مقايسه اثربخشي درمان شناختي رفتاري و درمان مبتني بر پذيرش و تعهد در كاهش وزن و كيفيت زندگي زنان داراي اضافه وزن

Comparing the Effectiveness of CBT and ACT on Weight Loss and Quality of Life among Over-weight women

زﻣﯿﻨﻪ و ﻫﺪف : اﺿﺎﻓﻪوزن و ﭼﺎﻗﯽ از ﺷﺎﯾﻊﺗﺮﯾﻦ ﻣﺸﮑﻼت ﻣﺮﺑﻮط ﺑﻪ ﺳﻼﻣﺖ در ﺟﻮاﻣﻊ ﻣﻌﺎﺻﺮ ﻫﺴﺘﻨﺪ. ﻣﺪاﺧﻼت روانﺷﻨﺎﺧﺘﯽ ﻣﺘﻌﺪدي ﺑﺮاي ﮐﺎﻫﺶ وزن ﺗﺪو ﯾﻦﺷﺪهاﻧﺪ. ﻟﺬا اﻫﻤﯿﺖ زﯾﺎدي دارد ﮐﻪ اﺛﺮﺑﺨﺸﯽ اﯾﻦ ﻣﺪاﺧﻼت ﻣﻮردﺳﻨﺠﺶ ﻗﺮار ﮔﯿﺮد. ﻫﺪف ﭘﮋوﻫﺶ ﺣﺎﺿــﺮ ﻣﻘﺎﯾﺴــﻪ اﺛﺮﺑﺨﺸــﯽ دو ﻣﺪاﺧﻠــﻪ ﺷــﻨﺎﺧﺘﯽ رﻓﺘﺎري و ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ در ﺷﺎﺧﺺ ﺗﻮده ﺑﺪﻧﯽ و ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ زﻧﺎن داراي اﺿﺎﻓﻪوزن ﺑﻮد ﻣﻮاد و روشﻫﺎ : ﻃﺮح ﭘﮋوﻫﺶ ﺣﺎﺿﺮ از ﻧﻮع ﻣﻄﺎﻟﻌﻪي ﻧﯿﻤﻪ ﺗﺠﺮﺑﯽ ﺑﺎ ﻃﺮح ﭘﯿﺶآزﻣﻮن ﭘﺲآزﻣﻮن-ﭘﯿﮕﯿﺮي ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل و ﺑﺎ ﮔﻤﺎرش ﺗﺼــﺎدﻓﯽ ﺑــﻮد. ﺟﺎﻣﻌﻪي آﻣﺎري ﭘﮋوﻫﺶ ﺣﺎﺿﺮ، ﮐﻠﯿﻪي زﻧﺎن داراي اﺿﺎﻓﻪوزن ﺳﺎﮐﻦ ﺷﻬﺮ ﻣﺸﻬﺪ ﺑﻮدﻧﺪ. ﭼﻬﻞوﭘﻨﺞ زن داراي اﺿﺎﻓﻪوزن ﺑﻪﺻﻮرت ﻧﻤﻮﻧﻪﮔﯿﺮي در دﺳــ ﺘﺮس اﻧﺘﺨﺎب ﺷﺪﻧﺪ و ﺑﻪﺻﻮرت ﺗﺼﺎدﻓﯽ در ﺳﻪ ﮔﺮوه درﻣﺎن ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري، درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ و ﮔﺮوه ﮔﻮاه ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﺷــﺎﺧﺺ ﺗــﻮده ﺑــﺪﻧﯽ در ﺳﻪ ﻧﻮﺑﺖ ﭘﯿﺶآزﻣﻮن، ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي اﻧﺪازهﮔﯿﺮي ﺷﺪ و ﭘﺮﺳﺸﻨﺎﻣﻪ ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﺳﺎزﻣﺎن ﺑﻬﺪاﺷﺖ ﺟﻬﺎﻧﯽ-ﻓﺮم ﮐﻮﺗﺎه و ﭘﺮﺳﺸﻨﺎﻣﻪ ﺟﻤﻌﯿﺖ ﺷــﻨﺎﺧﺘﯽ ﺗﻮﺳﻂ ﺷﺮﮐﺖﮐﻨﻨﺪﮔﺎن در ﭘﯿﺶآزﻣﻮن، ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي ﺳﻪﻣﺎﻫﻪ ﺗﮑﻤﯿﻞ ﺷﺪﻧﺪ. ﺑﺮاي ﺗﺤﻠﯿﻞ دادهﻫﺎ از ﺗﺤﻠﯿﻞ وارﯾﺎﻧﺲ ﺑﺎ اﻧﺪازهﮔﯿﺮي ﻣﮑﺮر اﺳﺘﻔﺎده ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﯾﺎﻓﺘﻪﻫﺎ ﻧﺸﺎن دادﻧﺪ ﮐﻪ ﺷﺎﺧﺺ ﺗﻮده ﺑﺪﻧﯽ در ﮔﺮوهﻫﺎي ﻣﺪاﺧﻠﻪ ﺑﻪ ﺷﮑﻞ ﻣﻌﻨﺎداري از ﮔﺮوه ﮐﻨﺘﺮل در ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي ﮐﻤﺘﺮ ﺑﻮد اﻟﺒﺘﻪ ﺑﯿﻦ دو ﮔﺮوه ﻣﺪاﺧﻠﻪ ﺗﻔﺎوﺗﯽ در اﯾﻦ زﻣﯿﻨﻪ وﺟﻮد ﻧﺪاﺷﺖ. ﯾﺎﻓﺘﻪﻫﺎ ﻫﻤﭽﻨﯿﻦ ﻧﺸﺎن دادﻧﺪ ﮐﻪ ﻧﻤﺮات ﺷﺎﺧﺺﻫﺎي ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ در ﺷﺮﮐﺖﮐﻨﻨﺪﮔﺎن ﮔﺮوهﻫﺎي ﻣﺪاﺧﻠــﻪ ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﮐﻨﺘﺮل در ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي ﺑﻪ ﺷﮑﻞ ﻣﻌﻨﺎداري ﺑﯿﺸﺘﺮ ﺑﻮد. ﻋﻼوه ﺑﺮ آن ﻧﻤﺮات ﺷﺮﮐﺖﮐﻨﻨﺪﮔﺎن در ﮔﺮوه ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬــﺪ در دو ﺷﺎﺧﺺ ﮐﯿﻔﯿﺖ ﮐﻠﯽ زﻧﺪﮔﯽ و ﺳﻼﻣﺖ روان ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري ﺑﻪ ﺷﮑﻞ ﻣﻌﻨﺎداري ﺑﯿﺸﺘﺮ ﺑﻮد. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻫﺮ دو ﻣﺪاﺧﻠﻪ اﺛﺮﺑﺨﺸﯽ ﻣﻄﻠﻮب در ﮐﺎﻫﺶ وزن داﺷﺘﻨﺪ اﻣﺎ ﻣﺪاﺧﻠﻪ ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ اﺛﺮﺑﺨﺸــﯽ ﺑﻬﺘــﺮي در ﺑﺮﺧــﯽ از ﺷــﺎﺧﺺﻫﺎي ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﻧﺸﺎن دادﻧﺪ.

Aim and Background: Overweight and obesity are among major health-related problems in modern societies. Many psychological interventions are developed to lose weight and it is important to study their effectiveness. The aim of the present study was to compare the effectiveness of cognitive behavior therapy (CBT), and acceptance and commitment therapy (ACT) on body mass index (BMI) and quality of life among overweight women. Methods and Materials: The research method was quasi-experimental with pretest-posttest-follow-up design and randomized allocation. The population consisted of all overweight women living in the city of Mashhad. Forty-five women with overweight were selected through convenience sampling and allocated randomly in two experiment groups of CBT and ACT, and one control group. BMI, quality of life, and demographic questionnaire were examined in pretest, posttest, and three months follow-up. Repeated measure ANOVA was used to analyze the data. Findings: Findings demonstrated that BMI was significantly lower in experiment groups in comparison of the control group in posttest and follow-up. However, no significant difference in BMI was found between CBT and ACT groups in posttest and follow-up. Findings also showed that subscales of quality of life were significantly higher among participants in intervention groups in comparison of the control group in posttest and follow-up. Furthermore, participants in the ACT group had significantly higher levels of quality of life and mental health in comparison of the CBT group. Conclusions: According to the results, both interventions had significant effectiveness in weight loss however ACT group had a more significant effect on some indicators of quality of life.