ﻣﻘﺎﯾﺴﻪ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺎ درﻣﺎن ﻣﺘﻤﺮﮐﺰ ﺑﺮ ﺷﻔﻘﺖ ﺑﺮ اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺷﻨﺎﺧﺘﯽ در ﻣﺮدان ﻣﺒﺘﻼ ﺑﻪ ﺳﻨﺪرم روده ﺗﺤﺮﯾﮏﭘﺬﯾﺮ

Comparison of the Effectiveness of Acceptance and Commitment Therapy with Compassion-Focused Therapy on Psychological Flexibility in Male Patients with Irritable Bowel Syndrome

ﻣﻘﺪﻣﻪ: ﺳﻨﺪرم روده ﺗﺤﺮﯾﮏﭘﺬﯾﺮ ﺑﻪﻋﻨﻮان ﺷﺎﯾﻊﺗﺮﯾﻦ اﺧﺘﻼﻻت ﮔﻮارﺷﯽ، ﺑﺎ ﻣﺸﮑﻼت روانﺷﻨﺎﺧﺘﯽ ﻣﺘﻌﺪدي ﻫﻤﺮاه اﺳﺖ و ﺑﺎر ﻗﺎﺑـﻞ ﺗ ﻮﺟﻬﯽ را ﺑﺮ دوش ﺳﯿﺴﺘﻢﻫﺎي ﺑﻬﺪاﺷﺘﯽ و درﻣﺎﻧﯽ ﻣﯽﮔﺬارد. اﯾﻦ ﭘﮋوﻫﺶ ﺑـﺎ ﻫـﺪف ﻣﻘﺎﯾﺴـﻪ اﺛﺮﺑﺨﺸـﯽ درﻣـﺎن ﭘـﺬﯾﺮش و ﺗﻌﻬـﺪ و درﻣﺎن ﻣﺘﻤﺮﮐﺰ ﺑﺮ ﺷﻔﻘﺖ ﺑﺮ اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺷﻨﺎﺧﺘﯽ ﻣﺮدان ﻣﺒﺘﻼ ﺑﻪ ﺳﻨﺪرم روده ﺗﺤﺮﯾﮏﭘﺬﯾﺮ اﻧﺠﺎم ﺷﺪ. ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﭘﮋوﻫﺶ، ﻧﯿﻤﻪآزﻣﺎﯾﺸﯽ ﺑﺎ ﭘﯿﺶآزﻣﻮن، ﭘﺲآزﻣﻮن و ﮔﺮوه ﮐﻨﺘﺮل ﺑﺎ ﭘﯿﮕﯿﺮي 3 ﻣﺎﻫﻪ ﺑﻮد. ﺟﺎﻣﻌﻪ آﻣـﺎري ، ﺗﻤـﺎﻣﯽ ﻣﺮدان ﻣﺒﺘﻼ ﺑﻪ ﺳﻨﺪرم روده ﺗﺤﺮﯾﮏﭘﺬﯾﺮ ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑـﻪ درﻣﺎﻧﮕـﺎه داﺧﻠـﯽ ﺑﯿﻤﺎرﺳـﺘﺎن ﻣـﯿﻼد ﺗﻬـﺮان در ﺳـﺎل 1398 ﺑﻮدﻧـﺪ . ﺑـﺎ ﻧﻤﻮﻧﻪﮔﯿﺮي در دﺳﺘﺮس 45 ﻧﻔﺮ اﻧﺘﺨﺎب و ﺑﻪﺻﻮرت ﺗﺼﺎدﻓﯽ در ﺳﻪ ﮔﺮوه ﻣﺴﺎوي ﮔﻤﺎرده ﺷـﺪﻧﺪ. ﻣـﺪاﺧﻼت درﻣـﺎﻧﯽ ﻃـﯽ 8 ﺟﻠﺴـﻪ ﯾﮏ ﺟﻠﺴﻪ 60 دﻗﯿﻘﻪاي در ﻫﻔﺘﻪ( ﺑﺮاي ﮔﺮوهﻫﺎي آزﻣﺎﯾﺶ اﻋﻤﺎل ﺷﺪ. ﮔﺮوه ﮐﻨﺘﺮل ﻣﺪاﺧﻠﻪاي درﯾﺎﻓﺖ ﻧﮑﺮد. ﺑﺮاي ﮔﺮدآوري دادهﻫـﺎ ا ز ﭼﮏﻟﯿﺴﺖ اﻃﻼﻋﺎت دﻣﻮﮔﺮاﻓﯿﮏ و ﭘﺮﺳﺶﻧﺎﻣﻪ اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺷﻨﺎﺧﺘﯽ Dennid و Wander-Wall اﺳﺘﻔﺎده ﺷﺪ. دادهﻫـﺎ ﺗﻮﺳـﻂ آ ﻧﺎﻟﯿﺰ وارﯾﺎﻧﺲ ﺑﺎ اﻧﺪازهﮔﯿﺮيﻫﺎي ﻣﮑﺮر ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: در ﺗﺮﮐﯿﺐ ﺧﻄﯽ ﻣﺘﻐﯿﺮﻫﺎي اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺷﻨﺎﺧﺘﯽ، ادراك ﮐﻨﺘﺮلﭘﺬﯾﺮي، ﺗﻮﺟﯿﻪ رﻓﺘـﺎر و راه ﺣـﻞ ﻫـﺎي ﻣﺘﻌـﺪد ﺑﺮﺣﺴـﺐ ﻋﻀﻮﯾﺖ ﮔﺮوﻫﯽ ﻣﺮاﺣﻞ ﭘﯿﺶآزﻣﻮن، ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي اﺛﺮ ﺗﻌﺎﻣﻠﯽ ﮔﺮوه و زﻣﺎن ﻣﻌﻨﯽدار ﺑﻮد )0/05

Introduction: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders worldwide. Psychological disorders are common among patients with IBS, posing a significant burden on healthcare systems. Therefore, this study aimed to compare the effectiveness of acceptance and commitment therapy with compassion-focused therapy on psychological flexibility in male patients with IBS. Materials and Methods: This study was quasi-experimental with a pre-test, post-test, control group, and 3 months follow-up. The statistical population included all men with irritable IBS referred to Milad Hospital in Tehran in 2019. Using available sampling method, 45 people were selected and randomly assigned to three equal groups. Therapeutic interventions for each treatment group were applied in 8 sessions once a week, and each session lasted 60 minutes for the experimental groups; however, the control group did not receive any intervention. A researcher-made demographic information checklist and Cognitive Flexibility Scale were used to collect data. Data were analyzed by descriptive statistics and repeated measures analysis of variance. Results: There was a significant difference in the linear composition of the psychological flexibility, and its dimensions included the tendency to perceive difficult situations as controllable, the ability to perceive multiple alternative explanations for life events and human behaviors, and the ability to generate multiple alternative solutions to difficult situations in terms of group membership, pre-test, post-test, follow-up, as well as the interactive effect of the group and time (p<0.05). Besides, the two treatment groups (acceptance and commitment therapy & compassion-focused therapy) showed significant differences compared to the control group in terms of the components of psychological flexibility and its dimensions (p<0.05). There was no significant difference between the effectiveness of these two treatments (p>0.05). Conclusion: Both treatments increased the psychological flexibility of patients with IBS; thus, they can be considered useful treatment strategies to improve the mental status of chronic patients.