Razi Journal of Medical Sciences

fa اثربخشی درمان پذیرش و تعهد بر حساسیت بین فردی بیماران اولسراتیو کولیتیس Effectiveness of Acceptance and Commitment Therapy on Interpersonal Sensitivity in Patients with Ulcerative Colitis روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: بیماری‌های التهابی روده شرایطی مادام‌العمر هستند که بیمار را نه تنها از نظر شکایات جسمی به چالش می‌کشند بلکه بر مسائل روانی– اجتماعی نیز اثر میگذارند. هدف از انجام پژوهش حاضر اثربخشی درمان مبتنی بر پذیرش و تعهد بر حساسیت بین فردی بیماران اولسراتیو کولیتیس بود. روش کار: برای انجام پژوهش نیمه آزمایشی حاضر که با طرح پیش‌آزمون- پس‌آزمون با گروه کنترل انجام شد از بین افراد مبتلا به اولسراتیو کولیتیس در سال 1400 با روش نمونهگیری هدفمند، 24 نفر با رعایت معیارهای ورود و خروج به مطالعه انتخاب و به صورت تصادفی به دو گروه درمان مبتنی بر پذیرش و تعهد و کنترل تقسیم شدند. بعد از تکمیل فرم رضایتنامه و گردآوری دادهها در پیش‌آزمون با استفاده از پرسشنامه بایس و پارکر (1989)، گروه آزمایش 8 جلسه 90 دقیقهای در معرض درمان مبتنی بر پذیرش و تعهد قرار گرفت اما گروه کنترل درمانی را دریافت نکرد. پس از مداخله و دو ماه بعد مجدداً پرسشنامه توزیع و جمعآوری شد. نهایتاً دادهها با استفاده از نرم‌افزار SPSS23 و آزمون تحلیل کواریانس چند متغیری و تحلیل واریانس با اندازهگیری مکرر تجزیه و تحلیل شدند. یافته‌ها: نتایج نشان داد که درمان مبتنی بر پذیرش و تعهد باعث کاهش حساسیت بین فردی بیماران اولسراتیو کولیتیس شد. نتیجه گیری: با توجه به نتایج استفاده از این مداخلات برای بهبود حساسیت بین فردی این بیماران پیشنهاد میشود. Background & Aims: Inflammatory bowel disease, including ulcerative colitis (UC) and Crohn's disease (CD), is a chronic debilitating condition characterized by an unpredictable period of flare-ups and periods of recovery that often affect people. And require lifelong follow-up and medical treatment (1). UC is characterized by diarrhea, severe cramps, and weight loss (3). Due to the bad consequences of this disease on individual and social life, various methods such as anti-inflammatory and immunosuppressive drugs such as aminosalicylates, corticosteroids, anti-tumor necrosis agents, dolizumab, sticnomab and tonacitinib are used to control the disease. (3). In general, inflammatory bowel diseases not only affect the patient in terms of physical complaints, but also challenge psychosocial issues, which necessitates the need for psychotherapy (12). One of the third wave therapies that has recently been widely used in physical and psychological health problems is commitment-based therapy, which has six central processes: acceptance, failure, self as context, communication with the present., Values and practice are committed. Mindfulness based on acceptance and commitment to manage inner experiences teaches us effective skills of mindfulness (13). For years, the main end point of IBD treatment was recovery and clinical response, followed by normalization of biomarkers and improvement of mucosa. In this regard, in recent decades, different therapies have been proven to be effective in treating IBD and the outcome reported by the patient (PRO) has made it more relevant (1). Considering the above and the negative impact of ulcerative colitis on the one hand and the role of treatment based on acceptance and commitment on the other hand, it is necessary to review the research conducted in the country and abroad so far. No individual has been performed in patients with ulcerative colitis. Research has been done on the psychological factors of other patients and the results have been contradictory, so the researcher seeks to answer the question of whether acceptance and commitment-based therapy has an effect on interpersonal sensitivity in patients with ulcerative colitis. Methods: The present study was a quasi-experimental with a pretest-posttest design with a control group. The statistical population of this study consisted of men and women with ulcerative colitis referred to Sari and Amol clinics in 1400. 24 people were selected as a sample by purposive sampling method and by observing the entry and exit criteria. They were randomly divided into two groups based on acceptance, commitment and control. After completing the consent form and the interpersonal sensitivity questionnaire of Bayes and Parker (1989) in the pre-test, the experimental group received 8 sessions (90 minutes each session) of acceptance and commitment based treatment once a week (8) according to the table. 1 were trained and the control group waited for treatment. Also, immediately after the intervention and after 2 months, the questionnaire was completed again by all subjects. Finally, descriptive statistics, Shapiro-Wilk tests, multivariate analysis of covariance, repeated measures analysis of variance and Bonferroni post hoc using SPSS software version 23 were used for statistical analysis. Results: The results showed that there was a difference between the two groups (Eta=0.504, p = 0.001, F = 21.21 (21, 1) F). In other words, there is a significant difference between the interpersonal sensitivity of the experimental group and the control group. The Eta size indicates that 50.4% of the improvement in interpersonal sensitivity of the subjects in the experimental group can be attributed to the effect of acceptance and commitment-based therapy. According to Table 3, there is a significant difference between the three stages of the values of interpersonal sensitivity variables (P <0.05), which indicates that the amount of interpersonal sensitivity variables during the three stages of pre-test, post-test and follow-up is different. Also, the results of pairwise comparisons showed that there was a significant difference between the adjusted means of the interpersonal sensitivity variable in the pre-test and post-test (P <0.001). Also, there was a significant difference between the adjusted means of the interpersonal sensitivity variable in the pre-test and follow-up stages (P <0.001). Also, there was no significant difference between the adjusted means of the interpersonal sensitivity variable in the post-test and follow-up stages (P <0.05). Therefore, it can be concluded that treatment based on acceptance and commitment has had an effect on patients' interpersonal sensitivity and the effects of treatment have remained in the follow-up stage. Conclusion: The aim of this study was to evaluate the effectiveness of acceptance and commitment therapy on interpersonal susceptibility of patients with ulcerative colitis. It was also found that in the post-test phase, there was a significant difference between the interpersonal sensitivity of the experimental and control groups and the effects of treatment were stable in the follow-up phase. In explaining these findings, it can be said that one of the things that is emphasized in the treatment of acceptance and commitment is evaluation. Evaluation is the application of a comparative relation to two or more verbal events. Unlike comparisons made by other beings, all of which are based on experience, evaluation for humans can be based entirely on verbal events that have never been experienced (21). Since non-evaluation and acceptance are among the goals of treatment in this treatment, it can be said that patients who receive this treatment learn to avoid evaluation and comparison, life events and people who are with them. Relate the relationship without judgment and accept it without evaluation, all of which can improve non-judgmental attitudes in these people and these people are less affected by negative thoughts related to interpersonal problems and have a more receptive attitude to people. All of this leads to less interpersonal sensitivity. Patients accept their mentality and being in the present and consciously instead of avoiding experiences and realities, and commit to expressing the right way of expressing their individuality and value (23) and this is the same flexibility. ذ is psychological receptivity. It seems that mental flexibility can free the individual from the trap of dysfunctional thoughts that lead to incompatibility in relationships and increase the development of interpersonal skills and constructive interactions; Thus, those who received this training can perform techniques such as mindfulness in this treatment by reducing the severity of the dysfunctional thoughts involved in interpersonal problems as well as adhering to the inner values that ¬ Can be a link between social relationships, improve their tolerance level and show less interpersonal sensitivity.   درمان مبتنی بر پذیرش و تعهد, حساسیت بین فردی, اولسراتیو کولیتیس Acceptance and Commitment Therapy, Interpersonal Sensitivity, Ulcerative Colitis 169 177 http://rjms.iums.ac.ir/browse.php?a_code=A-10-6477-1&slc_lang=fa&sid=1 Maryam Mahdavi مریم مهدوی 3900319475328460068101 3900319475328460068101 No Department of Psychology, Sari Branch, Islamic Azad University, Sari, Iran دانشجوی دکترای، روانشناسی، واحد ساری، دانشگاه آزاد اسلامی، ساری، ایرا Seyedeh Olia Emadian سیده علیا عمادیان emadian2012@yahoo.com 3900319475328460068102 3900319475328460068102 Yes Assistant professor, Department of Psychology, Sari Branch, Islamic Azad University, Sari, Iran استادیار، گروه روانشناسی، واحد ساری، دانشگاه آزاد اسلامی، ساری، ایران Ramazan Hassanzadeh رمضان حسن زاده 3900319475328460068103 3900319475328460068103 No Professor, Department of Psychology, Sari Branch, Islamic Azad University, Sari, Iran استاد، گروه روانشناسی، واحد ساری، دانشگاه آزاد اسلامی، ساری، ایران