اثر بخشي درمان مبتني‌ بر پذيرش و تعهد (ACT) بر سازگاري اجتماعي و تاب‌‌ آوري زنان مبتلا به سرطان پستان

Effects of Acceptance and Commitment Therapy on Social Adjustment and Resilience in Women with Breast Cancer

زمينه و هدف: سرطان به‌عنوان مشكل عمدهٔ سلامت قرن تلقي ‌‌مي‌‌‌‌شود. از ميان همهٔ سرطان‌‌ها، سرطان پستان دومين بيماري ‌‌شايع زنان در نظر گرفته شده است. هدف پژوهش حاضر بررسي اثربخشي درمان مبتني‌بر پذيرش و تعهد (ACT) بر سازگاري اجتماعي و تاب‌‌آوري زنان مبتلا به سرطان پستان بود. روش‌ بررسي: اين پژوهش از نوع نيمه‌آزمايشي با طرح پيش‌‌آزمون و ‌پس‌‌آزمون با گروه گواه بود. جامعه‌‌ٔ آماري پژوهش را همهٔ زنان مبتلا به سرطان پستان شهر اروميه در سال 1397 تشكيل دادند. از ميان آنان با استفاده از روش نمونه‌‌گيري دردسترس، 30 نفر انتخاب شدند و به‌طور تصادفي در دو گروه آزمايش (15 نفر) و گواه (15 نفر) قرار گرفتند. شركت‌كنندگان گروه آزمايش، هشت جلسهٔ90دقيقه‌اي درمان گروهي مبتني‌بر پذيرش و تعهد دريافت كردند. براي شركت‌‌كنندگان گروه گواه هيچ مداخله‌‌اي ارائه نشد. در اين پژوهش، پرسشنامهٔ سازگاري اجتماعي (بل، 1961) و مقياس تاب‌‌آوري كانر-ديويدسون (كانر و ديويدسون، 2003) به‌كار رفت. داده‌‌ها با استفاده از آزمون آماري تحليل كوواريانس چندمتغيري در نرم‌‌افزار SPSS نسخهٔ 20 در سطح معناداري (0٫05≥p) تجزيه‌وتحليل شدند. يافته‌‌ها: يافته‌‌ها نشان داد، درمان مبتني‌بر پذيرش و تعهد به‌طور معناداري در افزايش سازگاري اجتماعي (0٫001≥p) و تاب‌‌آوري (0٫001≥p) زنان مبتلا به سرطان پستان مؤثر است. به عبارتي ديگر، اين مداخله توانست ميزان سازگاري اجتماعي و تاب‌‌آوري را در گروه آزمايش ارتقا دهد. نتيجه‌گيري: نتايج اين پژوهش حاكي‌از كارآمدي درمان گروهي مبتني‌بر پذيرش و تعهد بر افزايش سازگاري اجتماعي و تاب‌‌آوري زنان مبتلا به سرطان پستان است؛ بنابراين از درمان مبتني‌بر پذيرش و تعهد مي‌‌توان به‌عنوان روشي براي بهبود سازگاري و تاب‌آوري بيماران مبتلا به سرطان پستان بهره برد.

Background & Objectives: One of the most stressful life events is the diagnosis and treatment of cancer. Cancer is considered to be the major health problem of the present century. Of all cancers, breast cancer is the second most prevalent gynecological disease. Breast cancer is the most common type of cancer in women, which can cause psychological problems in the affected individuals. Patients with cancer have a low social adjustment that poses extensive mental health issues. Another factor that plays a key role in the mental health of patients with cancer is resilience. The current research aimed to investigate the effects of Acceptance and Commitment Therapy (ACT) on social adjustment and resilience in patients with breast cancer. Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of the study included all women with breast cancer in Urmia City, Iran, in 2018. Using a convenience sampling approach, 30 of them were selected and randomly assigned into the experimental and control groups (n=15/group). The inclusion criteria of the study included the lack of significant psychiatric disorders according to a psychiatrist, not attending other psychological courses, at least 6 months past the diagnosis, and biopsychological inabilities to prevent individuals from attending the research. The exclusion criteria of the study included absence from >2 group therapy sessions and unwillingness to continue treatment. In this research, the Social Adjustment Inventory (Bell, 1961) and the Connor–Davidson Resilience Scale (Connor & Davidson, 2003) were used to collect the necessary data. The ethical considerations observed in this research included the following: patient satisfaction and not mentioning their names in information forms due to confidentiality observations. The experimental group participated in eight 90–minute weekly sessions of ACT; however, the control group received no intervention. The protocol used in this study was based on Hayes et al.’s training program (2006). After the end of the sessions, all research participants performed the posttest phase. To describe the achieved data, mean and standard deviation were used. For analyzing the obtained data, Multivariate Analysis of Covariance (MANCOVA) was applied in SPSS at the significance level of p≥0.05. Results: The collected results suggested that in all components of social adjustment; adjustment at home (p≥0.001), occupational adjustment (p≥0.001), health adjustment (p= 0.007), social adjustment (p≥0.001), and emotional adjustment (p=0.005) (p≥0.001), there was a significant difference in the mean posttest scores between the study groups after eliminating the effect of the pretest. Furthermore, concerning resilience, the effect of group or intervention, by removing the effect of the pretest, was statistically significant (p≥0. 001). Conclusion: The current study results indicated the effectiveness of ACT on social adjustment and resilience in patients with breast cancer. Therefore, ACT can be used as a method for the growth and improvement of patients with breast cancer.