پديد آورندگان :
نوري فرد، مرضيه دانشگاه آزاد اسلامي واحد اصفهان (خوراسگان) , نشاط دوست، حميدطاهر دانشگاه اصفهان - گروه روانشناسي , سجاديان، ايلناز دانشگاه آزاد اسلامي واحد اصفهان (خوراسگان) - گروه روانشناسي
كليدواژه :
ذهن آگاهي , آموزش اختصاصي سازي حافظهٔ سرگذشتي , راهبردهاي شناختي تنظيم هيجان , همودياليز
چكيده فارسي :
زمينه و هدف
نارسايي مزمن كليوي، تخريب رو به رشد و بازگشت ناپذير عملكرد كليوي است كه عوارض جسمي و رواني بي شماري را در پي دارد. اين پژوهش با هدف مقايسه اثربخشي آموزش ذهن آگاهي با آموزش اختصاصي سازي حافظه بر راهبردهاي شناختي تنظيم هيجان بيماران همودياليزي انجام شد.
روش بررسي
پژوهش حاضر از نوع شبه آزمايشي با طرح پيش آزمون پس آزمون و پيگيري بود. جامعه آماري را بيماران همودياليزي مراجعه كننده به مراكز همودياليز شهر تهران در سال 1396 تشكيل دادند. تعداد 36 نفر به روش نمونه گيري هدفمند از جامعه آماري انتخاب شده و به صورت تصادفي در سه گروه آموزش ذهن آگاهي (سگال، 2013) و آموزش اختصاصي سازي حافظه (مكس ول، 2016) و گروه كنترل قرار گرفتند. براي جمع آوري داده ها، پرسشنامه راهبردهاي شناختي تنظيم هيجان گارنفسكي (CERQ) به كار رفت. داده ها با استفاده از نرم افزار SPSS نسخه 22 و تحليل واريانس با اندازه گيري مكرر، تجزيه وتحليل شد. كد كارآزمايي باليني IRCT20190202042582N1 بود.
يافته ها
بررسي نتايج نشان داد كه بين راهبردهاي شناختي تنظيم هيجان مثبت و منفي گروه هاي آموزش ذهن آگاهي و آموزش اختصاصي سازي حافظه سرگذشتي و كنترل، در مرحله پس آزمون بيماران همودياليزي تفاوت وجود دارد (0٫001>p). همچنين بين راهبردهاي شناختي تنظيم هيجان مثبت و منفي سه گروه مذكور، در مرحله پيگيري بيماران همودياليزي تفاوت مشاهده مي شود (0٫001>p).
نتيجه گيري
براساس يافته هاي اين مطالعه مي توان از مداخله هاي ذهن آگاهي با آموزش اختصاصي سازي حافظه در افزايش استفاده از راهبردهاي شناختي تنظيم هيجان بيماران تحت همودياليز بهره برد.
چكيده لاتين :
Background & Objective: Chronic renal failure is a progressive and irreversible loss in kidney function, which results in numerous physical
and psychological complications. The complications of hemodialysis treatment causes disruption in patients’ happiness and well-being and
therefore leads to depression, anxiety and sometimes suicide attempts. Cognitive emotion regulation strategies are an important part of
hemodialysis patients’ lives. Disturbance in emotion and failure in its regulation can cause psychological trauma. The aim of this study was to
investigate the effectiveness of mindfulness with memory specificity training (MEST) on cognitive emotion regulation strategies of hemodialysis
patients.
Methods: The present study was quasi-experimental with a pretest-posttest and two-months follow-up with the control group. The statistical
population consisted of hemodialysis patients who referred to hemodialysis centers of Tehran city (capital city of Iran) in 2017. In total, 36
individuals were selected using purposive sampling method from the statistical population, and were randomly assigned into three groups:
mindfulness therapy group (n=12), MEST group (n=12) and control group (n=12). In order to collect data, the cognitive emotion regulation
questionnaire (CERQ) developed by Garnowski, for intervention mindfulness therapy (Segal, 2013), memory specify training (Maxwell, 2016)
were used. After selecting the sample, mindful and memory specificity training were done for the groups, no training was provided for the control
group. After training completion, posttest was performed for the subjects in all three groups. The posttest included the previous questionnaire.
Two months after the course completion, patients were asked to complete the same questionnaire again. This was done to track and evaluate the
viability of interventions. The obtained data were analyzed using SPSS-22 software and mixed analysis of variance.
Results: There was a significant difference in cognitive emotion regulation strategies between mindfulness therapy group and MEST group in
the port-test stages among hemodialysis patients (p<0.001). In addition, there was a significant difference in cognitive emotion regulation
strategies between mindfulness therapy group and MEST group in the follow up stages among hemodialysis patients (p<0.001).
Conclusion: In the present study, mindfulness therapy and MEST, compared with control group, were more effective for the positive and
negative cognitive emotion regulation during the posttest, and the effect was more durable during interventions. Comparison of MEST to
mindfulness therapy showed that MEST was more effective than mindfulness therapy for positive and negative cognitive emotion regulation. In
order to explain this effectiveness, it can be argued that mindfulness therapy and its techniques target the fundamental beliefs and negative
thoughts of self-efficacy in patients. It after making cognitive changes in patients and made aware of his own cognitive and emotional content,
allow him to explore more appropriate alternatives and avid automated responses. Furthermore, in MEST and its techniques, by challenging the
memory, irrational thoughts and beliefs about the chronic illness with depression, anxiety and emotional disorders caused by incurable renal
therapy, by reducing over general memory, increases the ability of solving social problems in individuals and prevent negative social interactions.
It also leads to increased sense of hope in patients by influencing on future visualization capabilities. This therapy prevents rumination as well.
It also reduces the psychological disorders in patients by experimenting with negative memories and the resultant negative emotions. Being
exposed to distressing memories and emotions, even if they cause worries and unpleasantness for a short period of time, has long-term benefits
for an individual’s mental health. According to the findings of this study, it can be deduced that MEST is more effective than mindfulness therapy
and control group in improving cognitive emotion regulation and this therapy is more durable, this durability is due to easier treatment and faster
training for patients as well as shorter duration of intervention sessions.
