كليدواژه :
درمان و پذيرش و تعهد , روانشناسي مثبت نگر , نشخوار فكري , آرتريت روماتوئيد , زنان
چكيده فارسي :
زمينه و هدف
آرتريت روماتوييد يك بيماري خود ايمني ناتوان كننده است و مزمن بودن اين بيماري بر روي متغيرهاي جسماني و روانشناختي اين بيماران اثرات بسيار وسيعي مي گذارد. پژوهش حاضر مقايسه اثربخشي درمان مبتني بر پذيرش و تعهد و روانشناسي مثبت نگر بر نشخوار فكري زنان مبتلا آرتريت روماتوييد بود.
روش كار
روش پژوهش نيمه آزمايشي با طرح پيش آزمون و پس آزمون با گروه گواه بود. جامعه آماري پژوهش شامل كليه زنان مبتلا به آرتريت روماتوييد شهر خرم آباد بودند كه با استفاده روش نمونه گيري در دسترس 60 نفر انتخاب و به صورت تصادفي در سه گروه آزمايشي 1 (درمان اكت)، گروه آزمايشي 2 (روانشناسي مثبت نگر)، و گروه گواه (هر گروه 20 نفر) جايگزين شدند. در شرايط يكسان و همزمان، پيش آزمون با پرسشنامه نشخوار فكري از هر سه گروه به عمل آمد. گروه هاي آزمايشي تحت درمان پذيرش و تعهد و رواشناسي مثبت نگر (8 جلسه 90 دقيقه اي) قرار گرفتند، اما گروه گواه هيج گونه درماني دريافت نكردند. سپس پس آزمون از هر سه گروه به عمل آمد.
يافته ها
نتايج نشان داد كه درمان اكت و مثبت نگر باعث كاهش نشخوار فكري بيماران گرديد (05/0p<)، آزمون تعقيبي بونفروني نشان داد درمان پذيرش و تعهد در نشخوارفكري كلي و مولفه حواس پرتي داراي تاثير بيشتري بود.
نتيجه گيري
براساس نتايج به دست آمده مي توان گفت، درمان پذيرش و تعهد و روانشناسي مثبت نگر باعث كاهش نشخوار فكري در زنان مبتلا به آرتريت روماتوييد شده و درمان پذيرش و تعهد اثربخشي بيشتري داشت. لذا از اين درمان ها در كنار درمان پزشكي براي بهبود حال اين بيماران مي توان استفاده كرد.
چكيده لاتين :
Rheumatoid arthritis is a debilitating autoimmune disease and the chronicity of this disease has a very large effect on the physical and psychological variables of these patients. The prevalence of this disease is estimated to be 0.5 to 2.4%, which is two to three times more common in women It is from men. The prevalence of this disease increases with age and the difference in sexual prevalence decreases with age. This disease causes progressive damage to the musculoskeletal system and leads to irreversible pain and destruction of bone and cartilage, which have different reactions. Ruminant is one of the problems that patients with rheumatoid arthritis are involved with and rumination is a significant predictor of depression in these patients. Ruminant thought is a repetitive thought and is a cognitive process that greatly increases the risk of developing symptoms of psychopathology. The aim of the present study was to compare the effectiveness of acceptance and commitment-based therapy and positive psychology on rumination in women with rheumatoid arthritis.
Methods
The research method was quasi-experimental with pre-test and post-test design with control group. The statistical population of the study included all women with rheumatoid arthritis in Khorramabad in 2019 who used the sampling
method
The statistical population of the study included all women with rheumatoid arthritis in Khorramabad in 2019. Using the sampling
method
60 people were selected and randomly divided into three experimental groups 1 (act therapy), experimental group 2 (positive psychology), and the control group (20 people in each group) was replaced. Under the same conditions, the pretest was performed with a rumination questionnaire from all three groups. The experimental groups were treated with acceptance and commitment (group 1) and positive psychology (group 2) in 8 sessions of 90 minutes, but the control group did not receive any treatment. Then post-test was performed from all three groups. Data were analyzed by descriptive and inferential methods. Multivariate analysis of covariance, univariate analysis of covariance and Bonferroni post hoc test were used in descriptive statistics of frequency, percentage, mean and standard deviation and in inferential statistics. Data were analyzed by SPSS-24 statistical analysis software.
Results
The results showed that both acceptance and commitment-based treatments and positive treatment reduced rumination in women with rheumatoid arthritis and there was a significant decrease between the mean rumination in pre-test and post-test in the two experimental groups. Using analysis of covariance, it was found that this decrease was statistically significant (p <0.05). In order to evaluate which treatment method was more effective, Bonferroni post hoc test was used, which showed that the treatment of acceptance and commitment was more effective in general rumination and distraction component. However, no significant difference was observed between the two experimental groups in the components of meditation and meditation.
Conclusion
Based on the obtained results, it can be said that the treatment of acceptance and commitment and positive psychology reduces rumination in women with rheumatoid arthritis and the treatment of acceptance and commitment was more effective. The results of the present study were compared with similar and consistent results that the results of these studies indicated the effectiveness of any treatment based on acceptance and commitment on rumination and variables such as: depression, anxiety, stress and anxiety. The effectiveness of acceptance and commitment therapy can be explained by the processes that govern it; Thus, the component of desire and acceptance allows the person to accept unpleasant inner experiences without trying to control them, and doing so makes those experiences seem less threatening and have less impact on the personchr('39')s life. This skill helps the person to consciously turn her attention to what is most useful and therefore helps the person to pass tempting thoughts through the mind and guide her mind towards a higher goal. Also, the practice of suppressing thinking in acceptance and commitment therapy, which is especially for people with rumination, helps therapists to get rid of annoying rumination or cognitive cognitions. No research has been done on the effectiveness of positive treatment on rumination, but research background shows that positive treatment has been effective on issues such as depression and stress. One of the components of positive psychology that affects rumination is the cognitive level of individuals and the effort to achieve positive emotions and happiness. In this study, based on the goals of positive psychology, an attempt was made to emphasize positive emotions, positive characteristics of people and their abilities and virtues, and people were encouraged to pay special attention to positive emotions and try to prevent emotions. Negatives increase the amount of positive emotions in their lives, because according to the falsification hypothesis, positive emotions also have the capacity to neutralize or nullify long negative emotions. On the other hand, people learn with this approach to be flexible and try to take steps to solve weaknesses by not focusing on weaknesses. Therefore, due to the effectiveness of treatment based on acceptance and commitment and positive treatment on rumination in women with rheumatoid arthritis, these treatments can be used along with medical treatment to improve the condition of these patients.
