Razi Journal of Medical Sciences

fa تأثیر آموزش ذهن آگاهی بر استرس، شادکامی و امید به زندگی بیماران قلبی-عروقی Effectiveness of mindfulness on stress, happiness and hope in patients with cardiovascular disease قلب و عروق Cardio Muscular Disease پژوهشي Research زمینه و هدف: در این پژوهش هدف تعیین تأثیر آموزش ذهن آگاهی بر استرس، شادکامی و امید به زندگی بیماران قلبی-عروقی بود. روش کار: پژوهش حاضر با توجه به هدف کاربردی و روش آن به شیوه نیمه آزمایشی و با طرح پیش‌آزمون-پس‌آزمون با گروه کنترل اجرا گردید. جامعه آماری پژوهش حاضر،شامل کلیه بیماران قلبی-عروقی مراجعه کننده به بیمارستان قلبی شهید رجایی و بیمارستان شریعتی شهرستان کرج در سال 1398 بوده است. حجم نمونه 40 نفر از بیماران قلبی-عروقی که به شیوه در دسترس انتخاب و به صورت تصادفی(به تعداد مساوی) در گروه‌های آزمایش و کنترل جایگزین شدند. سپس به منظور ارزیابی استرس از آزمون Dass-21، شادکامی از پرسشنامه آکسفورد OHI وامید به زندگی از پرسشنامه امید به زندگی اشنایدر، استفاده گردیده است. در مرحله بعد جلسات ذهن آگاهی در قالب 10 جلسه 90 دقیقه‌ای برای گروه آزمایش ارائه گردید. پس از پایان آموزش نیز بار دیگر آزمون‌های استرس، شادکامی و امید به زندگی برای هر دو گروه آزمایش و کنترل اجرا گردید. داده‌ها به وسیله نرم افزار SPSS 22 پردازش شد. یافته‌ها: نتایج حاصل از یافته‌های تحلیل کواریانس تک متغیره، نشان دادند که از نظر استرس، شادکامی و امید به زندگی در مرحله پس‌آزمون بین گروه‌ها تفاوت معناداری دیده می‌شود. بدین ترتیب تمامی فرضیه‌ها مورد تایید قرار گرفتند و می‌توان گفت آموزش ذهن آگاهی در کاهش استرس، بهبود شادکامی و امید به زندگی در بیماران قلبی-عروقی مؤثر بوده است. نتیجه‌گیری: بنابراین ذهن آگاهی می‌تواند وضعیت بیماران قلبی-عروقی را در زمینه‌های استرس، شادکامی و امید به زندگی بهبود بخشد. Background & Aims: Cardiovascular disease is considered one of the most important causes of mortality in many countries of the world. Cardiovascular disease causes physical and psychological complications for these patients. Their quality of life is usually reduced under the influence of simultaneous feelings of depression, anxiety, anger and stress (12). Stress has been shown to affect a wide range of cognitive and non-cognitive skills. It has been shown to impair memory, cognitive and executive functions, and to affect risk-taking behavior, which in turn impacts important day-to-day decisions. Prolonged stress can lead to both physical health problems (e.g., heart disease, high blood pressure, diabetes) and mental health problems (e.g., depression or anxiety), although the effects are not always clear (34). There is a lot of evidence associated with the psychological, physical and emotional implications associated with heart failure in patients. In addition, the family of cardiovascular patients who have the responsibility to take care of them also have many problems (13). Positive psychology is a new advent approach in psychology that addresses the happiness and well-being of individuals. This approach tries to use people's abilities and capacities to increase people's lives in the face of events and disadvantages, and increase their satisfaction with life (31). In recent years, the fields of preventive cardiology and positive psychology have both set ambitious goals that go beyond simply reducing risk of disease to include increasing healthy longevity, improving quality of life, preserving good mental health (32). The relationship of mindfulness with the pathological variables such as stress and health variables like adjustment ability  and  emotional  functioning,psychological  well-being, and   emotional, psychological  and social  wellbeing  have been  well illustrated. Other variables that are significant in the field of health and positive psychology are the concept of happiness tha  is  composed  of  cognitive  and  emotional  components (31). Happiness promotes activity and initiative, but no indication for negative effects on creativity. Last but not least, happiness is positive for health; happy people live longer (33). and Hope increases the ability to cope with problems. Hope is an important adaptation mechanism in chronic diseases including cardiovascular disease (10). Mindfulness reduces negative thoughts and increases mental and physical health (16). Mindfulness means maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment, through a gentle, nurturing lens (14). Mindfulness training, which are more concerned with the development of focus attention., could be associated with significant improvements in selective and executive attention. This mental state allows one to experience thoughts and feelings in a way that emphasizes their subjectivity and transient nature. Mindfulness has been associated with increased health outcomes. Mindfulness therapy and medical care together are effective methods for treating cardiovascular patients. According to recent research, mindfulness, reduces physical problems and psychological disorders and increases happiness, hope and quality of life (12, 10). Recently, due  to  the  development  of  chronic  physical  and psychological  disorders  the  mindfulness  and  lifestyle  have been  drawn  into  attention.  But there are few  empirical research  on  these  subjects  and  most  research  has  been performed on recognition of the therapeutic effects of mind-consciousness. Therefore, The purpose of this study was to determine the effectiveness of mindfulness on stress, happiness and Hope in cardiovascular patients.  Methods: According to the purpose, this study is applied. In this study which was a Quasi-Experimental with per-test, post-test with the control group, the sample group was selected by available sampling method from all cardiovascular patients referred to Shahid Rajaei Heart Hospital and Shariati Hospital in Karaj. Therefore, 40 cardiovascular patients were chosen and assigned to Experimental and control groups. To assess the severity of Stress, Dass-21 test was used, happiness Oxford OHI and Hope was measured by Snyder Hope Questionnaire. The experimental group received 10 90-minute mindfulness training sessions. After training, Dass-21, Oxford OHI and Snyder Hope were used again for both experimental and control groups. Results: Data were analyzed by SPSS 22 and the results of ANCOVA showed that There was a significant difference between groups regarding stress, happiness and Hope. Mindfulness has been able to reduce stress, and increase happiness and Hope of participants in the experimental group. According to the results, 72.2% of stress changes, 72% of happiness changes and 86% of Hope changes in the experimental group were related to the impact of mindfulness The results showed that mindfulness training has been effective in reducing stress mindfulness, improving happiness and Hope in cardiovascular patients. Conclusion: The results showed that mindfulness training has been effective in reducing stress, improving happiness and Hope in cardiovascular patients. mindfulness meditation techniques as they are empowering and teach skills individuals can use on their own to control depression and other health problems. It has been associated with enhanced emotional regulation It can be defined as bringing non-evaluative awareness to one’s inner and outer environment and then focusing attention on a limited range of experience (29). Mindfulness training focuses on attention to moment-by-moment experience and consists of routine exercises such as bringing the mind’s attention to the present (for example, by focusing attention on one’s breathing or on what one is eating). These techniques are seen as ideal training to improve self-control, perhaps because most of the exercises focus on training the ability to inhibit one’s impulses (34). mindfulness may decrease stress and mood dysfunction-related psycho physiologic activation by strengthening positive reappraisal and emotion regulation skills. Mindfulness has helped patients to understand the events without distortion and judgment. Mindfulness, in    general, through    ultra-consciousness, delaying conceptual processing and separating a  person from cognitive events can be effective in improving lifestyle (22).  Happiness through better assessment of individual skills and  more  positive  life  events  than  negative  events, interpersonal  skills,  Optimism,  hope  and  a  positive  look  at life  can  motivate  and  empower  people  to  lead  a  healthier lifestyle,  better  manage  stress  and  a  sense  of  responsibility for health (31). Joyful people usually evaluate their skills better than others and remind positive events more than negative ones and make better decisions in their life In   other words,  mind-consciousness  can  create  positive  changes  in happiness and psychological well-being. Therefore, Mindfulness can improve cardiovascular Patients stress, happiness and Hope.   ذهن آگاهی, استرس, شادکامی, امید به زندگی, بیماران قلبی-عروقی Mindfulness, Stress, Happiness, Hope, Cardiovascular Patients 19 30 http://rjms.iums.ac.ir/browse.php?a_code=A-10-4917-1&slc_lang=fa&sid=1 Mona Alipour Shahir مونا علیپور شهیر monaalipourshahir@gmail.com 3900319475328460057596 3900319475328460057596 Yes Islamic Azad University Malard Branch, Tehran, Iran دانشگاه آزاد ملارد Atena Esfahani Khaleghi آتنا اصفهانی خالقی Atena_esfahani_khaleghi@yahoo.com 3900319475328460057597 3900319475328460057597 No Islamic Azad University Malard Branch, Tehran, Iran دانشگاه آزاد اسلامی واحد ملارد، تهران، ایران Mehdi Arabzadeh مهدی عرب زاده mehdi_arabzadeh@hotmail.com 3900319475328460057598 3900319475328460057598 No Islamic Azad University Malard Branch, Tehran, Iran دانشگاه خوارزمی تهران، ایران Bahareh Alipour Shahir بهاره علیپور شهیر alipourshahir.b@gmail.com 3900319475328460057599 3900319475328460057599 No Islamic Azad University Malard Branch, Tehran, Iran دانشگاه آزاد اسلامی،تهران، ایران