اثر بخشي روش بازسازي شناختي بر كانون كنترل سلامت و خود مراقبتي در زنان مبتلا به فشارخون بالا

Effects of Cognitive Restructuring on Health Control and Self-Care in Women With Hypertension

زمينه و هدف: لازمهٔ كمك به افراد مبتلا به فشارخون بالا براي حل مشكلات مربوط به اين بيماري، شناخت عوامل مؤثر بر كانون كنترل سلامت و خودمراقبتي اين افراد است كه مي‌توان با استفاده از رويكردهاي مختلف به بهبود آن‌ها پرداخت؛ بنابراين هدف از انجام پژوهش حاضر، تعيين اثربخشي روش بازسازي شناختي بر كانون كنترل سلامت و خودمراقبتي در زنان مبتلا به فشارخون بالا بود. روش‌ بررسي: روش پژوهش حاضر نيمه‌آزمايشي، از نوع پيش‌آزمون و پس‌آزمون و پيگيري با گروه گواه بود. جامعهٔ آماري پژوهش را تمامي زنان مبتلا به فشارخون بالا مراجعه‌كننده به كلينيك تخصصي قلب و عروق فرشچيان شهر همدان در سال 1398 تشكيل دادند. حجم نمونهٔ آماري 30 نفر شامل دو گروه 15نفري (گروه آزمايش و گروه گواه) بود كه به‌صورت نمونه‌گيري دردسترس و داوطلبانه انتخاب شدند و به‌صورت تصادفي در دو گروه قرار گرفتند. آموزش گروهي در بازسازي شناختي طي دوازده جلسهٔ 90دقيقه‌اي براساس بستۀ آموزشي لارسون و همكاران (2016) انجام شد. داده‌ها با استفاده از مقياس چندوجهي منبع كانون كنترل سلامت (والستون و همكاران، 1976) و پرسشنامهٔ خلاصۀ فعاليت‌هاي خودمراقبتي ديابت (توبرت و همكاران، 2000) جمع‌آوري شد. در تجزيه‌و‌تحليل داده‌ها از آزمون‌هاي آماري تحليل واريانس با اندازه‌گيري مكرر و آزمون تعقيبي بونفروني با كمك نرم‌افزار SPSS نسخهٔ 22 استفاده شد. يافته‌ها: نتايج تحقيق نشان ‌داد كه آموزش بازسازي شناختي بر كانون كنترل ‌سلامت (0٫001

Background & Objectives: Cognitive Restructuring (CR) consists of a set of techniques that teach individuals to consider their assumptions about situations and the world and to make their ideas more realistic and wiser. Self–care is among the main aspects of a health–oriented lifestyle and health–promoting behaviors. Self–care is a self–developed activity for the normal protection of biopsychological health. Hypertension is a symptom characterized by an increase in systemic arterial pressure. Numerous studies have been conducted in this field. It is necessary to assist individuals with hypertension to solve problems related to their condition. It is essential to recognize the factors affecting the health control and self–care of this population to improve those using different approaches. The current study aimed to determine the effects of CR on health control and self–care in women with hypertension. Methods: This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population of the study included all women with hypertension referring to Farshchian Cardiovascular Clinic in Hamadan City, Iran, in 2019. The sample size equaled 30 individuals who were assigned into two groups of experimental and control (n=15/group). The study subjects were selected by convenience sampling method and participated voluntarily in the study. The inclusion criteria of the research were minimum education of diploma, providing informed consent forms for participation in the research, the lack of mental health disorders (based on medical records), and receiving no other psychological interventions. The exclusion criteria were the existence of mental health disorders requiring immediate treatments (e.g., psychotic symptoms) and substance dependence (based on medical records). Group CR training was performed in twelve 90– minute sessions based on Larson et al.'s training package (2016). The required data were collected using the Multidimensional Health Locus of Control Scale (MHLC) (Walston et al., 1976) and the Summary of Diabetes Self–Care Activities Measure (Toobert et al., 2000). The obtained data were analyzed using repeated–measures Analysis of Variance (ANOVA) and Bonferroni post hoc test in SPSS. Results: The collected results suggested that ANOVA data were significant for the within–subject factor (time) of self–care (p<0.001) and for between–subject (p<0.001) factors. Besides, respecting internal health, ANOVA data were significant for within–subject (time) (p<0.001) and between–subject (p<0.001) factors. In addition, ANOVA data were significant concerning health for within–subject (time) (p<0.001) and between–subject (p<0.001) factors. The health–related variable ANOVA results were significant for within–subject (time) (p<0.001) and between–subject (p<0.001) factors. The Bonferroni test data revealed that the test group’s self–care scores were higher in the posttest stage, compared to those of the pretest (p<0.05). Furthermore, the follow–up scores of self–care significantly differed from those of the pretest stage (p<0.05); however, there was no significant difference between the values of the posttest and follow–up in this respect (p>0.05). Additionally, the experimental group’s pretest scores of internal health were higher than those of the pretest (p<0.05); internal health scores presented a significant difference between the pretest and follow–up stages (p<0.05). However, there was no significant difference between the scores of the posttest and follow–up in this area (p>0.05). The test group’s posttest scores of health were higher than those of the pretest (p<0.005); the same values presented a significant difference between the follow–up and pretest stages (p<0.05). However, there was no significant difference between the two stages of the posttest and follow–up in this regard (p>0.05). The experimental group’s posttest scores of health were lower than those of the pretest (p<0.05); the same value suggested significant differences between follow–up and pretest stages in this aspect (p<0.05). Moreover, the health–related scores of the follow–up stage were significantly different from those of the pretest stage (p>0.05). Conclusion: Based on the current research findings, CR was effective in health control and self–care in women with hypertension.