اثربخشي شناخت‌درماني مبتني بر ذهن‌‌آگاهي بر رضايت زناشويي و نشانه‌هاي افسردگي در زنان مبتلا به اختلال افسردگي پس از زايمان

Mindfulness-Based Group Therapy on Marital Satisfaction and Decreasing signs of Postpartum Depression in Women with Postpartum Depression Disorders

زمينه و هدف: افسردگي پس از زايمان به‌طور جدي بر زندگي فرد و خانواده‌اش اثر نامطلوب دارد. ذهن‌‌آگاهي براي تصحيح راه‌هاي غلط تفكر در گذشته است. هدف پژوهش حاضر، تعيين اثربخشي گروه‌‌درماني شناختي مبتني بر ذهن‌آگاهي بر رضايت زناشويي و شدت نشانه‌هاي افسردگي در زنان مبتلا به اختلال افسردگي پس از زايمان بود. روش‌بررسي: پژوهش حاضر، از نوع نيمه‌آزمايشي با طرح پيش‌آزمون‌پس‌‌آزمون با گروه گواه بود. جامعۀ آماري اين پژوهش را زنان مبتلا به اختلال افسردگي پس از زايمان مراجعه‌كننده به بيمارستان مادر شهرستان يزد در سال 1396 تشكيل دادند كه از بين آنان 30 نفر به‌شيوۀ نمونه‌گيري در دسترس انتخاب شدند و در دو گروه آزمايش و گواه بررسي شدند. ابزار پژوهش، شامل پرسش‌نامۀ افسردگي بك و پرسش‌نامۀ رضايت زناشويي انريچ بود. داده‌ها با استفاده از آمار توصيفي (ميانگين و انحراف‌معيار) و آمار استنباطي (تحليل كوواريانس) با نرم‌افزار SPSS نسخۀ 23 تجزيه‌وتحليل شد. يافته‌ها: يافته‌هاي اين پژوهش حاكي از آن بود كه گروه‌درماني شناختي مبتني بر ذهن‌‌آگاهي، باعث كاهش نشانه‌هاي افسردگي (پس‌آزمون گروه آزمايش: 5٫87±27و گواه: 6٫60± 29٫87 و 0٫001

Background & Objective: Postpartum depression is a form of depression that may appear shortly after childbirth. This depression is seen in 5– 25% of women. Severe insomnia, mood instability and tiredness are common symptoms of the disease. Delusional beliefs and suicidal thoughts (as opposed to newborns) may arise. Therefore, based on the danger condition for mother and child's life, it may be considered urgent. Symptoms of childbirth and postpartum depression include: anger, feeling unprofitable, failing or guilty, crying, impatient (sensitive), restlessness, sadness, fatigue, inflammation, mood fluctuation are these symptoms. Other symptoms occur with sadness after delivery (which can be accompanied by a feeling of loneliness, anxiety, confusion and obsessive–compulsive disorder) disappear from a few days to a few weeks. Such symptoms are severe and durable with postpartum depression. It may interfere with patient ability to function and can include different range of symptoms: feelings of numbness or falling, fear of harm to self or to the baby, distracted focus and thinking, lack of pleasure in life, reduced interest to sexual intercourse, increased or no attention to the baby, weight loss, avoid from family or friends, headaches, chest pain, increased breathing may occur, although these are not the main symptoms of depression. Signs and symptoms associated with postpartum insanity are rare. These symptoms are more severe and usually start early. The purpose of this study was investigate the effectiveness of mental–based group therapy on marital satisfaction and decreasing signs of postpartum depression in women with postpartum depression disorders referring to maternal hospital in Yazd. Methods: This study was a semi–experimental design pretest– posttest with control group. The statistical population was women with postpartum depression disorders referring to maternal hospital in Yazd (Yazd province, center of Iran) at 2017. A total of 30 female were selected using available sampling. Subject were randomly divided to experimental and control group. The subject in experimental group were treated by mindfulness based on cognitive therapy in 9 sessions. The questionnaires of Beck depression (1996) and Enrich marital satisfaction was done in pretest and posttest. The Beck depression inventory (BDI, BDI–1A, BDI–II), created by Beck that is a 21–question multiple–choice self–report and one of the most widely used psychometric tests for measuring the severity of depression. Its development marked a shift among mental health professionals, who had until then, viewed depression from a psychodynamic perspective, instead of it being rooted in the patient's own thoughts. In its current version, the BDI–II is designed for individuals aged 13 and over, and is composed of items relating to symptoms of depression such as hopelessness and irritability, cognitions such as guilt or feelings of being punished, as well as physical symptoms such as fatigue, weight loss, and lack of interest to sex. Results: The findings of this study indicated that mindfulness–based cognitive group therapy reduced the symptoms of depression (experimental group post–test: 27±5.87 and control: 29.87±6.60, p<0.001) and increased marital satisfaction in affected women. Postpartum depressive disorder (Experimental group: 97.33±12.23 and control: 86.82±13.38, p<0.001). Conclusion: Based on the result of this study use of mindfulness based on cognitive therapy were recommended to psychologist and experts in this area.