اثر بخشي درمان مبتني بر پذيرش و تعهد بر تاب آوري و خودپنداره كودكان و نوجوانان مبتلا به سرطان

The Effictiveness of Acceptance and Commitment Therapy on Resiliency and Self-Concept in childres With Cancer

زﻣﯿﻨﻪ و ﻫﺪف: درﻣﺎن ﭘﺬﯾﺮش و ﺗﻌﻬﺪ، ﯾﮑﯽ از درﻣﺎنﻫﺎي رﻓﺘﺎري ﻣﻮج ﺳﻮم در زﻣﯿﻨﻪ درﻣﺎن اﺧﺘﻼﻻت اﺿﻄﺮاﺑﯽ اﺳﺖ. ﻫﺪف ﭘﮋوﻫﺶ ﺣﺎﺿــﺮ، ﺑﺮرﺳــﯽ اﺛﺮﺑﺨﺸــﯽ درﻣﺎن ﻣﺒﺘﻨﯽﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ ﺗﺎبآوري و ﺧﻮدﭘﻨﺪاره ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن اﺳﺖ. روش ﮐﺎر: ﭘﮋوﻫﺶ ﺣﺎﺿــﺮ از ﻧﻮع ﻧﯿﻤﻪﺗﺠﺮﺑﯽ ﺑﺎ ﻃﺮح ﭘﯿﺶآزﻣﻮن- ﭘﺲآزﻣﻮن ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل ﺑﻮد. ﺟﺎﻣﻌﻪ آﻣﺎري ﺷــﺎﻣﻞ ﮐﻠﯿﻪ ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳـﺮﻃﺎن ﺑﺴـﺘﺮي ﺑﯿﻤﺎرﺳـﺘﺎن اﻣﺎم ﺧﻤﯿﻨﯽ )ره( ﺗﻬﺮان در ﺳـﺎل 1398 ﺑﻮدﻧﺪ ﮐﻪ از ﺑﯿﻦ آنﻫﺎ 30 ﮐﻮدك ﺑﻪﺻــﻮرت ﺗﺼــﺎدﻓﯽ در دو ﮔﺮوه آزﻣﺎﯾﺶ و ﮐﻨﺘﺮل ﮔﻤﺎرده ﺷــﺪﻧﺪ و از ﭘﺮﺳــﺶﻧﺎﻣﻪﻫﺎي ﺧﻮدﭘﻨﺪاره ﭘﯿﺮز- ﻫﺮﯾﺲ )1969( و ﺗﺎبآوري ﮐﺎﻧﺮ- دﯾﻮﯾﺪﺳـﻮن )2003( اﺳـﺘﻔﺎده ﺷـﺪ. ﺑﺮاي آزﻣﻮدﻧﯽﻫﺎي ﮔﺮوه آزﻣﺎﯾﺶ، درﻣﺎن ﻣﺒﺘﻨﯽﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬـﺪ در ﺷـــﺶ ﺟﻠﺴـــﻪ 60دﻗﯿﻘـﻪاي اراﺋـﻪ ﺷـــﺪ. دادهﻫـﺎ ﺑـﺎ روش ﺗﺤﻠﯿـﻞ ﮐﻮوارﯾـﺎﻧﺲ ﺑـﻪ ﮐﻤـﮏ ﻧﺮماﻓﺰار SPSS24 ﺗﺠﺰﯾﻪوﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ ﻧﺸـﺎن داد درﻣﺎن ﻣﺒﺘﻨﯽﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ ﺧﻮدﭘﻨﺪاره 0/001 =F= 24/05 ،p و ﺗﺎب آوري (p = 0.002, F = 11.88) ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳــﺮﻃﺎن ﺗﺄﺛﯿﺮ داﺷــﺘﻪ اﺳــﺖ. ﯾﺎﻓﺘﻪﻫﺎ ﻧﺸــﺎن داد ﮐﻪ درﻣﺎن ﻣﺒﺘﻨﯽﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ ﻣﺆﻟﻔﻪﻫﺎي رﻓﺘﺎر، اﺿﻄﺮاب و ﻣﺤﺒﻮﺑﯿﺖ ﺧﻮدﭘﻨﺪاره ﻫﻤﭽﻨﯿﻦ ﺑﺮ ﺗﺎبآوري ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺗﺄﺛﯿﺮ داﺷﺘﻪ اﺳﺖ. ﻧﺘﯿﺠﻪﮔﯿﺮي: درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ ﺗﺎبآوري و ﺧﻮدﭘﻨﺪاره ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳـﺮﻃﺎن ﺗﺄﺛﯿﺮ ﻣﺜﺒﺖ داﺷـﺘﻪ اﺳـﺖ؛ از اﯾﻦ رو ﮐﺎرﺑﺮد اﯾﻦ ﮔﻮﻧﻪ درﻣﺎنﻫﺎ در ﮐﻨﺎر ﺳـﺎﯾﺮ روشﻫﺎي درﻣﺎﻧﯽ ﺑﻪ ﻣﺸـﺎوران و روانﺷـﻨﺎﺳـﺎن ﮐﻮدك ﺗﻮﺻـﯿﻪ ﻣﯽﺷﻮد.

Acceptance and commitment Therapy is One of the Third Wave behavioral Therapies for the treatment of anxiety disorders. The purpose of this study to investigate the effectiveness of Acceptance and Commitment Therapy on Resiliency and Self-Concept in children with cancer. Methods: The Present Study was quasi-experimental with post-test pretest design with control group. The statistical population included all children with cancer admitted to Imam Khomeini Hospital in Tehran in 1398, of which 30 children were randomly assigned to experimental and control group.Pears -Harris (1969) Self-Concept questionnaire and Connor-Davidson (2003) resilience were randomly assigned to experimental and control groups. For the experimental group, Acceptance and commitment Therapy was presented in six session of 60-minutes. Data were analyzed by analysis of covariance using SPSS24 software. Results: The results showed that the Treatment based on acceptance and commitment had an Effect on self-concept (p = 0.001, F = 24.05) and Resiliency (p = 0.002, F = 11.88) in children with cancer. The findings showed That Acceptance and Commitment based Therapy on the components of Behavior, Anxiety, popularity, Resiliency and self-concept on children with cancer. Conclusion: Acceptance and commitment therapy has a positive effect on resilience and self-concept of children with cancer.Therefore the use of such treatments methods is recommended to counselors and child psychologists.