اﺛﺮﺑﺨﺸﯽ آﻣﻮزش روﯾﮑﺮد ارﺗﻘﺎي ﺑﻬﺒﻮدي ذﻫﻦ آﮔﺎهﻣﺤﻮر ﺑﻪ ﺷﯿﻮه ﮔﺮوﻫﯽ ﺑﺮ واﮐﻨﺶﭘﺬﯾﺮي ﺷﻨﺎﺧﺘﯽ ﻧﺴﺒﺖ ﺑﻪ ﺧﻠﻖ ﻏﻤﮕﯿﻦ و اﺿﻄﺮاب ﻣﺮﺗﺒﻂ ﺑﺎ درد در ﺑﯿﻤﺎران داراي درد ﻣﺰﻣﻦ

The Effectiveness of Group Therapy based on Mindfulness Oriented Recovery Enhancement Approach on Cognitive Reactivity to Sad Mood and Pain-Related Anxiety in Chronic Pain Patients

زﻣﯿﻨﻪ ﭘﮋوﻫﺶ ﺣﺎﺿﺮ، ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ اﺛﺮﺑﺨﺸﯽ آﻣﻮزش روﯾﮑﺮد ارﺗﻘﺎي ﺑﻬﺒﻮدي ذﻫﻦ آﮔﺎهﻣﺤﻮر ﺑﻪ ﺷﯿﻮه ﮔﺮوﻫﯽ ﺑﺮ ﮐﺎﻫﺶ واﮐﻨﺶﭘﺬﯾﺮي ﺷﻨﺎﺧﺘﯽ ﻧﺴﺒﺖ ﺑﻪ ﺧﻠﻖ ﻏﻤﮕﯿﻦ و اﺿﻄﺮاب ﻣﺮﺗﺒﻂ ﺑﺎ درد در ﺑﯿﻤﺎران ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ اﻧﺠﺎم ﮔﺮﻓﺖ. روش ﮐﺎر اﯾﻦ ﭘﮋوﻫﺶ ﺑﻪﺻﻮرت ﻧﯿﻤﻪآزﻣﺎﯾﺸﯽ ﺑﺎ ﭘﯿﺶآزﻣﻮن- ﭘﺲآزﻣﻮن ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل اﺟﺮا ﺷﺪ. ﺟﺎﻣﻌﻪ آﻣﺎري ﻣﻮرد ﻣﻄﺎﻟﻌﻪ، ﻫﻤﻪ ﺑﯿﻤﺎران ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﻣﺮاﮐﺰ درﻣﺎﻧﯽ )ﺑﯿﻤﺎرﺳﺘﺎنﻫﺎي داراي درﻣﺎﻧﮕﺎهﻫﺎي ﺗﺨﺼﺼﯽ ﻃﺐ ﻓﯿﺰﯾﮑﯽ و ارﺗﻮﭘﺪي( ﺷﻬﺮ اﻫﻮاز در ﺗﺎﺑﺴﺘﺎن 1397 ﺑﻮدﻧﺪ. 30 ﻓﺮد ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ از ﻃﺮﯾﻖ ﻓﺮاﺧﻮان و ﺑﻪ ﺷﯿﻮه داوﻃﻠﺒﺎﻧﻪ ﺑﺮ اﺳﺎس ﺗﺸﺨﯿﺺ ﭘﺰﺷﮏ ﻣﺘﺨﺼﺺ اﻧﺘﺨﺎب ﺷﺪﻧﺪ و ﺑﻪ دو ﮔﺮوه آزﻣﺎﯾﺶ )15ﻧﻔﺮ( و ﮐﻨﺘﺮل )15 ﻧﻔﺮ( ﺑﻪ ﺻﻮرت ﺗﺼﺎدﻓﯽ، ﮔﻤﺎرش ﺷﺪﻧﺪ. از ﻫﺮ دو ﮔﺮوه، ﭘﯿﺶآزﻣﻮن ﮔﺮﻓﺘﻪ ﺷﺪ. اﻋﻀﺎي ﮔﺮوه آزﻣﺎﯾﺶ ﺑﻪ ﻣﺪت 8 ﺟﻠﺴﻪ 120 دﻗﯿﻘﻪاي ﺗﺤﺖ آﻣﻮزش ﮔﺮوﻫﯽ ﻣﺒﺘﻨﯽ ﺑﺮ روﯾﮑﺮد ارﺗﻘﺎي ﺑﻬﺒﻮدي ذﻫﻦ آﮔﺎهﻣﺤﻮر ﻗﺮار ﮔﺮﻓﺘﻨﺪ و اﻋﻀﺎي ﮔﺮوه ﮐﻨﺘﺮل، ﻫﯿﭻ ﻣﺪاﺧﻠﻪاي درﯾﺎﻓﺖ ﻧﮑﺮدﻧﺪ. اﺑﺰارﻫﺎي ﭘﮋوﻫﺶ ﺷﺎﻣﻞ ﺷﺎﺧﺺ ﺗﺠﺪﯾﺪﻧﻈﺮ ﺷﺪه ﺣﺴﺎﺳﯿﺖ در ﺑﺮاﺑﺮ اﻓﺴﺮدﮔﯽ ﻟﯿﺪن- ﺗﺠﺪﯾﺪﻧﻈﺮ ﺷﺪه )LEIDS_R و ﻣﻘﯿﺎس ﻧﺸﺎﻧﮕﺎن اﺿﻄﺮاب ﻣﺮﺗﺒﻂ ﺑﺎ درد )PASS( ﺑﻮد. ﺑﻪ ﻣﻨﻈﻮر ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ دادهﻫﺎ، از روشﻫﺎي آﻣﺎر ﺗﻮﺻﯿﻔﯽ و ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮه )ﺑﺎ ﻧﺮماﻓﺰار 211 SPSS اﺳﺘﻔﺎده ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ ﻧﺘﺎﯾﺞ ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮي ﺑﺎ ﺳﻄﺢ ﻣﻌﻨﺎداري )0/0001≤P( ﻧﺸﺎن داد ﮐﻪ ﺗﻔﺎوت ﻣﻌﻨﺎداري ﺑﯿﻦ دو ﮔﺮوه در ﻣﺮﺣﻠﻪ ﭘﺲآزﻣﻮن وﺟﻮد دارد ﮐﻪ ﻧﺸﺎندﻫﻨﺪه اﺛﺮﺑﺨﺸﯽ آﻣﻮزش ﮔﺮوﻫﯽ ﻣﺒﺘﻨﯽ ﺑﺮ ارﺗﻘﺎي ﺑﻬﺒﻮدي ذﻫﻦ آﮔﺎهﻣﺤﻮر ﺑﺮ واﮐﻨﺶﭘﺬﯾﺮي ﺷﻨﺎﺧﺘﯽ ﻧﺴﺒﺖ ﺑﻪ ﺧﻠﻖ ﻏﻤﮕﯿﻦ و اﺿﻄﺮاب ﻣﺮﺗﺒﻂ ﺑﺎ درد در ﺑﯿﻤﺎران ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ است ﻧﺘﯿﺠﻪﮔﯿﺮي از اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﯽﺗﻮان ﻧﺘﯿﺠﻪ ﮔﺮﻓﺖ ﮐﻪ آﻣﻮزش ﮔﺮوﻫﯽ ﻣﺒﺘﻨﯽ ﺑﺮ ارﺗﻘﺎي ﺑﻬﺒﻮدي ذﻫﻦ آﮔﺎهﻣﺤﻮر ﻣﯽﺗﻮاﻧﺪ روﯾﮑﺮدي ﻣﻨﺎﺳﺐ ﺑﺮاي ﮐﺎﻫﺶ واﮐﻨﺶﭘﺬﯾﺮي ﺷﻨﺎﺧﺘﯽ ﻧﺴﺒﺖ ﺑﻪ ﺧﻠﻖ ﻏﻤﮕﯿﻦ و اﺿﻄﺮاب ﻣﺮﺗﺒﻂ ﺑﺎ درد در ﺑﯿﻤﺎران ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ ﺑﺎﺷﺪ.

Introduction: This study aimed to determine the effectiveness of group therapy based on mindfulness oriented recovery enhancement approach on Cognitive Reactivity to Sad Mood and Pain-Related Anxiety among Chronic Pain Patients. Materials and Methods: This study is quasi-experimental with control group. The statistical population included all the patients with chronic pain at Ahwaz who have been referred to Health Center (Hospitals with specialized clinics of physical medicine and orthopedics) in summer 2017. 30 chronic pain patients were selected through recall and in a voluntary method based on pain specialist diagnosis and randomly allocated into two experimental(n=15) and control (n=15) groups. Both groups were tested before. The experimental group for eight sessions of 120-minute group therapy were based on mindfulness oriented recovery enhancement approach. Control group members did not receive any interventions. Data through questionnaires study were Index of Depression Sensitivity-Revised Version (LEIDS-R) and Pain Anxiety Symptoms Scale (PASS). Research data to way multivariate analysis of variance were analyzed by SPSS 21 software. Results: The results of multivariate analysis of covariance with significance level (p > 0.0001) on the hypothesis show a significant difference between the two groups at post-test, that represents the effectiveness of mindfulness oriented recovery enhancement approach group therapy based on Cognitive Reactivity to Sad Mood and Pain-Related Anxiety among Chronic Pain Patients. Conclusion: The conclusion of the study is based on group therapy, mindfulness oriented recovery enhancement approach is to reduce. Cognitive Reactivity to Sad Mood and Pain-Related Anxiety among Chronic Pain Patients.