﺎﮕـﺸﻧاد ﺮـﮕﯾد ﺎـﻫ

ﺖﯿﻟﺎﻌﻓ ياﺮﺑ

تروﺮـﺿ ﺮـﮕﯾد زا .ﺖﺳا ﯽﯾاﺮﺟا و ﯽﻤﻠﻋ يﺎﻫ ﺎـﻫ

ﻪـﺑ ﻒﯾﺎـﻇو حﺮﺷ و ﯽﺷزﻮﻣآ ﻊﺑﺎﻨﻣ ﻦﯾوﺪﺗ و يرﺎﺘـﺷﻮﻧ ترﻮـﺻ

حﺮـﻃ رد لﺎـﻌﻓ ﻪـﻧﺎﮔرﺎﻬﭼ حﻮﻄـﺳ و نﺎـﺒﻠﻃواد ياﺮـﺑ يراﺪﯿﻨﺷ .ﺖﺳا

يراﺰﮕﺳﺎﭙﺳ

ﻦﯾﺪﺑ مﺮﺘﺤﻣ روﺎﺸﻣ زا ﻪﻠﯿﺳو و ناﺮﻬﺗ رادﺮﻬﺷ ﺖﻣﻼﺳ ﺖﻗو

،حﺮﻃ ﺮﻇﺎﻧ ﻢﻫ

ﻦﯿـﻨﭼ وﺎﻌﻣ

ﯽـﮕﻨﻫﺮﻓ ﺖـﻧ -

يرادﺮﻬـﺷ ﯽﻋﺎـﻤﺘﺟا

،ناروﺎــﺸﻣ ،نادﺎﺘــﺳا ﯽﻣﺎــﻤﺗ و ،ناﺮــﻬﺗ ﺮﻬــﺷ ﺶــﺷ ﻪــﻘﻄﻨﻣ ،ناور ﺖــﺷاﺪﻬﺑ نﺎــﻄﺑار ،ﯽﮑــﺷﺰﭘ نﺎــﺼﺼﺨﺘﻣ ،نﺎــﺳﺎﻨﺸﻧاور ياﺮـﺟا رد ﻪـﮐ ،ناﺮـﻬﺗ ﯽﮑﺷﺰﭙﻧاور ﻮﺘﯿﺘﺴﻧا نﺎﻨﮐرﺎﮐ و نادﺎﺘﺳا حﺮﻃ ﺎﯾ ﯽﻧادرﺪﻗ ﻪﻧﺎﻤﯿﻤﺻ ،ﺪﻨﺘﺷاد ﺮﺛﺆﻣ يرﺎﮑﻤﻫ ﯽﻟﺎﻣ ﺖﯾﺎﻤﺣ

ﯽﻣ .دﻮﺷ ﻨﺴﯾﻮﻧ رﺎﻬﻇا ﻪﺑ ﺎﻨﺑ] ﺖﺳا ﻪﺘﺷاﺪﻧ دﻮﺟو ﻊﻓﺎﻨﻣ ضرﺎﻌﺗ ،ﻪﻟﺎﻘﻣ لﻮﺌﺴﻣ هﺪ

.[

ﻊﺑﺎﻨﻣ

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