Razi Journal of Medical Sciences

fa اثردرمان شناختی رفتاری در کاهش افکار اضطرابی و امید به زندگی در زنان مبتلا به ام اس Effectiveness of Cognitive Behavioral Therapy in Reducing Anxiety Thoughts and Life Expectancy in Women with MS روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: ام اس از شایعترین بیماری‌های مزمن سیستم عصبی مرکزی است. این بیماری باعث ایجاد اختلالات روانی متعددی در  افراد می‌گردد که در میان آن‌ها افکار اضطرابی و عدم امید به زندگی از شیوع بالایی برخوردار است. پژوهش حاضر با هدف اثر درمان شناختی رفتاری در کاهش افکار اضطرابی و امید به زندگی در زنان مبتلا به ام اس در شهر تهران انجام گرفته است. روش کار: پژوهش حاضر، از نوع پژوهش‌های نیمه آزمایشی با طرح پیش‌آزمون - پس‌آزمون و پیگیری با گروه کنترل و با استفاده از انتخاب آزمودنی‌ها در گروه‌های آزمایشی و کنترل است. جامعه آماری پژوهش حاضر را تمامی زنان مبتلا به ام اس عضو انجمن ام اس عضو شهر تهران را   تشکیل دادند. نمونه پژوهش حاضر به تعداد ۳۰ نفر به روش نمونه گیری هدفمند انتخاب شدند و به شیوه گمارش تصادفی در دو گروه آزمایش (15 نفر) و گواه (15 نفر) قرار گرفتند. گروه آزمایش به مدت 8 جلسه 1 و نیم ساعته در معرض درمان شناختی-رفتاری قرار گرفتند و برای گروه کنترل هیچ گونه مداخله ای انجام نگرفت. ابزار پژوهش شامل مقیاس امید اشنایدر و همکاران (1991)،   و مقیاس افکار اضطرابی ولز (1994) بود. در این پژوهش از تحلیل کواریانس چند متغیری و تک متغیری، تحلیل واریانس با اندازه گیری مکرر استفاده شده است. یافته‌ها: یافته نشان میدهد که فرضیههای پژوهش مبنی بر اثربخشی درمان شناختی-رفتاری در کاهش افکار اضطرابی در زنان مبتلا به ام اس و اثربخشی درمان شناختی-رفتاری بر افزایش امید به زندگی در زنان مبتلا به ام اس  تأیید شده است. نتیجه‌گیری: نتایج نشان داد اثردرمان شناختی رفتاری در کاهش افکار اضطرابی و امید به زندگی در زنان مبتلا به ام اس در شهر تهران بود. (001/0).وبه نقش و اثردرمان شناختی رفتاری در کاهش افکار اضطرابی و امید به زندگی در زنان مبتلا به ام اس تاکید شد.</div> <div style="text-align: justify;">Background & Aims: Multiple Sclerosis or MS is one of the most common chronic diseases of the central nervous system, which causes physical changes in the body and limits the performance of patients. Multiple sclerosis or M. S. is one of the most common degenerative diseases of the central nervous system, which leads to this disease being the most common cause of disability in adolescents. This disease leads to many mental disorders in people, among which anxiety thoughts and lack of hope for life and future are more than other negative consequences of this disease. Also, among the complications of this disease, it can be mentioned that the person's performance drops, which affects the way patients play their personal and social roles in their lives. On the other hand, research results show that patients with chronic debilitating diseases such as MS also face other specific problems related to their disease. These problems increase secondary complications and limit independent life and have negative and destructive consequences on patients' lives. This disease and similar chronic debilitating diseases lead to a decrease in the quality of life of patients and create a background for their depression. Depression in these patients generally appears with aggression, irritability, anxiety, sociability, and specific reluctance. Depression is a motivating factor for the deterioration of the patients' disease, and the presence of depression in these people causes biological changes for the patients. Depression in these patients is accompanied by chronic fatigue, reduced quality of life and reduced results of drug treatments. Therefore, knowing the factors related to depression in these patients is one of the most important mental health factors and a productive factor in the disease process. On the other hand, research results show that the prevalence of MS in women is much higher than in men. Research results show that the prevalence of MS in women is 2 to 3 times higher than in men, and this rate is in the age range of 20 to 40 years. Life expectancy is one of the key indicators of human development, which is influenced by factors such as income, education, health and nutrition, and can help patients with chronic and debilitating diseases such as MS in better treatment of their disease. Therefore, the aim of this research is to investigate the effect of cognitive behavioral therapy in reducing anxiety thoughts and life expectancy of women with MS living in Tehran. Methods: The current research can be classified from different dimensions. This research is a semi-experimental type with a pre-test-post-test design and follow-up with a control group and using the selection of test and control group subjects. The method of collecting information was library (using books, theses, publications, reliable internet sites, using information) and the method of collecting information was field and questionnaire. The statistical population of the current study includes all women with MS living in Tehran who are members of the MS Association of this city. The sample of the present study was based on the purposeful sampling method and included 30 people with this disease who were randomly divided into two experimental groups including 15 respondents and 15 controls. The collected data are related to the year 2019. The experimental group underwent cognitive-behavioral therapy for 8 1.5-hour sessions, which was not done for the control group. The current research tools include the hope scale of Schneider et al. (1991), which includes the THS Trait Hope Scale (1991), the CHS Children's Hope Scale (1993), the SHS State Hope Scale (1996), and the Wells Anxiety Thinking Scale (1994). Also, Wells' Anxious Thoughts Scale (1994) is a multidimensional tool for assessing worries. The content of this questionnaire was obtained from interviews with patients with generalized anxiety disorder and panic disorder. The analysis method in this research was based on multivariate and univariate covariance analysis as well as variance analysis with repeated measurements. Results: The results of the current research, which were obtained from different age groups; So that it includes 20% of the respondents in the age group of 20 to 30 years, 46.67% in the age group of 31 to 40 years, 20% in the age group of 41 to 50 years and 13.33% in the age group of 51 to 60 years. and also, 13.33% of subjects in the control group are in the age group of 20 to 30 years, 40% in the age group of 31 to 40 years, 20% in the age group of 41 to 50 years and 26.67% of the subjects in age group are 51 to 60 years old, it shows that the effect of cognitive behavioral therapy is effective in reducing anxiety thoughts and life expectancy in women with MS, a member of the Tehran MS Association, and cognitive behavioral therapy can reduce the negative and destructive consequences of MS. improve S in these patients. . heal and provide the basis for improving their quality of life. In other words, the application of cognitive-behavioral treatment methods based on cognitive strategies in challenging thoughts and inefficient cognitive and behavioral systems through skill training can be effective in improving the life expectancy of women with MS. Cognitive behavioral therapy with the mechanisms it brings is effective in reducing anxiety thoughts and increasing people's life expectancy. In fact, the key concept in the effectiveness of cognitive behavioral therapy and its more positive effectiveness than drug therapy is improving anxious thoughts and increasing life expectancy in accepting reality and responsibility for what has happened and the change that should occur. Although these people feel better by taking the drug due to the change in the chemical process related to brain neurotransmitters, they do not consider themselves responsible for this phenomenon. Also, tasks such as functional analysis, skill training and a feeling of mastery and empowerment are created in people, which are effective in increasing the motivation of treatment or at least continuity in treatment and avoiding irrelevant thoughts such as rumination. Therefore, it can be expected that cognitive-behavioral therapy has been able to increase the life expectancy of women with MS. The assumption of the normality of the distribution of the scores of the experimental and control groups in the variables of anxious thoughts, resilience and life expectancy according to the output results of the software, indicates the verifiability of the results. This means the normality of all data in the pre-test, post-test and follow-up comparison groups. Also, the non-significance of Levin's test in most cases, which is equal to (P<0.05), shows that the assumption of homogeneity of variances has been confirmed. Conclusion: The richness of the present study is that patients with MS. They are prone to other diseases in the field of psychology, which we call multifaceted. Institutions related to the affairs of these patients should always consider the consequences of this disease. Therefore, the results of this research show that patients with MS are more likely to suffer from depression, and suffering from depression along with chronic motion sickness, including MS, can overshadow these patients even more. and this affects the quality of life of these patients. Therefore, focusing on resilience and creating sparks of hope and motivation in these patients can increase their vigor and vitality and facilitate the path of disease control. </div> درمان شناختی رفتاری, افکار اضطرابی, امید به زندگی, زنان, ام اس Cognitive behavioral therapy, Anxious Thoughts, Life Expectancy, Women, MS 206 221 http://rjms.iums.ac.ir/browse.php?a_code=A-10-6552-1&slc_lang=fa&sid=1 Fatemeh Maghsoudloo فاطمه مقصودلو 3900319475328460074897 3900319475328460074897 No PhD Student, Psychology Department, Islamic Azad University, Zahedan,Iran دانشجوی دکتری تخصصی، گروه روانشناسی، واحد زاهدان، دانشگاه آزاد اسلامی، زاهدان، ایران Gholamreza Sanagouye Moharer غلامرضا ثناگوی محرز reza.sanagoo@gmail.com 3900319475328460074898 00000001699183 Yes Assistant Professor, Psychology Department, Islamic Azad University, Zahedan,Iran استادیار، گروه روانشناسی، واحد زاهدان، دانشگاه آزاد اسلامی، زاهدان، ایران Mahmoud Shirazi محمود شیرازی 3900319475328460074899 0000000291396607 No Associate Professor, Psychology Department, Sistan and Balouchestan Univeraity, Zahedan, Iran دانشیار، گروه روانشناسی، دانشگاه سیستان و بلوچستان، زاهدان، ایران