Razi Journal of Medical Sciences

fa تأثیر مقابله درمانگری بر استرس در زنان مبتلا به دیابت نوع 2 The Effect of Coping Therapy on Stress in Women with Type 2 Diabetes روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: دیابت یکی از بیماری‌های متابولیک و شایع است که علاوه بر هزینه‌های زیاد تأثیرات روانی بسزایی نیز بر جای می‌گذارد. هدف این پژوهش تعیین اثر بخشی مداخله مقابله درمانگری (CT) بر استرس در بیماران زن دیابتی نوع 2 بود. روش کار: این مطالعه یک طرح نیمه‌آزمایشی بود، که با طرح پیش‌آزمون-پس‌آزمون و پیگری در دو گروه آزمایش و کنترل اجرا شد. جامعه آماری شامل کلیه بیماران زن دیابتی نوع 2 مراجعه‌کننده به آزمایشگاه طبی رسالت واقع در شهر تهران بود، که به روش نمونه‌گیری در دسترس 23 نفر به صورت تصادفی در گروه آزمایش و کنترل گمارده شدند. برای جمع‌آوری داده‌ها از پرسشنامه استرس و تغییرات زندگی مک‌کابین 1991 استفاده گردید. برای تجزیه و تحلیل داده‌ها از تحلیل واریانس با اندازه‌گیری مکرر استفاده شد. یافته‌‌ها: نتایج حاصل از یافته‌های پژوهش حاضر نشان داد که مقابله درمانگری در کاهش میزان شاخص کلی استرس نسبت به گروه کنترل به طور معناداری مؤثر بوده است (01/0˂p)، و در میزان زیر مقیاس‌های استرس ناشی از فشارهای مالی، استرس ناشی از بیماری و پرستاری از اعضای خانواده نیز تفاوت معناداری بین گروه مقابله درمانگری و کنترل وجود دارد (04/0˂p)، (007/0˂p). نتیجه‌گیری: مطالعه نشان داد که مقابله درمانگری توانست نمره کل استرس و استرس ناشی از فشارهای مالی، استرس ناشی از بیماری و پرستاری از اعضای خانواده را در بیماران زن دیابتی نوع 2 کاهش دهد، بنابراین پیشنهاد می‌گردد از مقابله درمانگری برای کاهش استرس بیماران دیابتی استفاده گردد.   Background & Aims: Diabetes is one of the most common metabolic disorders in the world, which has been increasing at an alarming rate since the start of the 21st century, driven by health determinants (1). Characteristics of this medical disorder are hyperglycemia, impaired metabolism of carbohydrates, fats, and proteins accompanied by a complete defect or partial use of insulin in the body (2). According to the report of the World Health Organization, the report in 2016 was equal to 10.3% in the adult population of Iran, which was 9.6% for men and 11.1% for females (5). Approximately 4.2 million adults aged 20–79 years are estimated to die as a result of diabetes and its complications in 2019. This is equivalent to one death every eight seconds. Almost half (46.2%) of deaths associated with diabetes among the 20–79 years age group are in people under the age of 60 years- the working-age group. Globally, there are more deaths associated with diabetes in women (2.3 million) than in men (1.9 million) (7). On the other hand, about half of the cases of diabetes in the world are unknown, and annually more than 1 million people in the world and 38 thousand people in Iran die due to complications of diabetes (8). In Iran, as a developing country where people are transitioning from a rural and active lifestyle to an urban one, the incidence of diabetes is also increasing day by day. In fact, with the lifestyle of apartment living, the prevalence of fast food and low nutritional value, sedentary lifestyle, weight gain, environmental stress in Iran, diabetes statistics are increasing. Evidence shows that about 5.5 million people in Iran have diabetes and it is estimated that by 1404, one in seven Iranians will develop diabetes (9). Given that numerous studies have been conducted in the field of Cognitive Therapy in the field of health and diabetes, but so far, no research has been done before to evaluate the effectiveness of the approach of Cognitive (Coping Therapy) on stress in female patients with type 2 diabetes. Therefore, to estimate the validity of Coping therapy, it is necessary to do more research is needed. So, the purpose of this study is to investigate. The effectiveness of Coping Therapy was on stress in female patients with type 2 diabetes. Methods: The design of this research is a semi-experimental design with pre-test, post-test in an experimental group, and a control group with follow-up. in this research, intervention methods as an independent variable in two levels of intervention were based on Coping therapy and non-intervention and stress variables along with its 9 subscales were considered as dependent variables. The statistical population of this study consisted of all women with type 2 diabetes referred to Resalat Tehran Medical Laboratory and considering that the present study, among all diabetic patients, only to type 2 diabetic women referred to Resalat Tehran Medical Laboratory, for that reason study prototyping was available. Therefore, in this study, after public announcement through random phone calls among the patients of the Laboratory, while conducting an exclusive interview and obtaining written consent to participate in the study, among 35 women 35 to 65 years old volunteered and available, according to inclusion criteria: Willingness to cooperate with the project, age range 35 to 65 years, having type 2 diabetes, having diabetes for more than one year, higher education diploma, no pregnancy and lactation, no insulin use, no other physical illness (by visiting patients by a physician), no disabling psychological disorders (with a diagnostic interview by a clinical psychologist based on DSM-5), 30 persons in 2 groups of 15 were randomly selected and assigned as participants in two groups of CT and control, which for It is also desirable to predict the subject's decline. After the drop among subjects, this number reached 23 persons and considering that 4 persons from the Coping therapy group and 3 persons from the control group according to the exclusion criteria: insulin consumption, pregnancy, physical illness Other than diabetes, having psychological disorders, not attending two consecutive sessions, and reasons such as air pollution and relocation and refusing to participate in the study were excluded from the study. Therefore, intervention and data analysis were performed with 11 patients in the CT group and 12 patients in the control group. Candidates were assessed using the McCubbin Stress and Life Change Questionnaire as a pre-test. Intervention by a protocol of complete package of Coping Therapy by Aghayousefi 2001 (27), adapted from Lazarus and Folkman's 1984 theories of stress and coping (28), introduced and invented; and their effectiveness has been confirmed in Aqhayousefi's research (27, 29), used to manage stress. In the CT treatment program, the first session was devoted to the introduction of protocol, pre-test implementation, 1 month after the last session of post-test, and 3 months later to the follow-up test, and the subjects underwent Coping therapy for 8 weeks. Data analysis was performed by SPSS software version 24, and after examining the concepts of the test, the repeated measures analysis of variance test was increased. Results: Findings from changes in the scores of CT and control groups in stress variables and its 9 subscales showed that changes in total stress scores and stress subscales due to financial pressures and stress due to illness and nursing of family members in the treatment group compared to the control group is significant P<0.05. Therefore, therapeutic coping has been effective in reducing the overall stress index. The two subscales of financial pressures and stress caused by the disease and the difference were significant compared to the control group P<0.05. There were no significant differences between the other coping scales of treatment and control under stress scales (P>0.05). Conclusion: The study showed that Coping therapy was capable to reduce the overall stress score and lead to a reduction in stress subscales (stress due to financial pressures and disease stress). مقابله درمانگری, استرس,دیابت Coping Therapy (CT), Stress, Diabetes 41 52 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5474-2&slc_lang=fa&sid=1 Farzaneh Shajari فرزانه شجری 3900319475328460066494 3900319475328460066494 No PhD in Psychology, Department of Psychology, Saveh Branch, Islamic Azad University, Saveh, Iran دکترای روانشناسی، گروه روانشناسی، واحد ساوه، دانشگاه آزاد اسلامی، ساوه، ایران Alireza Aghayousefi علیرضا آقایوسفی arayeh1100@gmail.com 3900319475328460066495 3900319475328460066495 Yes : Associate Professor, Department of Psychology, Payame Noor University, Tehran, Iran, Invited Department of Psychology, Saveh Branch, Islamic Azad University, Saveh, Iran دانشیار، گروه روانشناسی دانشگاه پیام نور تهران، ایران، مدعو گروه روانشناسی، واحد ساوه، دانشگاه آزاد اسلامی، ساوه، ایران Mojgan Agahheris مژگان آگاه هریس 3900319475328460066496 3900319475328460066496 No Associate Professor Department of Psychology, Payame Noor University, Tehran, Iran دانشیار، گروه روانشناسی دانشگاه پیام نور تهران، ایران