پديد آورندگان :
موسوي نژاد، محمود دانشگاه آزاد اسلامي، واحد زاهدان - گروه روان شناسي , ثناگوي محرر، غلامرضا دانشگاه آزاد اسلامي، واحد زاهدان - گروه روان شناسي , زربان، اصغر دانشگاه علوم پزشكي، بيرجند - گروه بيوشيمي
كليدواژه :
شناخت درماني مبتني بر ذهن آگاهي , انعطاف‌پذيري شناختي , استرس ادراك‌شده , ديابت نوع دو
چكيده فارسي :
هدف: ديابت نوع دو يكي از عوامل تنش‌زا و استرس‌زا در زندگي است كه نقش عمده‌اي را در انعطاف پذيري شناختي ايفا مي‌كند. لذا هدف مطالعهٔ حاضر بررسي اثربخشي شناخت‌درماني مبتني بر ذهن‌آگاهي بر انعطاف‌پذيري شناختي و استرس ادراك‌شدهٔ بيماران ديابتي نوع دو بود.
روش‌بررسي: پژوهش حاضر نيمه‌آزمايشي از نوع پيش‌آزمون - پس‌آزمون با گروه گواه بود. از بيماران مبتلا به ديابت نوع دو مركز ديابت شهر بيرجند در سال 1396، تعداد 40 بيمار ديابتي (20 نفر گروه آزمايش، 20 نفر در گروه گواه) به صورت نمونه‌گيري در دسترس انتخاب و به طور تصادفي در دو گروه قرار گرفتند. ابزار پژوهش شامل مقياس انعطاف‌پذيري شناختي دنيس و وندروال (2010)، خرده مقياس استرس لاويبوند و لاويبوند (1995) و هشت جلسهٔ 60 دقيقه‌اي شناخت درماني مبتني بر ذهن‌آگاهي سيگال و همكاران (2003) بود. جهت تحليل داده، از نرم‌افزار SPSS نسخهٔ 22 و آزمون تحليل كوواريانس تك متغيره استفاده شد.
يافته‌ها: نتايج نشان داد كه ميانگين و انحراف معيار انعطاف‌پذيري شناختي گروه آزمايش قبل از مداخله برابر با 11٫60± 94٫05 و پس از مداخله 12٫30± 103٫76؛ ميانگين و انحراف معيار نمرات استرس ادراك‌شدهٔ گروه آزمايش قبل از مداخله برابر با 57/7± 42٫24 و پس از مداخله 10٫68± 33٫65 به دست آمد. همچنين اندازه اثر نمرهٔ انعطاف‌پذيري شناختي 0٫120 (0٫044=p) و اندازه اثر نمرهٔ استرس ادراك‌شده 0٫179 (0٫013=p) به دست آمد.
نتيجه‌گيري: آموزش شناخت درماني مبتني بر ذهن آگاهي مي‌تواند به عنوان روشي مؤثر در بهبود وضعيت روان‌شناختي بيماران ديابتي دو به كار گرفته شود.
چكيده لاتين :
Background & Objective: Diabetes mellitus is the most common chronic metabolic disease, which is characterized by abnormalities in the
metabolism of carbohydrates, proteins and fats. The most common symptoms are glucose intolerance or increased blood glucose. For this reason,
the person affects the short and long-term complications of diabetes. Diabetes is a side effect such as an increase in myocardial infarction, renal
failure, blindness, amputation, and psychological problems, such as stress. There is a two-way relationship between stress and diabetes. Perceived
stress is capable of activating the hypothalamic pituitary-adrenal axis (HPA). Increase or increase blood glucose levels. On the other hand,
diabetes can also be a major source of stress in these patients. As the disease causes a lot of changes in the lifestyle of patients, they impose
certain dietary supplements, require frequent medical tests, and patients should regularly inject insulin; all of these are difficult and stressful
processes. Diabetics also have a sense of failure and disappointment because of conflict with disease and planning, and their emotional and social
well-being is affected. This inadequate cause of exacerbation of emotional problems such as depression, anxiety, change in processes Cognitive
skills such as rumination and reduced flexibility. In the end, because stress and cognitive flexibility play an important role in the emergence,
prognosis, and treatment of diabetic patients, research is needed in this regard. On the other hand, interventions based on psychological education
and psychological training, such as cognitive therapy based on mind-consciousness, are among the new behavioral approaches of the third wave,
are of particular importance. Finally, a review of research findings in diabetic patients shows that few studies have been conducted on the
relationship between cognitive stress and cognitive flexibility and diabetes in the country that are not sufficient and coherent, and the different
dimensions of this issue have not been well addressed. The aim of this study was to determine the effectiveness of cognitive therapy based on
mind-awareness on cognitive flexibility and perceived stress in type II diabetic patients.
Methods: This is a semi-experimental pre-test post-test with control group. In this research, cognitive therapy based on mind-consciousness as
independent variables and cognitive flexibility and perceived stress are considered as dependent variables. Cognitive therapy based on
Mindfulness was performed only on the experimental group and its effect on post-test scores of the subjects in the experimental group was
compared to that of the control group. The statistical population of all patients with type 2 diabetes who referred to Birjand diabetes center during
the second half of 1396 was 40 randomly selected diabetic patients (20 experimental group, 20 controls). They were randomly selected. The
band was placed. The research tools included Denis and Vendoral Cognitive Flexibility Scale (2010), Levi Bond Stress Scale and Leviibond
(1995), and eight 60-minute sessions of cognitive therapy based on Mindfulness of Siegal et al. (2018). For data analysis, SPSS software version
22 and descriptive statistics methods such as mean, standard deviation, and inferential statistics of single variable variance analysis were used at
the significance level of 0.05.
Results: The results showed that the mean and standard deviation of the cognitive flexibility of the experimental group before the intervention
was 94.05±11.66 and after the invasion was 106.76±12.30; the mean and standard deviation of the perceived stress scores of the experimental
group before the invasion were equal after 42.48±7.7 and after the intervention was 65.33±10.68. Also, the effect size of the cognitive flexibility
score was 0.41 (p<0.05), and the effect size of the perceived stress score was 0.179 (p<0.05).
Conclusion: The results showed that cognitive therapy based on mind-awareness is effective in increasing cognitive flexibility and reducing the
perceived stress of type II diabetic patients; therefore, cognitive therapy education based on mind-awareness can be used as an effective method
for improving the psychological status of this group of patients. Their treatment centers and their care centers. Also, considering the positive
effect of cognitive-based cognitive therapy on increasing cognitive flexibility, it is suggested that therapists in the field of psychology and
especially health psychologists use this treatment to improve the cognitive flexibility of diabetic patients.
