اثر بخشي درمان شناختي- رفتاري متداول درد با نسخه كامپيوتري آن بر كاهش شدت درد و خشم كودكان مبتلا به سرطان

The Effectiveness of Cognitive- Behavior Therapy and its Computerized Version on Reduction of Pain Intensity and Anger in Children with Cancer in Ahvaz

زمينه و هدف هدف اين پژوهش بررسي اثر بخشي درمان شناختي- رفتاري متداول درد و نسخه كامپيوتري آن بر كاهش شدت درد و خشم كودكان مبتلا به سرطان در شهر اهواز بود. روش كار اين پژوهش داراي طرح آزمايشي با پيش آزمون، پس آزمون و پي گيري با گروه كنترل بود كه اثربخشي دو مداخله درمان شناختي رفتاري متداول درد و نسخه كامپيوتري آن، در مقايسه با گروه كنترل بررسي شدند. نمونه مورد بررسي شامل 45 نفر كودك 8 تا 12 ساله مبتلا به انواع سرطان بوده اند كه بر اساس ملاك هاي ورود و خروج انتخاب شدند. سپس اين افراد به طور تصادفي به سه گروه 15 نفره(دو گروه آزمايش و يك گروه كنترل) تقسيم شدند. ابزار پژوهش شامل پرسشنامه خشم اسپيلبرگر(Brunner & Spielbeger، 2009) و مقياس بين المللي اندازه گيري درد (Wong & Baker، 2002) بوده است. اولين گروه آزمايش، به مدت 6 هفته در جلسات درمان شناختي رفتاري متداول درد شركت داشتند و دومين گروه آزمايش به مدت 6 هفته تحت برنامه درماني آموزشي نسخه كامپيوتري درمان شناختي رفتاري درد قرار گرفتند، اما گروه كنترل هيچ گونه مداخله اي دريافت نكردند. اين برنامه توسط محققين اين پژوهش، طراحي و ساخته شد كه مشتمل بر يك قسمت سايكو اجوكيشن، انيميشن و بازي كامپيوتري مي باشد (Hamedy & et.al.2017). يافته‌ها: نتايج حاصل نشان داد كه ميزان خشم و درد در دو گروه مداخله نسبت به پيش آزمون و گروه كنترل به طور معني‌داري كاهش يافته بود (0/0001

Cancer is a medical problem that has always been associated with pain. Because the experience of pain is associated with negative emotions such as anxiety, depression and anger, these negative emotions themselves reduce the quality of life, disrupt sleep habits and even people eating. Today, with the development of new technologies and pervasive influence of these technologies, the field of psychological therapies is also try to use the computer-based interventions. In this research, the effectiveness of conventional cognitive-behavioral pain therapy and its computer prescription on reducing the severity of pain and anger in children with cancer in Ahvaz was investigated. Methods This research method was an experimental with pre-test, post-test and follow-up with the control group in which the effectiveness of two psychological interventions (cognitive behavior therapy of pain management and its computer version) were compared with the control group. The statistical population of the present study consists of all children with cancer who met the criteria for this study. There were about 73 subjects. The sample consisted of 45 children aged 8 to 12 years with various types of cancer, based on inclusion and exclusion criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria among the cancer patients in the pediatric ward of Shafa Hospital. 2 Ahvaz were selected. Then randomly divided into three groups of 15 (two experimental groups and one control group). The research instruments included the Spielberger Anger Questionnaire (Brunner & Spielbeger, 2009) and the International Pain Measurement Scale (Wong & Baker, 2002). The first experimental group participated in routine cognitive-behavioral pain therapy sessions for 6 weeks and the second experimental group administered a computer-based training program for cognitive-behavioral pain management therapy for 6 weeks, but the control group did not receive any intervention. However, for ethical reasons, they were provided with a computerized training program, a computerized version of cognitive-behavioral pain therapy. This program was designed and developed by the researchers of this study, which includes a part of psycho-education, animation and computer games (Hamedy. & Et.al. 2017). After 6 weeks, all three groups were evaluated as post-test and finally after one-month follow-up period. Results The results showed that there was a significant difference between the intervention and control groups in terms of anger and pain variables (p<0.0001), the rate of anger and pain in the two intervention groups compared to the pretest and control groups decreased. These results were significantly continued after the follow-up period. During the follow-up period, the computer version of pain management was significantly more effective in reducing anger than the conventional cognitive-behavioral therapy of pain management, although computer intervention during the follow-up period reduced the pain better than the other intervention, but this reduction has not reached a significant level. Conclusion Children with cancer face a lot of pain and anger. The introduction of psychological interventions based on new technologies will help these children to recover. The results of this study showed that the use of computer cognitive-behavioral pain intervention such as conventional cognitive-behavioral pain therapy has been effective to reduce pain and anger in children with cancer, but the therapeutic effect of cognitive-behavioral computer intervention program is effective in reducing pain and especially anger. Therefore, prescription of cognitive-behavioral pain management intervention and computerized prescription cognitive-behavioral pain management intervention, especially the recent approach, are recommended to reduce pain and anger in children with cancer along with drug therapies.