پديد آورندگان :
خسروشاهي، حسين دانشگاه آزاد اسلامي واحد گرگان - گروه روانشناسي , ميرزائيان، بهرام دانشگاه آزاد اسلامي واحد ساري - گروه روانشناسي , حسن زاده، رمضان دانشگاه آزاد اسلامي واحد ساري - گروه روانشناسي
كليدواژه :
درمان فراشناختي , سلامت عمومي , خودكارآمدي , ادراك بيماري , بيمار كرونر قلبي
چكيده فارسي :
زمينه و هدف
پژوهش ها نشان داده اند بيماران قلبي عروقي داراي مشكل هايي در سلامت عمومي و خودكارآمدي و ادراك بيماري هستند. جهت افزايش اين شاخص ها درمان هاي روان شناختي متعددي به كار رفته است. پژوهش حاضر با هدف بررسي تاثير درمان فراشناختي بر شاخص هاي سلامت عمومي و خودكارآمدي و ادراك بيماري در بيماران كرونر قلبي صورت گرفت.
روش بررسي
طرح پژوهش نيمه آزمايشي از نوع پيش آزمون و پس آزمون با گروه گواه بود. جامعه آماري را تمامي مردان مبتلا به بيماري قلبي (CHD) در شهر قائم شهر تشكيل دادند كه به كلينيك قلب بيمارستان وليعصر قائم شهر در سال 97-1396 مراجعه كردند. از اين تعداد 30 نفر به روش نمونه گيري هدفمند انتخاب شده و به صورت تصادفي در دو گروه آزمايش و گواه (هر گروه 15 نفر) قرار گرفتند. سپس به پرسشنامه هاي سلامت عمومي (گلدنبرگ و همكاران، 1997) و خودكارآمدي (شرر و همكاران، 1982) و ادراك بيماري (برودبنت، پتريه، وينمن و مين، 2006) پاسخ دادند. برنامه مداخله فراشناختي به مدت هشت جلسه 90دقيقه اي بر گروه آزمايش انجام پذيرفت. داده هاي به دست آمده با استفاده از نرم افزار SPSS نسخه 21 و به شيوه تحليل كواريانس تجزيه و تحليل شد.
يافته ها
نتايج نشان داد ميانگين نمرات پيش آزمون در گروه آزمايش در نمره كل سلامت عمومي و خودكارآمدي و ادراك بيماري به ترتيب 63٫67 و 54٫80 و 54٫2 و در پس آزمون به ترتيب 46٫45 و 66٫13 و 58٫46 است. نتايج آناليز كواريانس مشخص كرد درمان فراشناخت به طور معناداري موجب كاهش مشكل هاي سلامت عمومي و افزايش خودكارآمدي و ادراك بيماري بيماران مي شود (0٫05>p).
نتيجه گيري
باتوجه به يافته ها، درمان فراشناختي مي تواند درمان مناسبي جهت افزايش سلامت عمومي و خودكارآمدي و همچنين تعديل ادراك بيماري در بيماران مبتلا به كرونر قلبي باشد.
چكيده لاتين :
Background & Objective: heart disease is caused by stenosis and coronary artery disease, is a health problem in developing and developing
countries, and is one of the leading causes of death in the world, including Iran. Coronary heart disease (CHD) is among the diseases affected
by psychological factors. Recently, role of disease perception has been taken into account on the life quality of people with chronic diseases.
The concept of perceived illness is organized cognitive representation of the patient. One of the factors influencing the life quality of patients is
self–efficacy during researches on different patients, which refers to the ability of a person to perform their caring behaviors in specific
circumstances. Self–efficacy is considered as an important predictor of behavior that it acts as an independent part of a person's basic skills. Of
course, it should be noted that the role of self–efficacy in initiating and maintaining health behaviors is illustrated by several studies in other
subjects. Holistic philosophy about health emphasizes on the unity of various human dimensions. From the perspective, diseases are result of an
irregular in physical, psychological and environmental dimensions. Therefore, all dimensions integrate and work together such as health types
including physical, social and emotional health. Several studies have been carried out on the identification of risk factors for cardiovascular
disease. The treatment that emphasis in this study was metacognitive therapy. The metacognitive therapy approach describes the cognitive and
metacognitive factors of the underlying and continuing perspectives of psychological disorders and emotional vulnerabilities. The aim of this
study was to investigate the effect of metacognitive therapy on general health, self–efficacy and perception of disease in cardiovascular patients
Methods: In this study, 30 patients were selected through purposeful sampling. Then, 15 patients were randomly assigned to the experimental
group and 15 to the control group. The questionnaires included general health questionnaire, self–efficacy and perception of the disease. Data
were collected before and after the implementation of 8 sessions of treatment and analyzed by SPSS 21 software and by covariance analysis.
Results: Mean and standard deviation of pretest scores in the experimental group in the general health, self–efficacy and perceived disease
variables were 63.67, 2.14, 54.8, 6.1, 54.2 and 71.7 respectively. The post–test was 46.45, 23.2, 66.13, 58.9, 58.46 and 12.28 respectively. In
addition, the pre–test score in the control group was 62.22, 2.71, 64.06, 4.84, 39.26, 4.99 and 63.41 after test, 2.71, 65.73, 41.4, 40.38 and 65.2.
The results of covariance analysis indicated that treatment significantly decreased anxiety and depression in general health, increased
autoimmunity and perceived illness (p<0.001).
Conclusion: As a result, metacognitive therapy could be an effective treatment for general health, self–efficacy and modulation of perception of
disease in patients with coronary artery disease.
