Razi Journal of Medical Sciences

fa مقایسه‌ی اثربخشی درمان شفقت به خود و روان درمانی مثبت نگر بر معنای زندگی، امید به زندگی و رفتارهای خودمراقبتی در بیماران مبتلا به دیابت نوع 2 Comparison of the Effectiveness of Self-Compassion Therapy and Positivist Group Therapy on the Meaning of Life, Life expectancy, and Self-Care Behaviors in Patients with Type Two Diabetes روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: بیماری دیابت نوع 2، بر خلق و خوی بیماران اثر منفی دارد و برای افزایش امید به زندگی این بیماران، راهکارهای روان درمانی بسیاری وجود دارد، بنابراین پژوهش حاضر با هدف مقایسهی اثربخشی درمان شفقت به خود و گروه درمانی مثبت‌نگر بر معنای زندگی، امید به زندگی و رفتارهای خودمراقبتی در بیماران مبتلا به دیابت نوع 2 انجام گرفت. روش کار: روش پژوهش حاضر نیمه آزمایشی بود. جامعه آماری پژوهش را کلّیهی بیماران مبتلا به دیابت نوع 2 شهر بوشهر در سال 1399 تشکیل می‌دادند که با روش نمونه&rlm;گیری در دسترس از بین آن‌ها 45 نفر انتخاب گردیده و به&rlm;طور تصادفی در 2 ﮔﺮوه آزمایش (هر گروه 15 نفر) و 1 گروه کنترل (15 نفر) جایگزین شدند. به یک گروه آزمایش، 8 جلسه برنامه‌ی درمانی شفقت به خود و به گروه آزمایش دوم 6 جلسه رواندرمانی مثبتنگر آموزش داده شد. برای جمعآوری دادهها از پرسشنامههای معنای زندگی استگر و همکاران (2006)، امید به زندگی هرث (1992) و رفتارهای خودمراقبتی دیابت توبرت، هامپسون و گلاسکو (2000) استفاده شد. دادهها از طریق آزمون آماری تحلیل کوواریانس چندمتغیری و آزمون تعقیبی بونفرونی مورد تجزیه و تحلیل قرار گرفتند.  یافته ها: یافته&rlm;ها نشان داد که هر دو برنامه درمانی شفقت به خود و رواندرمانی مثبتنگر موجب افزایش معنای زندگی، امید به زندگی و رفتارهای خودمراقبتی در بیماران مبتلا به دیابت نوع 2 میگردد (05/0>P). نتیجه گیری: با توجه به این نتایج می‌توان بیان نمود که استفاده از درمان شفقت به خود و روان درمانی مثبت‌نگر می&rlm;تواند قابل کاربرد برای متخصصین در جهت بهبود شرایط بیماران مبتلا به دیابت نوع 2 باشد. Background & Aims: Chronic diseases such as diabetes have a complex origin, slow onset, and unpredictable deterioration and recovery that requires self-care due to the long process. Diabetes, especially type 2 diabetes, is one of the major threats to human health in the 21st century. This disease is one of the global problems and the main cause of death and disability. Uncontrolled diabetes often leads to complications such as heart disease, stroke, high blood pressure, blindness, kidney disease, and amputation. Despite the cost of preventing and controlling diabetes, the number of patients is increasing every day, which seems to be a weakness in the psychological and self-care variables of these patients. Diabetes is at the heart of behavioral issues and psychological factors. And society plays a vital role in its management. Therefore, the study of psychological factors affecting this disease can be effective in controlling it. One of the most important psychological factors associated with diabetes that has been considered by researchers is the meaning of life. The meaning of life deals with the category of purpose or goals of human life in this world. A goal is a location and time that the person or other creature is looking for. Having a goal and using it among people helps them to seek the meaning of life in life. Research shows that there is a significant relationship between low hope and depressive symptoms. One of the effective treatments for people with chronic diseases is self-care. In this treatment, instead of focusing on changing people's self-esteem, people's relationship with their self-esteem changes. Self-improvement exercises emphasize relaxation, calm mind, self-compassion, and mindfulness, which will play an important role in calming the mind, reducing stress and negative spontaneous thoughts. In addition, compassion-focused therapy helps reduce clients' psychological problems by increasing internal awareness, acceptance without judgment, empathy, and constant attention to inner feelings. The effectiveness of this therapeutic approach on improving coping with stressful situations and reducing self-criticism, self-destructive thoughts, and rumination in patients has also been confirmed. Another therapeutic approach used for patients is positivist group therapy. Comparing different therapeutic interventions and finally choosing the best type of intervention based on the research results can be helpful. Among these, according to studies, the therapeutic approaches in the present study, ie positive psychotherapy due to focus on strengths and abilities on the one hand and compassion-focused treatment due to creating a sense of responsibility and self-worth on the other hand, can be effective in the field that for more certainty and to determine a stronger type of intervention in the present study, we seek to compare these interventions. In general, the results of this study can be used both theoretically and practically in medical science health centers, diabetes research centers, doctors, psychiatrists and psychologists, and scientific research centers such as universities. Methods: The method of the present study was quasi-experimental with pre-test-post-test design with control and follow-up groups. The statistical population of the study consisted of all patients with type 2 diabetes in Bushehr in 1399, from which 45 people were selected by available sampling method and randomly in two experimental areas (15 people in each group) and The control group (15 people) was replaced. One experimental group was taught 8 sessions of the self-compassion therapy program and the second experimental group was taught 6 sessions of positive psychotherapy. The data collection included the meaning of life questionnaires of Steger et al. (2006), Hurts life expectancy (1992), and self-care behaviors of Diabetes Tobert, Hampson, and Glasgow (2000). Data were analyzed by multivariate analysis of covariance and Bonferroni post hoc test. Results: The results showed that both self-compassion and positive psychotherapy treatment programs increase the meaning of life, life expectancy, and self-care behaviors in patients with type 2 diabetes (P<0.05). Conclusion: The results showed that both treatments cause significant changes in the meaning of life, life expectancy, and self-care behaviors in patients with type 2 diabetes in the post-test and follow-up period and differ in the effectiveness of both. There is no intervention type. In other words, both types of treatment are beneficial for patients with diabetes. The findings will be explained below: The first finding of the study showed that both treatments increased the meaning of life in patients in the experimental groups. In this regard, it can be said that compassion itself has appropriate coping resources that help people to face the negative events of their lives. Self-compassion enhances the ability to interact with others and provides a clearer quality of dealing with emotions. Therefore, it can be said that injured people, by learning new sources of coping, can effectively and efficiently deal with the negative events of their lives and show good adaptation. Self-compassion is one of the most important components of mental health and has capabilities that people can achieve happiness and psychological well-being by learning and performing related skills. The second finding of the study showed that both treatments increased the life expectancy of patients in the experimental group. In the present explanation, it can be stated that although the presence of illness causes major psychological damage to the individual, but in the meantime, self-compassion training can act as a motivating force for the individual. Compassion in itself leads to increased social communication and reduced self-criticism, reduced rumination, reduced thought suppression, anxiety, and stress, as well as psychological balance, all of which play a key role in increasing their life expectancy. Thus, flexibility in thoughts and kindness to oneself causes people to have a realistic judgment about themselves, to analyze their functional shortcomings, and to make appropriate decisions to address them. The third finding of the study also showed that there was a significant difference between the self-care behaviors of patients in the experimental and control groups. In the present explanation, it can be stated that negative ideas and attitudes about themselves are the main part of the change, and through the treatment of compassion, individuals learn to apply new experiences that this It promotes ideas such as alternative and more adaptive burdens; adaptive adaptation to unpleasant events such as chronic illness by focusing on assessing that situation increases patients' ability to make new connections. See ideas, organize information, integrate, and come up with new solutions to problems. In other words, increasing self-compassion leads to more self-care.   درمان شفقت به خود, گروه درمانی مثبت‌نگر, معنای زندگی, امید به زندگی, رفتارهای خودمراقبتی Self-compassion therapy, Positivist group therapy, The meaning of life, Life expectancy, Self-care behaviors, Patients, Diabetes 86 99 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5627-2&slc_lang=fa&sid=1 Shahin Afsharpoor شاهین افشارپور 3900319475328460069617 3900319475328460069617 No PhD Student of General Psychology, Department of General Psychology, Bushehr Branch, Islamic Azad University, Bushehr, Iran دانشجوی دکتری، گروه روانشناسی عمومی، واحد بوشهر، دانشگاه آزاد اسلامی، بوشهر، ایران Ali Pouladi Reyshahri علی پولادی ریشهری alipoladei@yahoo.com 3900319475328460069618 3900319475328460069618 Yes Assistant Professor, Department of General Psychology, Bushehr Branch, Islamic Azad University, Bushehr, Iran; Payam Noor Bushehr University استادیار، گروه روانشناسی عمومی، واحد بوشهر، دانشگاه آزاد اسلامی، بوشهر، ایران؛ دانشگاه پیام نور، بوشهر، ایران Moloud Keykhosrovani مولود کیخسروانی moloud.keykhosrovani@gmail.com 3900319475328460069619 3900319475328460069619 No Assistant Professor, Department of General Psychology, Bushehr Branch, Islamic Azad University, Bushehr, Iran استادیار، گروه روانشناسی عمومی، واحد بوشهر، دانشگاه آزاد اسلامی، بوشهر، ایران Kamran Ganji کامران گنجی 3900319475328460069620 3900319475328460069620 No Associate Professor, Department of Educational Psychology, Malayer Branch, Islamic Azad University, malayer, Iran دانشیار، گروه روانشناسی تربیتی، واحد ملایر، دانشگاه آزاد اسلامی، ملایر، ایران