پديد آورندگان :
رنجبري پور، طاهره دانشگاه آزاد اسلامي واحد كرج , واثقي، زهره دانشگاه آزاد اسلامي واحد كرج , برقي ايراني، زيبا دانشگاه پيام نور تهران
كليدواژه :
مديريت استرس به‌شيوهٔ شناختي‌رفتاري , افسردگي و اضطراب , فشارخون , سالمندان
چكيده فارسي :
زمينه و هدف: مسائل مربوط به سالمندان از ديرباز در جامعهٔ بشري مدنظر انديشمندان بوده است. اضطراب يكي از عوامل خطر بيماري فشارخون بوده و باعث كاهش سلامت عمومي سالمندان با فشارخون زياد مي‌شود. هدف از پژوهش حاضر بررسي اثربخشي مداخلهٔ مديريت استرس به‌شيوهٔ شناختي‌رفتاري بر اضطراب و افسردگي و فشارخون سالمندان بود.
روش‌بررسي: اين پژوهش به‌روش نيمه‌تجربي از نوع پيش‌آزمون و پس‌آزمون با گروه كنترل بود. براي انتخاب آزمودني‌ها از نمونه‌گيري دردسترس استفاده شد؛ بدين‌صورت كه 27 نفر از سالمندان 65تا75ساله جهت شركت در پژوهش انتخاب شده و به‌صورت تصادفي در گروه آزمايش (13 نفر) و گروه كنترل (14 نفر) قرار گرفتند. همهٔ شركت‌كنندگان به‌وسيلهٔ دستگاه فشارخون و پرسشنامه‌هاي اضطراب كتل و افسردگي بك (BDI-II) ارزيابي شدند. در گروه آزمايش به‌مدت 10 جلسه آموزش مديريت استرس به‌شيوهٔ شناختي‌رفتاري صورت گرفت. سپس در مرحلهٔ پس‌آزمون هر دو گروه به پرسشنامه‌هاي پژوهش پاسخ دادند. آناليز آماري بااستفاده از نرم‌افزار SPSS نسخهٔ 23 و شاخص‌هاي آماري توصيفي و تحليل كواريانس چندمتغيره (مانكوا) انجام شد.
يافته‌ها: نتايج تحليل كوواريانس نشان داد مداخلهٔ مديريت استرس به‌شيوهٔ شناختي‌رفتاري به‌گونهٔ معنا‌داري اضطراب و افسردگي و فشارخون افراد گروه آزمايش را درمقايسه با گروه كنترل، بهبود مي‌بخشد (0٫001≥p).
نتيجه‌گيري: يافته‌ها بيان مي‌كند مداخلهٔ مديريت استرس به‌شيوهٔ شناختي‌رفتاري مي‌تواند به‌عنوان روش روان‌درماني انتخابي و همچنين مكمل درمان‌هاي پزشكي در بيماران فشارخون درنظر گرفته شده و در كاهش اضطراب و افسردگي و فشارخون سالمندان بافشارخون زياد مفيد واقع شود؛ بنابراين، درنظرگرفتن اين نوع درمان به‌عنوان بخشي از برنامهٔ درماني سالمندان بافشارخون زياد مي‌تواند سودمند باشد.
چكيده لاتين :
Background and objective: Aging is a progressive physiological change in an organism that leads to a decline of biological functions and o f
the organism's ability to adapt to st ress. The World Health Organization has pointed out that a world-wide r ev o lut io n is t akin g p lace in
demography. Looking at the statist ics and figures, the depth, intensity and importance of this issue become more apparent. There are about 600
million older people over 60 in the world, this figure will double by 2025 and will rise to 2 billion by 2050. One of the most debili t at ing an d
prevalent diseases in the elderly is blood pressure, which imposes enormous costs on the government. High blood pressure is one of the most
common chronic diseases that afflicts a large population and is one of the most serious Psycho-physiological disorders which has at t r acted a
lot of thoughts. In several studies, psychological factors such as depression and anxiety were int roduced as risk factors for blo o d p r essur e.
Depression is one of the most common psychiatry diagnoses that has created a major problem for mental health with its growin g t rend an d
prevalence. Among the effective therapies for depression and anxiety due to physical illnesses, st ress management via cognitiv e -behav ioral
approach has been successfully applied to combine anxiety reduct ion methods such as muscle relaxation, cognitive rehabilitat ion , ef f ect iv e
coping t raining, exerting t raining and anger management to treat emotional and physical problems such as anxiety and depression, in somnia,
diabetes, high blood pressure, heart disease, arthritis, AIDS and cancer. Therefore, this study was conducted to evaluate the effect iveness o f
t raining cognitive-behavioral st ress management techniques on anxiety, depression and blood pressure in elderly people.
Methods: The design of this study was quasi-experimental with pre-test and post-test and control group. The study population consisted of al l
the elderly people living in the nursing home of dist rict 5 in Tehran, that were in the elderly group list in the year 1395. The sample consisted
of 30 people from nursing home living in Mehrban Nursing Home, who were selected by simple random sampling method. In o ther wo rds,
after accessing the centers, due to the extensive aging centers of Tehran, one of the elderly centers of Dist r ict 5 o f Tehr an ( the Mehrban
nursing Center) was selected, which was also the place of study. The following tools were used to collect data: Beck Depr ession Inv en tory
(BDI-II) and Cat tel's Anxiety Scale. The experimental group was t rained in cognitive-behavioral stress management approach, and the control
group received no intervention. The durat ion of the treatment sessions consisted of 10 sessions of 60 minutes, performed as a gro up o n ce a
week in the Mehrban nursing home. Single Variable-Covariance Analysis (ANCOVA) was used to test the research hypotheses.
Result: Based on the results of the Ancova test, after neutralizing the pre-test scores, st ress management t raining has a meaningful ef fect o n
the anxiety (p<0.001, F(27,1)=16.099), and depression (p<0.001, F(27,1)=66.69) and blood pressure (p<0.001, F(27,1)=23 .0 62) .Ther e is a
meaningful difference in average moderated scores of anxiety, depression and blood pressure between stress management t rainin g group s v ia
cognit ive-behavioral approach and in the control group. In other words, these findings indicate a decrease in anxiety, depressio n an d blo o d
pressure in the experimental group compared with the control group. The extent of this effect was 45% for anxiety, 61% for dep ressio n an d
50% for blood pressure.
Conclusion: A series of t raining courses presented in form of st ress management in a cognitive-behavioral approach have significant posit ive
effects on the reduct ion of anxiety and depression in the elderly and thereby protecting them from the numerous side-effects o f an x iety and
depression. Therefore, it can be used as a useful intervention to reduce the components of depression and an x iety an d ben efi t f rom i t in
educat ional and health centers.
