اثربخشي درمان مبتني بر پذيرش و تعهد بر افسردگي،اضطراب،پرخاشگري و كيفيت زندگي بيماران دياليزي

Effectiveness of Acceptance and Commitment Based Therapy on the Depression, Anxiety, Aggression, and Life Quality of Dialysis Patients

اﯾﻦ ﭘﮋوﻫﺶ ﺑﺎ ﻫﺪف ﺑﺮرﺳﯽ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ اﻓﺴﺮدﮔﯽ، اﺿﻄﺮاب، ﭘﺮﺧﺎﺷﮕﺮي و ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﺑﯿﻤﺎران دﯾﺎﻟﯿﺰي ﺑﻪ ﻣﺮﺣﻠﻪ اﺟﺮا درآﻣﺪه اﺳﺖ. روش ﻣﻄﺎﻟﻌﻪ ﻧﯿﻤﻪ ﺗﺠﺮﺑﯽ ﺑﺎ ﻃﺮح ﭘﯿﺶ آزﻣﻮن، ﭘﺲ آزﻣﻮن و ﮔﺮوه ﮐﻨﺘﺮل ﺑﻮد. ﻧﻤﻮﻧﻪ ﭘﮋوﻫﺶ ﺷﺎﻣﻞ 30 ﺑﯿﻤﺎر دﯾﺎﻟﯿﺰي ﺑﻮد ﮐﻪ ﺑﻪ ﺻﻮرت ﻧﻤﻮﻧﻪ ﮔﯿﺮي در دﺳﺘﺮس از ﺑﯿﻦ ﺑﯿﻤﺎران ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن ﺷﻬﺪاي ﻟﻨﺠﺎن اﻧﺘﺨﺎب ﺷﺪﻧﺪ و ﺑﻪ ﺻﻮرت ﮔﺰﯾﻨﺶ ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه آزﻣﺎﯾﺶ ﮐﻨﺘﺮل ﮔﻤﺎرده ﺷﺪﻧﺪ )ﻫﺮ ﮔﺮوه 15 ﻧﻔﺮ(. ﺗﻤﺎم ﺑﯿﻤﺎران ﻃﯽ ﺳه ﻣﺮﺣﻠﻪ ﭘﯿﺶ آزﻣﻮن، ﭘﺲ آزﻣﻮن و ﭘﯿﮕﯿﺮي 2 ﻣﺎﻫﻪ ﭘﺮﺳﺸﻨﺎﻣﻪ ﻫﺎي اﻓﺴﺮدﮔﯽ )ﺑﮏ و ﻫﻤﮑﺎران، 2000(، اﺿﻄﺮاب )ﺑﮏ و ﻫﻤﮑﺎرا 1990(، ﭘﺮﺧﺎﺷﮕﺮي )ﺑﺎس و ﭘﺮي، 1992( و ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ )ﺳﺎزﻣﺎن ﺟﻬﺎﻧﯽ ﺑﻬﺪاﺷﺖ، 1989( را ﺗﮑﻤﯿﻞ ﮐﺮدﻧﺪ. ﮔﺮوه آزﻣﺎﯾﺶ ﻃﯽ 8 ﺟﻠﺴﻪ 90 دﻗﯿﻘﻪ اي درﻣﺎن ﭘﺬﯾﺮش و ﺗﻌﻬﺪ را درﯾﺎﻓﺖ ﮐﺮدﻧﺪ. ﻧﺘﺎﯾﺞ ﺑﺎ اﺳﺘﻔﺎده از ﺗﺤﻠﯿﻞ وارﯾﺎﻧﺲ ﺑﺎ اﻧﺪازه ﮔﯿﺮي ﻣﮑﺮر ﻧﺸﺎن داد ﮐﻪ درﻣﺎن ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﻫﻢ در ﻣﺮﺣﻠﻪ ﭘﺲ آزﻣﻮن و ﻫﻢ ﻣﺮﺣﻠﻪ ﭘﯿﮕﯿﺮي ﺑﺮ ﮐﺎﻫﺶ اﻓﺴﺮدﮔﯽ، اﺿﻄﺮاب و ﭘﺮﺧﺎﺷﮕﺮي و ﺑﻬﺒﻮد ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﺑﯿﻤﺎران ﺗﺄﺛﯿﺮ داﺷﺘﻪ اﺳﺖ (0/05 >P). ضرايب تأثير براي متغيرهاي فوق نيز به ترتيب 0/134, 0/263, 173 و 0/204 به دست آمد. نتيجه گيري شد كه مي توان از درمان پذيرش و تعهد در جهت كاهش افسردگي، اضطراب و پرخاشگري و همچنين بهبود كيفيت زندگي بيماران دياليزي استفاده كرد.

This study was aimed to investigating effectiveness of acceptance and commitment based therapy on the depression, anxiety, aggression, and life quality of Dialysis patients. Research methods was quasi-experimental with pretest-posttest design and control group. The sample of research included 30 Dialysis patients of Velenjan hospital which selected by using convenience samplings. Then randomly divided two group:1-expeirment group, 2. control group. (each group 15 persons). All patients in pretest, posttest, and 2 months’ follow-up stages completed The following questionnaire: Depression (Beck et al., 2000), anxiety (Beck et al., 1990), aggression (Buss and Perry, 1992) and quality of life (World Health Organization, 1989). The experimental group received 8 sessions of (each session 90-minute) acceptance and commitment based therapy. The results of analysis of variance and repeated measurements showed that acceptance and commitment therapy in post-test and followup had impact on reducing depression, anxiety and aggression and improving the life quality of Dialysis patients (p‹0.05), impact factors for the above variables, respectively was 0.134, 0.263, 173 and 0.204. Results showed that we can use acceptance and commitment therapy for reducing depression, anxiety and aggression as well as improving the life quality of Dialysis patients.