اثربخشي درمان مبتني بر پذيرش و تعهد بر اجتناب هيجاني و ابعاد خستگي رواني زنان مبتلا به مولتيپل اسكلروزيس

The effectiveness of acceptance and commitment therapy on emotional avoidance and dimensions of mental fatigue in women with multiple sclerosis

ﻫﺪف از ﭘﮋوﻫﺶ ﺣﺎﺿﺮ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ اﺟﺘﻨﺎب ﻫﯿﺠﺎﻧﯽ و اﺑﻌﺎد ﺧﺴﺘﮕﯽ رواﻧﯽ زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﻣﻮﻟﺘﯿﭙﻞ اﺳﮑﻠﺮوزﯾﺲ ﺑﻮد. روش: ﭘﮋوﻫﺶ ﺣﺎﺿﺮ از ﻧﻮع ﻧﯿﻤﻪ ﺗﺠﺮﺑﯽ ﺑﺎ ﻃﺮح ﭘﯿﺶآزﻣﻮن - ﭘﺲآزﻣﻮن ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل ﺑﻮد. آزﻣﻮدﻧﯽﻫﺎ زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ MS با دامنه ﺳﻨﯽ 40-20 ﺳﺎل و ﺑﺎ ﻣﻘﯿﺎس ﻧﺎﺗﻮاﻧﯽ ﺟﺴﻤﺎﻧﯽ(EDSS)، ﻫﺪﻓﻤﻨﺪاﻧﻪ اﻧﺘﺨﺎب و ﺑﻪ ﺻﻮرت ﺗﺼﺎدﻓﯽ ﺑﻪ ﮔﺮوهﻫﺎي ﺗﺠﺮﺑﯽ و ﮐﻨﺘﺮل ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﻫﺮ دو ﮔﺮوه در ﻣﺮﺣﻠﻪ ﭘﯿﺶآزﻣﻮن و ﭘﺲآزﻣﻮن ﺑﻪ ﭘﺮﺳﺸﻨﺎﻣﻪﻫﺎي اﺟﺘﻨﺎب ﻫﯿﺠﺎﻧﯽ ﮐﻨﺪي (2015) و ﺧﺴﺘﮕﯽ ﺷﻨﺎﺧﺘﯽ ﻓﯿﺴﮓ (1994) ﭘﺎﺳﺦ دادﻧﺪ. ﮔﺮوه آزﻣﺎﯾﺶ 10 ﺟﻠﺴﻪ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ را ﺑﻪ ﺻﻮرت ﻫﻔﺘﻪاي ﯾﮑﺒﺎر ﺑﻪ ﻣﺪت 1/5 ﺳﺎﻋﺖ درﯾﺎﻓﺖ ﮐﺮدﻧﺪ. دادهﻫﺎي ﺟﻤﻊآوري ﺷﺪه ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰار SPSS ﻧﺴﺨﻪ 23 و روش ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮي ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﮐﻪ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ ﮐﺎﻫﺶ اﺟﺘﻨﺎب ﻫﯿﺠﺎﻧﯽ و ﺧﺴﺘﮕﯽ ﺷﻨﺎﺧﺘﯽ زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺑﯿﻤﺎري ﻣﻮﻟﺘﯿﭙﻞ اﺳﮑﻠﺮوزﯾﺲ ﻣﺆﺛﺮ اﺳﺖ (0/001≥P). ﻧﺘﯿﺠﻪﮔﯿﺮي: ﺑﺮاﺳﺎس ﻧﺘﺎﯾﺞ اﯾﻦ ﭘﮋوﻫﺶ ﻣﯽ ﺗﻮان از درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮاي ﮐﺎﻫﺶ اﺟﺘﻨﺎب ﻫﯿﺠﺎﻧﯽ و ﻋﻼﺋﻢ ﺧﺴﺘﮕﯽ (ﺟﺴﻤﺎﻧﯽ، ﺷﻨﺎﺧﺘﯽ و اﺟﺘﻤﺎﻋﯽ) زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺑﯿﻤﺎري ﻣﻮﻟﺘﯿﭙﻞ اﺳﮑﻠﺮوزﯾﺲ در ﻣﺮاﮐﺰ درﻣﺎﻧﯽ اﺳﺘﻔﺎده ﻧﻤﻮد.

Aim: The aim of this study was the effectiveness of acceptance and commitment therapy on emotional avoidance and dimensions of mental fatigue in women with multiple sclerosis. Method: The present study was a quasi-experimental study with a pretest-posttest with control group design. The subjects were women with MS within an age range of 20-40 years, who were purposefully selected through a scale of physical disability (EDSS) and randomly assigned into experimental and control groups. Both groups nswered the Kennedy (2015) Emotional Avoidance Questionnaire and Fisk (1994) fatigue Impact scale in the pre-test and post-test stages. The experimental group received 10 sessions of acceptance and commitment treatment once a week for 1.5 hours. The collected data were analyzed using SPSS-23 software and multivariate covariance analysis method. Results: The results indicated that acceptance and commitment therapy is effective in reducing emotional avoidance and cognitive fatigue in women with multiple sclerosis (P≤0.001).Conclusion: Based on the results of this study, acceptance and commitment therapy can be used to reduce emotional avoidance and fatigue symptoms (physical, cognitive and social) of women with multiple sclerosis in medical centers.