پديد آورندگان :
يادآوري، ماندانا دانشگاه آزاد اسلامي، خرمشهر، ايران - واحد بين المللي خرمشهر-خليج فارس - گروه روان شناسي سلامت , نادري، فرح دانشگاه آزاد اسلامي، اهواز، ايران - گروه روان شناسي , مكوندي، بهنام دانشگاه آزاد اسلامي، اهواز، ايران - گروه روان شناسي , حافظي، فريبا دانشگاه آزاد اسلامي، اهواز، ايران - گروه روان شناسي
چكيده لاتين :
Background & Objectives: Pain leads to avoiding dangerous and unpleasant stimuli; thus, it plays a significant protective role in preserving human life. A pain with low severity that lasts for more than a month is called chronic pain. Chronic pain generates enormous and distressing
issues, such as demoralization, emotional disorders, personal restrictions, social and professional activities restriction, increased drug use, repeated referrals to the healthcare centers, and the spread of disease impact to other parts of the patient's life. Most of the patients with chronic
pain, despite receiving pharmacotherapy, experience pain. Besides, if they are unable to compromise with the condition, their quality of life
could be significantly affected. Furthermore, pain catastrophizing consists of the exaggerated negative attitude to actual or anticipated pain
experience that increases the pain intensity, distress, and disability in patients with chronic pain. Psychological therapies assist the patient to
efficiently cope with pain and its associated symptoms. Moreover, the active participation of patients could enhance their sense of self–efficacy
concerning the ability to prevent and control pain. Subsequently, this process reduces the pain–induced inability. The metacognitive approach,
instead of including challenging with dysfunctional thoughts and beliefs about chronic pain, involves communicating with thoughts in a manner
that prevents individuals from resisting pain and enables them to eliminate inconsistent thinking strategies about anxiety. The current study
aimed to explore the effects of metacognitive therapy on pain relief and quality of life in patients with chronic pain.
Methods: This was an experimental study with pretest–posttest–follow–up and a control group design. The research statistical population
consisted of patients aged >30 years with chronic pain who referred to medical centers in Ahvaz City, Iran, in 2019. In total, 30 patients who
met the study inclusion criteria were selected through the purposive sampling method. Then, the study subjects were randomly assigned to the
experimental and control groups (n=15/group). The experimental group received nine 90–minute individual treatment sessions; however, the
control group received no intervention. The study inclusion criteria included the age range of 30–65 years, experiencing chronic pain, the ability
to attend meetings and collaborate on performing home tasks, no severe psychiatric disorders, no history of attending other psychological therapy
or training, and no alcohol or drug use. Additionally, the ethical considerations, such as describing the research purpose to the study participants,
patient satisfaction, and confidentiality of research data were met in this research project. To collect data, the McGill Pain Questionnaire (MPQ)
(Melsak, 1997), the Quality of Life Questionnaire (QoLQ) (Weir & Sherborne, 1992), and the Pain Catastrophizing Scale (PCS) (Sullivan et al.,
1995) were implemented. At the beginning and end of the group meetings, pretest and posttest assessments were conducted. Eventually, 2 months
after the posttest run, all of the study inventories were re–performed as the follow–up step. The protocol used in this study was based on the
Adrian Wells approach. The obtained data were analyzed using frequent measurement methods in SPSS and R 3.5.3 software at a significance
level of 0.05.
Results: The present study findings revealed that metacognitive therapy education significantly impacted the studied dependent variables in the
research subjects. Moreover, there was a significant difference between the experimental and control groups in terms of pain catastrophizing and
quality of life (p<0.001). On the other hand, the results show that the time effect factor affected (p<0.001). Therefore, pain catastrophizing and
quality of life demonstrated a significant change over time in the experimental group, compared with the controls. As a result, metacognitive
treatment significantly reduced pain catastrophizing and increased quality of life in the explored patients with chronic pain (p<0.001).
Conclusion: The obtained data proposed that metacognitive therapy provided a positive and considerable effect on reducing pain catastrophizing
and improving the quality of life in the investigated patients with chronic pain. Consequently, it is recommended that metacognitive strategies
be used as a formal treatment protocol in healthcare and counseling centers. This intervention should be presented by therapists who have received the necessary training throughout the country.
