تعيين اثر بخشي درمان متمركز بر شفقت بر افسردگي، رفتارهاي خود مراقبتي و كيفيت زندگي بيماران مبتلا به سندرم رودهٔ تحريك‌ پذير

The Effects of Self-Compassion Therapy on Depression, Self-Care Behaviors, and Quality of Life in Patients With Irritable Bowel Syndrome

زمينه و هدف: سندرم رودهٔ تحريك‌پذير مي‌تواند تأثير نامطلوبي بر كيفيت ‌زندگي بيماران بگذارد. مطالعهٔ حاضر با هدف تعيين اثربخشي درمان متمركز بر شفقت بر افسردگي، رفتارهاي خودمراقبتي و كيفيت ‌زندگي بيماران مبتلا به سندرم رودهٔ تحريك‌پذير انجام شد. روش‌ بررسي: پژوهش حاضر از نوع تحقيقات نيمه‌آزمايشي با طرح پيش‌آزمون-پس‌آزمون و پيگيري همراه با گروه گواه بود. جامعهٔ آماري تمامي بيماران مبتلا به سندرم رودهٔ تحريك‌پذير مراجعه‌كننده به بيمارستان خورشيد شهر اصفهان بين ماه‌هاي شهريور تا آبان 1398 بودند. از بين آن‌ها، تعداد 30 نفر داوطلب واجد شرايط وارد به‌صورت دردسترس انتخاب شدند. سپس به‌طور تصادفي در دو گروه آزمايش و گواه قرار گرفتند. داده‌ها با استفاده از مقياس افسردگي بك-ويرايش دوم (بك، 1996) و پرسشنامهٔ خودمراقبتي (عليزاده ‌اقدم و همكاران، 1395) و پرسشنامهٔ كيفيت ‌زندگي (وير و شربورن، 1992) جمع‌آوري شدند. تحليل داده‌ها با استفاده از روش تحليل واريانس با اندازه‌گيري‌ مكرر و نرم‌افزار SPSS نسخهٔ 22 انجام پذيرفت. سطح معناداري آزمون‌ها 0٫05 در نظر گرفته شد. يافته‌ها: نتايج نشان داد كه درمان متمركز بر شفقت به‌طور معناداري منجربه بهبود افسردگي (اثر گروه: 0٫004=p، اثر زمان: 0٫001>p، اثر زمان*گروه: 0٫001>p)، رفتارهاي خودمراقبتي (اثر گروه: 0٫022=p، اثر زمان: 0٫001>p، اثر زمان*گروه: 0٫001>p) و كيفيت‌ زندگي (اثر گروه: 0٫006=p، اثر زمان: 0٫001>p، اثر زمان*گروه: 0٫001>p) در گروه آزمايش در پس‌آزمون و پيگيري مي‌شود؛ اما نمرات افسردگي و رفتارهاي خودمراقبتي و كيفيت ‌زندگي در گروه گواه تغييري ندارد. نتيجه‌گيري: براساس يافته‌هاي اين پژوهش درمان متمركز بر شفقت بر افسردگي، رفتارهاي خودمراقبتي و كيفيت ‌زندگي بيماران مبتلا به سندرم رودهٔ تحريك‌پذير مؤثر است.

Background & Objectives: Irritable Bowel Syndrome (IBS) is the most frequent diagnosis among gastrointestinal diseases. Anxiety and depression are prevalent among individuals with IBS and are strongly associated with the onset and severity of symptoms. The Quality of Life (QoL) is an essential part of medical evaluation and health status assessment of patients with IBS. A crucial goal of controlling IBS is to empower patients to perform self-care. Self-care is affected by important psychological factors considered by researchers in this field, such as anxiety and depression. Self-Care improves QoL and reduces the cost of treatment. The present study aimed to determine the effects of self-compassion therapy on depression, self-care behaviors, and QoL among patients with IBS. Methods: This was an applied and quasi-experimental research with a pretest-posttest-follow-up and a control group design. The statistical population of this study included all patients with IBS, referring to Khorshid Hospital in Isfahan City, Iran, from September to November 2019. Of them, 30 volunteers were selected to participate in the study by convenience sampling method. They were randomly divided into the intervention and control groups. The study inclusion criteria included the diagnosis of IBS based on Roman II criteria according to a gastroenterologist and not receiving psychological treatment for the past three months. The study exclusion criteria included symptoms, such as gastrointestinal bleeding, blood in the stool, fever, 10% weight loss over the past 6 months, a family history of colon cancer, or severe psychiatric illnesses in the first-degree relatives or neighbors. Self-Compassion therapy was performed for the experimental group in 4 sessions (one 90- min session per week); however, the control group received no training. The required data were obtained using the Beck Depression Inventory- II (Beck, 1996), the Self-Care Questionnaire (Alizadeh Aghdam et al., 2016), and the Quality of Life Scale (Ware & Sherborne, 1992). The obtained data were analyzed using repeated-measures Analysis of Variance (ANOVA) in SPSS. The significance level of the tests was considered as 0.05. Results: The current research results suggested that self-compassion therapy significantly improved the scores of depression (group effect: p=0.004; the effect of time: p<0.001; the effect of time*group: p<0.001), self-care behaviors (group effect: p=0.022; time effect: p<0.001; time effect*group: p<0.001), and QoL (group effect: p=0.006; time effect: p<0.001; time effect*group: p<0.001) in the experimental group at posttest and follow-up; however, the scores of depression, self-care behaviors, and QoL remained unchanged in the controls. Additionally, the scores of depression decreased in the experimental group at posttest, compared to the pretest (p<0.001). Furthermore, depression scores in the follow-up stage were significantly different from those of the pretest stage (p<0.001). There was also a significant difference between the posttest and follow-up values in the test group (p=0.035). The posttest QoL scores of the experimental group were higher than those of the pretest stage (p<0.001). The follow-up scores of QoL significantly differed from those of the pretest stage (p<0.001). We also detected a significant difference between the scores of the posttest and follow-up stages (p=0.011). The collected results revealed that the scores of self-care behaviors in the experimental group were higher in the post-test stage, compared to those of the pretest (p<0.001). Moreover, the scores of self-care behaviors in the follow-up stage were significantly different from those of the pretest stage (p<0.001). There was a significant difference between the posttest and follow-up scores in this regard (p=0.035). The present research findings demonstrated that the effectiveness of self-compassion treatment failed to last until the follow-up phase concerning depression, QoL, and self-care behaviors; the relevant values significantly reduced in the follow-up. Conclusion: It can be concluded that self-compassion therapy was effective on depression, self-care behaviors, and QoL among the explored patients with IBS.