Razi Journal of Medical Sciences

fa کیفیت زندگی، عقاید وسوسه‌انگیز و بهزیستی روان‌شناختی در بیماران مصرف‌کننده متادون: اثربخشی برنامه کاهش استرس مبتنی بر ذهن‌آگاهی Quality of Life, Craving Beliefs, and Psychological Well-being in Methadone Patients: The Effectiveness of Mindfulness-Based Stress Reduction Program روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: اختلالهای مصرف مواد و پیامدهای ناخوشایند آن از مهمترین مشکلات سلامت عمومی در جهان امروز برشمرده میشود که کلیه سیستمهای اجتماعی از جمله خانواده، جامعه و همچنین خود فرد از آن تاثیر میپذیرد. هدف پژوهش حاضر، بررسی اثربخشی برنامه کاهش استرس مبتنی بر ذهن آگاهی بر کیفیت زندگی، عقاید وسوسه‌انگیز و بهزیستی روان شناختی بیماران مصرف‌کننده متادون بود. روش کار: در یک طرح کارآزمایی بالینی با گروه کنترل، از کلیه افراد مصرف‌کننده متادون مراجعه کننده به کلینک‌های ترک اعتیاد واقع در شهر گرگان (150 نفر)، 30 نفر به روش در دسترس انتخاب و به صورت تصادفی به دو گروه آزمایش (15 نفر) و گروه کنترل (15 نفر) تقسیم شدند. سپس شرکت کنندگان گروه آزمایش به مدت 8 جلسه تحت آموزش ذهن آگاهی مبتنی بر کاهش استرس قرار گرفتند. قبل از مداخله و پس از آن، مقیاس کیفیت زندگی واروشربون (1992)، بهزیستی روانشناختی کارو ریف (1989) و عقاید وسوسه‌انگیز رایت و بک (1993) جهت سنجش عملکرد آزمودنی‌ها در هر یک از متغیرها استفاده شد.  داده‌ها با استفاده از روش  تحلیل کوواریانس تحلیل گردید. یافته ها: پس از کنترل اثرات پیش آزمون، برنامه کاهش استرس مبتنی بر ذهن‌اگاهی موجب کاهش عقاید وسوسه‌انگیز و بهبود‌ بهزیستی روانشناختی و کیفیت زندگی در گروه آزمایش نسبت به گروه گواه گردید.  نتیجه گیری: بر اساس نتایج، با آموزش تکنیکهای ذهنآگاهی میتوان عقاید وسوسهانگیز  مصرفکنندگان متادون را کاهش و بهزیستی روانشناختی و کیفیت زندگی  آنان را بهبود بخشید. </div> <div style="text-align: justify;">Background & Aims: Methadone treatment is an effective, safe and harm-reducing program for people with opioid dependence through which methadone is used as a synthetic substance to prevent and control drug dependence. On the other hand, although methadone use can reduce drug addiction, drug-related harm, risky behaviors, crime, and human immunodeficiency virus and hepatitis virus transmission among addicts (3), Such substances disrupt the relationships of family members, deprive them of vitality and well-being, and ultimately degrade the quality of life. Although methadone therapy is considered as a common and effective way to stop substance abuse, however, this method does not take into account the psychological dimensions of patients and only physically prepares them to quit. Therefore, in the process of methadone treatment, it seems necessary to emphasize and rely on psychological approaches. Accordingly, considering that tempting beliefs, quality of life and psychological well-being play an important role in creating and even improving the process of methadone users, and considering that stress-based mindfulness approach as a cognitive approach to these variables in the patient community Methadone treatment has not been used, so the main question of the present study is whether teaching mindfulness-based stress reduction programs is effective on tempting beliefs, quality of life and psychological well-being of patients treated with methadone? Methods: After using the experimental and control groups and before intervening in both groups, pre-tests were performed. The mindfulness treatment program was then performed in such a way that the subjects in the experimental group had one 2-hour treatment session per week, but the control group did not receive any intervention. Before the main treatment sessions, a session to explain about the research, establish a good relationship, perform a pre-test (run tests) and gather information about the problems that have caused confusion, explain the treatment model of stress reduction based on mindfulness, create hope in clients. held. An 8-week exercise program and a mindfulness model based on a package written by Bowen, Chaula, and Marlat (2011) were used to conduct the sessions. In a study conducted by Agha Yousefi et al. (2013), this protocol was translated into Persian and used. It should be mentioned that based on the observance of the ethical charter in the research, for the control group, after the post-test stage, a mindfulness method based on stress reduction was performed. Results: The results show that by removing the effect of the pre-test variable and considering the calculated F coefficient, it is observed that there is a significant difference between the adjusted means of the subjects' psychological well-being scores in terms of group membership of "experiment and control" in the post-test stage (P <0.05). Therefore, according to the modified means, it is concluded that the mindfulness-based stress reduction program in the participants of the experimental group had a greater impact on the psychological well-being of patients using methadone than the control group. Also, the two experimental and control groups have significant differences in terms of quality of life, except for the subscales of physical health, energy / fatigue and emotional well-being. Therefore, it can be stated that mindfulness-based stress reduction program is effective on quality of life in patients using methadone. Also, the experimental and control groups have significant differences in terms of tempting beliefs, so it can be stated that mindfulness-based stress reduction program is effective on tempting beliefs in patients using methadone. Conclusion: The aim of this study was to evaluate the effectiveness of mindfulness-based stress reduction program on quality of life, tempting beliefs and psychological well-being of patients using methadone. The results showed that mindfulness-based stress reduction program is effective on quality of life in patients using methadone. The results are consistent with the findings of Brewer et al. (25), Garland et al. (21), Levin (26) and show that mindfulness-based stress reduction has a positive effect on quality of life in different patients. In explaining this issue, it can be stated that mindfulness increases physical self-monitoring and body awareness, which may lead to improved bodily mechanisms and improved self-care. Similar to traditional relaxation training, mindfulness meditation is associated with increased parasympathetic activation, which can lead to deep muscle relaxation and reduce tension and arousal, reduce pain, and ultimately increase the quality of life of these individuals. Affect life. Mindfulness may lead to the view that thoughts and feelings are transient, and this transient attitude allows people to view cognitions, thoughts, and feelings as if they were just thoughts or only feelings. Likewise, mindfulness-based stress reduction programs are effective in tempting beliefs in patients using methadone and reduce tempting beliefs. This finding with different previous results such as Salo et al. (27); Preston et al. (19), Clayton et al. (20) who examine the effectiveness of mindfulness-based stress reduction methods on tempting beliefs in various fields such as; Three: drug use, craving, anxiety of people avoiding, rumination studied, are consistent. Mindfulness-based stress reduction seems to help reduce a person's stress simply by changing cognitive and emotional conditions. On the other hand, family and social factors are not addressed in mindfulness, so the lack of difference between married and single men in the effectiveness of mindfulness-based intervention can be due to the lack of attention of mindfulness-based intervention to support others. Also, people who have more substance-related beliefs (tempting beliefs) experience more temptation after quitting and during the abstinence period. One reason for this may be that during the Turkish period, when they are under pressure from this period, their network of dysfunctional ideas about substances is activated. As a result, they see the positive points of the material as more colorful and the negative points as less colorful, and eventually they are more tempted. It was also found that stress-based mindfulness training increases the psychological well-being score of the experimental group members. Research on the effect of mindfulness training on psychological well-being shows that this hypothesis is in line with other studies. Findings of this with the results of research by Lee and Koob (29), Garland et al. (21), Danwan et al. (17), Nevsky et al. (30) who stated in their research that mindfulness is a strong predictor of psychological well-being. Is aligned. In explaining this issue, it can be said that if we have a biological approach to addiction, neurotransmitters will be considered and drug interventions will be very important. On the other hand, paying attention to psychosocial factors to increase the patient's motivation to continue and maintain treatment and emphasize psychological support can be very effective. Combining medication with a cognitive-behavioral approach can improve the treatment process. Mindfulness gives clarity to experiences and teaches people to experience their life moment by moment, which reduces negative psychological symptoms and increases psychological well-being. Karmodi and Bauer (31) believe that doing mindfulness exercises promotes the development of various factors of mindfulness such as observation, non-judgment, non-reaction and conscious action. The growth of these factors also leads to the growth of psychological well-being, stress reduction and psychological symptoms. In fact, as the mind becomes more aware, our ability to stand back and observe states such as anxiety increases.</div> برنامه کاهش استرس مبتنی بر ذهن‌آگاهی, کیفیت زندگی, عقاید وسوسه انگیز, بهزیستی روان‌شناختی, متادون Mindfulness-Based Stress Reduction Program, Quality of Life, Craving Beliefs, Psychological Well-being, Methadone 1 10 http://rjms.iums.ac.ir/browse.php?a_code=A-10-4655-3&slc_lang=fa&sid=1 Mehdi Sharifi مهدی شریفی mehdisharifi273@gmail.com 3900319475328460078615 3900319475328460078615 Yes Department of Psychology, Islamic Azad University, Bandargaz Branch, Bandargaz, Iran کارشناسی ارشد، گروه روان شناسی، واحد بندرگز، دانشگاه آزاد اسلامی، بندرگز، ایران Ghodsiyeh Ebrahimpour قدسیه ابراهیم پور 3900319475328460078616 3900319475328460078616 No Assistant Professor, Department of Psychology, Hoda International College, Qom, Iran استادیار، گروه روان شناسی، دانشکده بین المللی هدی، قم، ایران Milad Fatehizadeh Khosh baten میلاد فاتحی زاده خوش باطن 3900319475328460078617 3900319475328460078617 No Department of Psychology, Islamic Azad University, Bandargaz Branch, Bandargaz, Iran کارشناسی ارشد، گروه روان شناسی، واحد بندرگز، دانشگاه آزاد اسلامی، بندرگز، ایران