اثربخشي درمان پذيرش و تعهد (ACT) بر اضطراب، استرس ادراك‌شده و راهبردهاي مقابله با درد بيماران مبتلا به سرطان خون

The effectiveness of acceptance and commitment therapy (ACT) on anxiety, perceived stress and pain coping strategies for patients with leukemia

ﺳﺎﺑﻘﻪ و ﻫﺪف: ﺳﺮﻃﺎن، ﻣﺸﮑﻠﯽ ﺟﻬﺎﻧﯿﻤﯽﺑﺎﺷﺪ و در اﯾﺮان ﻧﯿﺰ ﺳﻮﻣﯿﻦ ﻋﻠﺖ ﻣﺮگوﻣﯿﺮ اﺳﺖ. ﻫﺪف ﭘﮋوﻫﺶ ﺣﺎﺿﺮ، ﺗﻌﯿﯿﻦ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﭘﺬﯾﺮﺷﻮﺗﻌﻬﺪ )ACT( ﺑﺮ اﺿﻄﺮاب، اﺳﺘﺮس ادراكﺷﺪه و راﻫﺒﺮدﻫﺎي ﻣﻘﺎﺑﻠﻪ ﺑﺎ درد ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎﻧﺨﻮن ﺑﻮد. ﻣﻮاد و روشﻫﺎ:ﭘﮋوﻫﺶ ﺣﺎﺿﺮ از ﻃﺮحﻫﺎي ﮐﺎرﺑﺮدي و ﺷﺒﻪآزﻣﺎﯾﺸﯽ و ﻧﻮع ﭘﯿﺶآزﻣﻮن - ﭘﺲآزﻣﻮن ﻫﻤﺮاه ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل اﺳﺖ. ﺟﺎﻣﻌﻪ آﻣﺎري اﯾﻦ ﭘﮋوﻫﺶ، ﺷﺎﻣﻞ ﮐﻠﯿﻪ ﺑﯿﻤﺎراﻧﻤﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺧﻮن ﺑﻮد ﮐﻪ ﺑﯿﻦ ﻣﺎهﻫﺎي ﻓﺮوردﯾﻦ ﺗﺎ ﺧﺮداد 1398 در ﺑﯿﻤﺎرﺳﺘﺎن ﺳﯿﺪاﻟﺸﻬﺪاي اﺻﻔﻬﺎﻧﺒﺴﺘﺮﯾﺒﻮدﻧﺪ و ﺑﯿﻤﺎري آنﻫﺎ ﻣﺤﺮزﮔﺮدﯾﺪه ﺑﻮد. ﻧﻤﻮﻧﻪﻫﺎي اﯾﻦ ﭘﮋوﻫﺶ، 30 ﻧﻔﺮ از ﺟﺎﻣﻌﻪ ﻣﺬﮐﻮر ﺑﻮدﻧﺪ ﮐﻪ ﺑﺎ اﺳﺘﻔﺎده از روش ﻧﻤﻮﻧﻪﮔﯿﺮي در دﺳﺘﺮس اﻧﺘﺨﺎب ﮔﺮدﯾﺪﻧﺪ و ﺑﻪ ﮐﻤﮏ ﺷﯿﻮه ﺗﺼﺎدﻓﯽﺳﺎزي ﺳﺎده، در دو ﮔﺮوه درﻣﺎن ﭘﺬﯾﺮش و ﺗﻌﻬﺪ )15=n( و ﮔﺮوه ﮐﻨﺘﺮل )15=n( ﮔﻤﺎﺷﺘﻪ ﺷﺪﻧﺪ. دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﻣﻘﯿﺎس اﺳﺘﺮس ادراكﺷﺪه، ﻣﻘﯿﺎس اﺿﻄﺮاب ﺑﮏ و ﭘﺮﺳﺸﻨﺎﻣﻪ راﻫﺒﺮدﻫﺎي ﻣﻘﺎﺑﻠﻪ ﺑﺎ درد ﺑﻪدﺳﺖ آﻣﺪﻧﺪ. ﺑﺮاي ﺗﺤﻠﯿﻞ اﺳﺘﻨﺒﺎﻃﯽ از روش ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﺗﮏﻣﺘﻐﯿﺮه و ﭼﻨﺪﻣﺘﻐﯿﺮه )MANCOVA( اﺳﺘﻔﺎده ﺷﺪ ﮐﻪ ﺑﺎ ﻧﺮماﻓﺰار SPSS وﯾﺮاﯾﺶ 22 ﺑﻪ اﺟﺮا درآﻣﺪ. ﻧﺘﺎﯾﺞ: ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﮐﻪ ﮔﺮوه ﺑﻪﺻﻮرت ﻣﻌﻨﯽداري روي ﻧﻤﺮه اﺿﻄﺮاب )0/78=partial و0/0001F=72/89،P(، اﺳﺘﺮس ادراكﺷﺪه )0/78=partial ƞ و 0/0001F= 71/01 ،P( و راﻫﺒﺮدﻫﺎي ﻣﻘﺎﺑﻠﻪ ﺑﺎ درد )0/85=partial ƞ و 0/0001F=113/14 ،P( ﺗﺄﺛﯿﺮ دارد. ﻧﺘﯿﺠﻪﮔﯿﺮي:درﻣﺎن ﭘﺬﯾﺮش و ﺗﻌﻬﺪ )ACT( ﺑﺮ اﺿﻄﺮاب، اﺳﺘﺮس ادراكﺷﺪه و راﻫﺒﺮدﻫﺎي ﻣﻘﺎﺑﻠﻪ ﺑﺎ درد ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺧﻮن، ﻣﺆﺛﺮ اﺳﺖ. ﺑﻨﺎﺑﺮاﯾﻦ ﻣﺪاﺧﻼت روانﺷﻨﺎﺧﺘﯽ ﻣﯽﺗﻮاﻧﻨﺪ ﺑﺮاي ﮐﺎﻫﺶ ﻣﺸﮑﻼت روانﺷﻨﺎﺧﺘﯽ ﻧﺎﺷﯽ از ﺳﺮﻃﺎن ﺧﻮن در ﺑﯿﻤﺎران، ﻣﻮرد اﺳﺘﻔﺎده ﻗﺮار گيرند

As a universal problem, cancer is the third cause of death in Iran. This study aimed to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on anxiety, perceived stress and pain coping management strategies for patients with leukemia. Materials and Methods: The present study is an applied and quasi-experimental project of pretest- post-experimental type with control group. The statistical population of this study included all patients with leukemia who were hospitalized in Seyed Al-Shohada Hospital in Isfahan between April and June 2019 and their disease was confirmed. A sample of 30 people from the community who were selected using the available sampling method and using simple randomization method in two groups of acceptance and commitment treatment (n=15) and control group (n=15) were appointed. Data were obtained using the perceived stress scale, Beck's anxiety scale and pain response strategies questionnaire. In order to deduce the inferential analysis, the one-dimensional and multivariate analysis of covariance (MANCOVA) was used, which was performed with SPSS.22 software. Results: The results showed that the group had a significant effect on anxiety score (F=72.89, P<0.0001, partial ƞ2=0.78), perceived stress (F=71.01, P<0.0001, partial ƞ2=0.78), and pain coping strategies (F=113.14, P<0.0001, partial ƞ2=0.85). Conclusion: Acceptance and commitment therapy (ACT) is effective in addressing anxiety, perceived stress, and pain coping strategies in patients with leukemia. Therefore, psychological interventions can be used to reduce the psychological problems caused by leukemia in patients