كليدواژه :
پذيرش و تعهد , استرس , افسردگي , اضطراب امتحان , تالاسمي
چكيده لاتين :
Background & Objectives: Chronic diseases, including thalassemia, occur in all age groups, socioeconomic classes, and cultures. Thalassemia is a chronic and life–threatening condition that limits the quality of life of the affected patients. It also impacts them clinically; their children and
families are exposed to various emotional and behavioral problems and stress. Psychological issues could negatively influence the immune system and disrupt the central nervous system. Paying adequate attention to these psychological states is of significant importance. Acceptance
and Commitment Therapy (ACT), i.e., derived from cognitive therapy, is among the third wave of therapies. The present study aimed to examine
the effects of ACT on reducing stress, depression, and test anxiety in students with thalassemia.
Methods: This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population of this
research included 209 patients with thalassemia who were treated at the Center for Special Diseases in Zabol City, Iran. The study participants
were selected based on the inclusion criteria; medical diagnosis, patients’ test records, as well as studying and residing in the mentioned city.
The individuals with intellectual disabilities and other mental and behavioral disorders were excluded from the study. In total, 30 qualified
subjects voluntarily participated in the study. Besides, they were randomly divided into the experimental and control groups (n=15/group ). The
experimental group received ten 90–minute sessions of ACT. Moreover, after the completion of the project course, the posttest was performed;
one month later, the follow–up sessions were held. The Lovibond and Lovibond's Depression Anxiety Stress Scales (DASS) (1995) and Sarason
Test Anxiety Scale (1975) were used to collect the required data. The collected data were analyzed by repeated–measures Analysis of Variance
(ANOVA) in SPSS.
Results: The mean values of stress, depression, and test anxiety has increased in the experimental group; this change was more stable in the
posttest, compared to the follow–up stage. The same scores in the control group faced fewer changes in the control group; therefore, repeated–
measures ANOVA was used to determine differences in inferential statistics. To perform repeated–measures ANOVA, its aspects were first
examined. Kolmogorov–Smirnov test was used to inspect the normality of the data. The relevant results indicated that the score distribution of
stress, depression, and test anxiety was normal in pretest and post–test steps. Levene's test was used to determine the homogeneity of variances.
The related results confirmed the homogeneity of variances of stress, depression, and test anxiety. Furthermore, the Box's M test data revealed
that the covariances were homogeneous. Therefore, repeated–measures ANOVA could be performed. First, Mauchly's sphericity was examined;
then, the level of Greenhouse–Geisser estimate of epsilon was evaluated. The repeated–measures ANOVA was used (2×3 design) to explore the
significant differences between the mean scores of the study groups. Mauchly's sphericity test result was significant (p=0.001). Besides,
Greenhouse–Geisser Estimate Epsilon data demonstrated that the epsilon level was <0.75; therefore, Feldt–Huynh correction was used.
Considering the effect of time between the three study stages (i.e., pretest, posttest, & 3–month follow–up), there was a significant difference in
stress, depression, and test anxiety (p≤0.001) between the study groups. In addition, ACT training effectively reduced stress, depression, and test
anxiety in the assessed students with thalassemia at posttest and follow–up steps (p≤0.001). The effect scores of test stress, depression and test
anxiety were 0.20, 0.19 and 0.15, respectively..
Conclusion: The present study findings suggested that ACT training effectively reduced stress, depression, and test anxiety in the evaluated
students with thalassemia at the posttest and follow–up stages. It is suggested that the Ministry of Education provide some workshops on this therapy for the counselors and psychologists in the schools and the families of students with this condition.
