Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1399
5
1
gregorian
2020
8
1
27
6
online
1
fulltext
fa
مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و روانشناسی مثبتنگر بر نشخوار فکری زنان مبتلا آرتریت روماتوئید
Comparison of the effectiveness of acceptance and commitment therapy and positive psychology on rumination in women with rheumatoid arthritis
روماتولوژی
Rheumatology
پژوهشي
Research
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">زمینه و هدف:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">آرتریت روماتوئید یک بیماری خود ایمنی ناتوان کننده است و مزمن بودن این بیماری بر روی متغیرهای جسمانی و روانشناختی این بیماران اثرات بسیار وسیعی می­گذارد. پژوهش حاضر مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و روانشناسی مثبت­نگر بر نشخوار فکری زنان مبتلا آرتریت روماتوئید بود. </span></span></span><br>
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">روش کار:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">روش پژوهش نیمه آزمایشی با طرح پیش­آزمون و پس­آزمون با گروه گواه بود. جامعه آماری پژوهش شامل کلیه زنان مبتلا به آرتریت روماتوئید شهر خرم­آباد بودند که با استفاده روش نمونه­گیری در دسترس 60 نفر انتخاب و به صورت تصادفی در سه گروه آزمایشی 1 ( درمان اکت)، گروه آزمایشی 2 (روانشناسی مثبت­نگر)، و گروه گواه (هر گروه 20 نفر) جایگزین شدند. در شرایط یکسان و همزمان، پیش­آزمون با پرسشنامه نشخوار فکری از هر سه گروه به عمل آمد. گروه­های آزمایشی تحت درمان پذیرش و تعهد و رواشناسی مثبت­نگر (8 جلسه 90 دقیقه­ای) قرار گرفتند، اما گروه گواه هیج­گونه درمانی دریافت نکردند. سپس پس­آزمون از هر سه گروه به عمل آمد. </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><br>
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">یافته­ ها:</span></span></span></strong><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> نتایج نشان داد که درمان اکت و مثبت­نگر باعث کاهش نشخوار فکری بیماران گردید (05/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p<</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">)، آزمون تعقیبی بونفرونی نشان داد درمان پذیرش و تعهد در نشخوارفکری کلی و مولفه حواس پرتی دارای تاثیر بیشتری بود. </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><br>
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">نتیجه­ گیری:</span></span></span></strong><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> براساس نتایج به دست­آمده می­توان گفت، درمان پذیرش و تعهد و روانشناسی مثبت­نگر باعث کاهش نشخوار فکری در زنان مبتلا به آرتریت روماتوئید شده و درمان پذیرش و تعهد اثربخشی بیشتری داشت. لذا از این درمان­ها در کنار درمان پزشکی برای بهبود حال این بیماران می­توان استفاده کرد.</span></span></span>
<strong>Background and Aims:</strong> Rheumatoid arthritis is a debilitating autoimmune disease and the chronicity of this disease has a very large effect on the physical and psychological variables of these patients. The prevalence of this disease is estimated to be 0.5 to 2.4%, which is two to three times more common in women It is from men. The prevalence of this disease increases with age and the difference in sexual prevalence decreases with age. This disease causes progressive damage to the musculoskeletal system and leads to irreversible pain and destruction of bone and cartilage, which have different reactions. Ruminant is one of the problems that patients with rheumatoid arthritis are involved with and rumination is a significant predictor of depression in these patients. Ruminant thought is a repetitive thought and is a cognitive process that greatly increases the risk of developing symptoms of psychopathology. The aim of the present study was to compare the effectiveness of acceptance and commitment-based therapy and positive psychology on rumination in women with rheumatoid arthritis.<br>
<strong>Methods: </strong>The research method was quasi-experimental with pre-test and post-test design with control group. The statistical population of the study included all women with rheumatoid arthritis in Khorramabad in 2019 who used the sampling method: The statistical population of the study included all women with rheumatoid arthritis in Khorramabad in 2019. Using the sampling method: 60 people were selected and randomly divided into three experimental groups 1 (act therapy), experimental group 2 (positive psychology), and the control group (20 people in each group) was replaced. Under the same conditions, the pretest was performed with a rumination questionnaire from all three groups. The experimental groups were treated with acceptance and commitment (group 1) and positive psychology (group 2) in 8 sessions of 90 minutes, but the control group did not receive any treatment. Then post-test was performed from all three groups. Data were analyzed by descriptive and inferential methods. Multivariate analysis of covariance, univariate analysis of covariance and Bonferroni post hoc test were used in descriptive statistics of frequency, percentage, mean and standard deviation and in inferential statistics. Data were analyzed by SPSS-24 statistical analysis software.<br>
<strong>Results: </strong>The results showed that both acceptance and commitment-based treatments and positive treatment reduced rumination in women with rheumatoid arthritis and there was a significant decrease between the mean rumination in pre-test and post-test in the two experimental groups. Using analysis of covariance, it was found that this decrease was statistically significant (p <0.05). In order to evaluate which treatment method was more effective, Bonferroni post hoc test was used, which showed that the treatment of acceptance and commitment was more effective in general rumination and distraction component. However, no significant difference was observed between the two experimental groups in the components of meditation and meditation.<br>
<strong>Conclusion:</strong> Based on the obtained results, it can be said that the treatment of acceptance and commitment and positive psychology reduces rumination in women with rheumatoid arthritis and the treatment of acceptance and commitment was more effective. The results of the present study were compared with similar and consistent results that the results of these studies indicated the effectiveness of any treatment based on acceptance and commitment on rumination and variables such as: depression, anxiety, stress and anxiety. The effectiveness of acceptance and commitment therapy can be explained by the processes that govern it; Thus, the component of desire and acceptance allows the person to accept unpleasant inner experiences without trying to control them, and doing so makes those experiences seem less threatening and have less impact on the person's life. This skill helps the person to consciously turn her attention to what is most useful and therefore helps the person to pass tempting thoughts through the mind and guide her mind towards a higher goal. Also, the practice of suppressing thinking in acceptance and commitment therapy, which is especially for people with rumination, helps therapists to get rid of annoying rumination or cognitive cognitions. No research has been done on the effectiveness of positive treatment on rumination, but research background shows that positive treatment has been effective on issues such as depression and stress. One of the components of positive psychology that affects rumination is the cognitive level of individuals and the effort to achieve positive emotions and happiness. In this study, based on the goals of positive psychology, an attempt was made to emphasize positive emotions, positive characteristics of people and their abilities and virtues, and people were encouraged to pay special attention to positive emotions and try to prevent emotions. Negatives increase the amount of positive emotions in their lives, because according to the falsification hypothesis, positive emotions also have the capacity to neutralize or nullify long negative emotions. On the other hand, people learn with this approach to be flexible and try to take steps to solve weaknesses by not focusing on weaknesses. Therefore, due to the effectiveness of treatment based on acceptance and commitment and positive treatment on rumination in women with rheumatoid arthritis, these treatments can be used along with medical treatment to improve the condition of these patients.<br>
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کلید واژهها: درمان, پذیرش و تعهد, روانشناسی مثبتنگر , نشخوار فکری, آرتریت روماتوئید, زنان
Treatment, Acceptance and Commitment, Positive Psychology, Ruminant, Rheumatoid Arthritis, Women
75
89
http://rjms.iums.ac.ir/browse.php?a_code=A-10-5105-1&slc_lang=fa&sid=1
zahraZahra
Mordai
زهرا
مرادی
zahramoradi1214@gmail.com
3900319475328460053919
3900319475328460053919
No
university tehran
دانشگاه تهران
Masoud
Sadeghi
مسعود
صادقی
sadeghi.m@lu.ac.ir
3900319475328460053920
3900319475328460053920
Yes
Faculty of Literature and Humanities, Lorestan University, Khorramabad, Iran
دانشکده ادبیات و علوم انسانی، دانشگاه لرستان، خرمآباد، ایران