تاثير گروه درماني شناختي رفتاري بر علائم زودرس يائسگي

The Effect of Cognitive–Behavioral Group Therapy on Menopausal Symptoms

ﻋﻼﺋﻢ ﺷـﻨﺎﺧﺘﻪ ﺷـﺪه ﯾﺎﺋﺴـﮕﯽ، ﺑﺮاي اﻏﻠﺐ زﻧﺎن ﺑﺎ ﻧﻮﻋﯽ اﺿـﻄﺮاب و آﺷـﻔﺘﮕﯽ ﻫﻤﺮاه ﺑﻮده و ﯾﮑﯽ از ﭼﺎﻟﺶ ﻫﺎي ﻣﻬﻢ ﻣﺮاﻗﺒﺘﯽ ﻣﯽ ﺑﺎﺷﺪ. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺑﺮرﺳﯽ ﮔﺮوه درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري ﺑﺮ ﻧﺸﺎﻧﻪ ﻫﺎي ﯾﺎﺋﺴﮕﯽ )ﭘﯿﺎﻣﺪ اوﻟﯿﻪ( اﻧﺠﺎم ﺷﺪ. ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ ﺗﺼﺎدﻓﯽ ﮐﻨﺘﺮل ﺷﺪه، ﺑﺮ روي 90 زن ﯾﺎﺋﺴﻪ داراي ﭘﺮوﻧﺪه ﺑﻬﺪاﺷﺘﯽ در دو ﻣﺮﮐﺰ ﺑﻬﺪاﺷﺘﯽ درﻣﺎﻧﯽ ﺷﻬﺮ ﺗﻮﯾﺴﺮﮐﺎن در ﺳﺎل 1395 ﮐﻪ ﺑﻪ روش ﺑﻠﻮك ﺑﻨﺪي ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه 45 ﻧﻔﺮه ﻣﺪاﺧﻠﻪ و ﮐﻨﺘﺮل ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ، اﻧﺠﺎم ﮔﺮدﯾﺪ و 6 ﺟﻠﺴﻪ 90 دﻗﯿﻘﻪ اي ﻃﯽ 6 ﻫﻔﺘﻪ ﻣﺘﻮاﻟﯽ، ﮔﺮوه درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري ﺟﻬﺖ ﮔﺮوه ﻣﺪاﺧﻠﻪ ﺑﺮﮔﺰار ﺷﺪ. در ﻫﺮ ﯾﮏ از اﯾﻦ ﺟﻠﺴﺎت ﺑﺎ اﺳﺘﻔﺎده از ﺗﮑﻨﯿﮏ ﻫﺎي ﺷﻨﺎﺧﺘﯽ ﻣﺎﻧﻨﺪ ﺷﻨﺎﺳﺎﯾﯽ اﻓﮑﺎر ﺧﻮدآﯾﻨﺪ ﻣﻨﻔﯽ و ﺗﮑﻨﯿﮏ ﻫﺎي رﻓﺘﺎري ﻣﺎﻧﻨﺪ ﺗﮑﻨﯿﮏ ﺗﻨﻔﺲ ﺷﮑﻤﯽ، ﻋﻼﺋﻢ ﯾﺎﺋﺴﮕﯽ ﻣﻮرد ﺑﺤﺚ ﻗﺮار ﮔﺮﻓﺖ. ﻧﺸﺎﻧﻪ ﻫﺎي ﯾﺎﺋﺴﮕﯽ ﺑﺎ اﺳﺘﻔﺎده از ﻣﻘﯿﺎس ﮔﺮﯾﻦ )0-63( ﻗﺒﻞ از ﺷﺮوع ﻣﺪاﺧﻠﻪ و ﭘﺲ از اﺗﻤﺎم 6 ﻫﻔﺘﻪ در ﻫﺮ دو ﮔﺮوه ﺳﻨﺠﯿﺪه ﺷﺪ. ﭘﺲ از ﭘﺎﯾﺎن ﺳﻨﺠﺶ ﻫﺎ ﺑﻪ ﺟﻬﺖ رﻋﺎﯾﺖ اﺻﻮل اﺧﻼﻗﯽ ﮔﺮوه ﮐﻨﺘﺮل ﯾﮏ ﺟﻠﺴﻪ ﻣﺸﺎوره آﻣﻮزﺷﯽ درﯾﺎﻓﺖ ﻧﻤﻮد. ﯾﺎﻓﺘﻪﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮه ﮐﻠﯽ ﮔﺮﯾﻦ ﻗﺒﻞ از ﻣﺪاﺧﻠﻪ در ﮔﺮوه ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري )22/78±12/22( و ﮐﻨﺘﺮل ) 24/8±10/25( ﺗﻔﺎوت آﻣﺎري ﻣﻌﻨﯽ داري ﻧﺪاﺷﺖ. ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮه ﮐﻠﯽ ﮔﺮﯾﻦ ﭘﺲ از ﭘﺎﯾﺎن ﻣﺪاﺧﻠﻪ در ﮔﺮوه ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري) 15/75±7/24( ﺑﻪ ﺻﻮرت ﻣﻌﻨﯽ دار ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﮐﻨﺘﺮل)24/97±9/25( ﮐﺎﻫﺶ ﯾﺎﻓﺘﻪ ﺑﻮد)p<0/05(. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻧﺘﺎﯾﺞ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد ﮐﻪ ﮔﺮوه درﻣﺎﻧﯽ ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري ﻣﯽ ﺗﻮاﻧﺪ ﺑﺎﻋﺚ ﮐﺎﻫﺶ ﻧﺸﺎﻧﻪ ﻫﺎي ﯾﺎﺋﺴﮕﯽ ﮔﺮدد.

The common symptoms of menopause are associated with anxiety and discomfort for most women, and this is one of the major healthcare challenges. The aim of this study was to evaluate the effect of cognitive – behavioral group therapy on menopausal symptoms (primary outcome). METHODS This randomized controlled clinical trial was conducted among 90 menopausal women with health records at two health centers in Tuyserkan in 2016 and were randomly assigned to two groups of intervention and control (45 patients in each group). To perform cognitive – behavioral group therapy, six 90-minute sessions were held for the intervention group for six consecutive weeks. Menopausal symptoms were discussed in each of these sessions based on cognitive techniques such as identifying negative automatic thoughts and behavioral techniques such as diaphragmatic breathing technique. Menopausal symptoms were assessed in both groups using the Greene Climacteric Scale (0 – 63) before the intervention and at the end of the sixth week. To adhere to ethics, the control group received one session of educational counseling after the assessments were done. FINDINGS There was no statistically significant difference in mean total Greene score between the cognitive– behavioral group (22.78±12.22) and control group (24.8±10.25) before intervention. After the intervention, the mean total Greene score decreased significantly in the cognitive – behavioral group (15.75±7.24) compared to the control group (24.97±9.25) (p < 0.05). CONCLUSION The results showed that cognitive – behavioral group therapy can decrease menopausal symptoms.