اثربخشي درمان مبتني‌ بر پذيرش و تعهد (ACT) بر ميزان استرس ادراك‌ شده در بيماران كرونري قلبي

Acceptance and commitment (ACT) therapy on perceived stress in coronary artery disease patients

زمينه و هدف: بيماري كرونري قلبي (CHD) از انواع بسيار شايع‌ بيماري‌هاي قلبي‌ عروقي در ميان بزرگسالان سراسر جهان، ازجمله در ايران است. پژوهش حاضر با هدف بررسي اثربخشي درمان مبتني‌بر پذيرش و تعهد (ACT) بر ميزان استرس ادراك‌شده در بيماران كرونري قلبي انجام شد. روش‌بررسي: روش اين ﭘﮋوﻫﺶ نيمه‌آزﻣﺎيﺸﯽ (ﺗﺠﺮﺑﯽ) ﺑﺎ طرح پيش‌آزمون‌ﭘﺲ‌آزﻣﻮن و پيگيري با گروه گواه ﺑﻮد. ﺟﺎﻣﻌﻪٔ آﻣﺎري را ﺑﯿﻤﺎران كرونري قلبي مراجعه‌ﮐﻨﻨﺪه ﺑﻪ كلينيك قلب بيمارستان دكتر باهنر كرج در پاييز و زمستان 1396 تشكيل دادند ﮐﻪ از ﺑﯿﻦ آن‌ﻫﺎ 40 ﻧﻔﺮ ﺑﻪ‌ﺻﻮرت داوﻃﻠﺒﺎﻧﻪ اﻧﺘﺨﺎب شدند. ﺳﭙﺲ ﺑﻪ‌شكل ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه آزﻣﺎيﺶ و گواه (20 ﻧﻔﺮ ﮔﺮوه آزﻣﺎيﺶ و 20 ﻧﻔﺮ ﮔﺮوه گواه) قرار گرفتند. در ﮔﺮوه آزﻣﺎيﺶ ﻃﯽ هشت ﺟﻠﺴﻪ، درمان مبتني‌بر پذيرش و تعهد (ACT) اجرا شد. اﺑﺰار ﭘﮋوﻫﺶ پرسشنامهٔ استرس ادارك‌شده ﺑﻮد. داده‌ها قبل و بعد از اجراي درمان جمع‌آوري و توسط نرم‌افزار SPSS نسخهٔ 21، به‌شيوهٔ تحليل واريانس اندازه‌گيري مكرر با سطح معناداري 0٫05 ﺗﺤﻠﯿﻞ ﺷﺪند. يافته‌ها: نتايج نشان داد، در گروه آزمايش ميانگين و انحراف معيار نمرهٔ پيش‌آزمون به‌ترتيب برابر با 7٫60±31٫75 و پس‌آزمون 6٫33±29٫07 بود. همچنين در گروه گواه نمرۀ پيش‌آزمون 6٫8 ±22٫21 و پس‌آزمون 7٫5±31٫56 به‌دست آمد. نتايج تحليل واريانس اندازه‌گيري مكرر مشخص كرد درمان به‌طور معناداري موجب كاهش استرس بيماران شده است (0٫001>p). نتيجه‌گيري: براساس يافته‌هاي اين پژوهش در روان‌درماني مبتني‌بر پذيرش و تعهد (ACT) هر فرد به‌طور نهفته توانايي برقراري ارتباط كامل با زمان حال و تغيير يا حفظ رفتار براي زندگي ارزشمند را پيدا مي‌كند. اين توانايي مي‌تواند موجب بهبود استرس ادراك‌شدهٔ بيماران كرونري قلبي شود.

Background & Objective: Coronary heart disease (CHD) is the most common type of cardiovascular disease among adults throughout the world, including in Iran. The purpose of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) on perceived stress in coronary heart disease patients. ACT treatment is the source of the very precise knowledge of behavioral analysis and functional textual philosophy, and is based on six processes of acceptance, disorientation, and association with momentary moment, committed action, self as a background and values, and the main strategies of treatment to deal with injuries psychologically and in relation to these processes. ACT is difficult to spot for some people, because it focuses on weakening the harmful and ineffective aspects of the language and, to a certain extent, the use of unfamiliar concepts such as non–harmonic cognition and denial. This study aimed to study Acceptance and commitment (ACT) therapy on perceived stress in coronary artery disease patients. Methods: The study was a semi–experimental with pretest, post–test and follow–up with the control group. Statistical population of the study was coronary patients who referred to the heart clinic of Bahonar Hospital in Karaj (Alborz province, Iran) in autumn and winter of 2017. A total of 40 voluntaries were selected and then randomly assigned to two experimental and control groups (20 in each groups). The experimental group received acceptance and commitment (ACT) treatment in 8 sessions. Instruments of the study were stress perception questionnaire. Data were collected before and after the treatment and for analysis, SPSS 21 software was used with a significant level of 0.05. Results: Mean and standard deviation of the pre–test scores in the experimental group were 31.75 ±7.60 and 29.07 ± 6.33, respectively. In addition, the pre–test score in the control group was 22.21 ± 6.8 and the post–test was 31.56 ± 7.5. Results of repeated measures analysis of variance analysis showed that treatment significantly reduced the stress of patients (p<0.001). Conclusion: According to the findings of this study, in actuality and commitment (ACT) psychotherapy, each person potentially finds the ability to communicate fully with the present and change or maintain behavior for a valuable life, and this ability can improve the perceived stress of coronary heart disease.