اثربخشي راهبردهاي نظم‌جويي هيجاني گراس بر ميزان استرس ادراك‌شده در بيماران قلبي

Emotion Regulation Strategies Based on Gross Model Processing on Perceived Stress in Patients with Coronary Artery Disease

زمينه و هدف: بيماري كرونري قلبي (CHD) از انواع شايع‌تر بيماري قلبي در ايران است. ‌پژوهش حاضر با هدف اثربخشي راهبردهاي نظم‌جويي هيجاني گراس بر ميزان استرس ادراك‌شده در بيماران قلبي انجام شد. روش‌بررسي: اﻳﻦ ﭘﮋوﻫﺶ نيمه‌آزﻣﺎيشي ﺑﺎ ﻃﺮح ﭘﻴﺶ‌آزﻣﻮن‌ﭘﺲآزﻣﻮن و پيگيري ﺑﺎ ﮔﺮوه گواه ﺑﻮد. ﺟﺎﻣﻌﻪٔ آﻣﺎري را ﺑﯿﻤﺎران قلبي بيمارستان دكترباهنر كرج در سال 1396 تشكيل دادند كه ﺑﻪ‌ﺻﻮرت ﺗﺼﺎدﻓﯽ ﺑﻪ دو ﮔﺮوه آزﻣﺎيﺶ و گواه (هركدام 20 نفر) تقسيم شدند. اﺑﺰار ﭘﮋوﻫﺶ پرسشنامهٔ استرس ادراك‌شدهٔ كوهن (1983) ﺑﻮد. داده‌ها قبل و بعد از اجراي نُه جلسه درمان جمع‌آوري و با استفاده از نرم‌افزار SPSS نسخهٔ 21، به‌‌شيوهٔ تحليل واريانس اندازه‌گيري مكرر تجزيه‌و تحليل شدند. يافته‌ها: نتايج نشان داد ميانگين و انحراف معيار نمرهٔ پيش‌آزمون در گروه آزمايش به‌ترتيب 37٫65 و 7٫60 و پس‌آزمون به‌ترتيب 20٫54 و 3٫58 به‌دست آمد. همچنين نمرۀ پيش‌آزمون در گروه گواه به‌ترتيب 25٫30 و 6٫62 و پس‌آزمون به‌ترتيب 38٫30 و 5٫68 بود. نتايج تحليل واريانس اندازه‌گيري مكرر مشخص كرد درمان به‌‌طور معناداري موجب كاهش استرس بيماران شده است (0٫001>p). نتيجه‌ﮔﻴﺮي: براساس يافته‌هاي پژوهش حاضر، اين نتايج مي‌تواند پشتوانه‌اي براي انجام درمان راهبردهاي نظم‌جويي هيجاني گراس در بيماران قلبي جهت بهبود استرس ادراك‌شده باشد.

Background & Objective: Coronary heart disease (CHD) is the most common type of cardiovascular disease among adults throughout the world, including in Iran. Stress is experienced during the life and effect of that depends on individual sensibility will different. McEwen (1998) explained that a controllable stress is healthy and has beneficial to grow. However, high level of perceived stress may influence the quality of the immune system (Cohen, 1996). For example, Morgan (1997) and Walton (2002) found that exam anxiety is the most commonly perceived stress experienced by undergraduate students. Sometime high level of perceived stress lead to suicide. Emotion adjustment refers to strategies that individuals use to control of excite, exacerbate and express a wide range of emotions. Emotion regulation and dysregulation plays an important role in the continuation of emotional disturbances. People who have trouble in expressing and experiencing excitement use maladaptive emotional regulation strategies such as suppressing and avoiding, hiding or ignoring them, with negative consequences. More effort to control an emotional experience leads to an increase in emotions that an individual try to adjust them. This pattern may put individuals in a disorder emotional and psychological arousal. Therefore more unsuccessful attempts to suppress them, which in turn contribute to psychological distress and reduce mental well–being and quality of life. The purpose of this study was to evaluate the effectiveness of emotion regulation strategies based on Gross model processing on perceived stress in patients with coronary artery disease. Methods: The study method was semi–experimental (experimental) and statistical population of the study was coronary heart patients who referred to the heart clinic of Dr. Bahonar Hospital in Karaj city (Alborz province, North of Iran) in 2015–16. Of them, 40 volunteers were selected and then randomly divided into two groups experiment and control (n=20 for each group). The experimental group received acceptance and commitment treatment (ACT) in 9 sessions. The instruments of the research were stress perception questionnaire. Data were collected before and after the treatment, and analyzed by SPSS software, using variable analysis with repeated measurements. Results: The results showed that the mean and standard deviation of the pre–test scores of perceived stress in the experimental group were 37.65 and 7.60, respectively. Mean and standard deviation of post–test score in the experimental group were 20.54 and 5.38, respectively. The mean and standard deviation of the pre–test scores of perceived stress in the control group were 25.30 and 6.62, respectively. Mean and standard deviation of post–test scores in the control group were 38.30 and 5.68, respectively. The results of analysis of variance analysis with repeated measurements showed that Grass's emotional ordering strategies significantly reduced the perceived stress of cardiac patients (p<0.001). Conclusion: Based on the findings of this study, these results can be considered as a supportive tool for psychotherapy based on Grass's emotional ordering strategies in coronary heart disease patients to improve stress.