ﻣﻘﺎﯾﺴﻪ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﻓﺮاﺗﺸﺨﯿﺼﯽ و درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑـﺮ ﺗﻨﻈـﯿﻢ ﻫﯿﺠـﺎن و ادراك ﺑﯿﻤﺎري در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﺳﻨﺪروم روده ﺗﺤﺮﯾﮏ ﭘﺬﯾﺮ

The Comparison of the Effectiveness of Trans-diagnostic Treatment and the Acceptance and Commitment Therapy (ACT) on Emotion Regulation and Illness Perception in Patients with Irritable Bowel Syndrome (IBS)

زﻣﯿﻨﻪ و ﻫﺪف: در ﺑﯿﻦ اﺧﺘﻼﻻت ﮔﻮارﺷﯽ ﮐﺎرﮐﺮدي، ﺳﻨﺪرم روده ﺗﺤﺮﯾﮏﭘﺬﯾﺮ ﺷﺎﯾﻊﺗﺮﯾﻦ، ﭘﺮﻫﺰﯾﻨﻪﺗﺮﯾﻦ و ﻧﺎﺗﻮانﮐﻨﻨﺪهﺗﺮﯾﻦ ﻧﻮع آنﻫﺎ اﺳﺖ. ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﺑﺎﻫﺪف ﻣﻘﺎﯾﺴﻪ ﻣﯿﺰان اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﻓﺮاﺗﺸﺨﯿﺼﯽ و درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ و ﮔﺮوه ﮐﻨﺘﺮل ﺑﺮ ﺗﻨﻈﯿﻢ ﻫﯿﺠﺎن و ادراك ﺑﯿﻤﺎري در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﺳﻨﺪروم روده ﺗﺤﺮﯾﮏﭘﺬﯾﺮ اﻧﺠﺎم ﺷﺪ. ﻣﻮاد و روشﻫﺎ: ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﺷﺒﻪ آزﻣﺎﯾﺸﯽ و از ﻧﻮع ﭘﯿﺶآزﻣﻮن- ﭘﺲآزﻣﻮن ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل ﺑﻮد. ﺟﺎﻣﻌﻪ آﻣﺎري ﭘﮋوﻫﺶ ﺷﺎﻣﻞ ﻫﻤﻪ ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑـﻪ ﺳﻨﺪروم روده ﺗﺤﺮﯾﮏﭘﺬﯾﺮ ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﻣﺮﮐﺰ ﭘﻮرﺳﯿﻨﺎي ﺣﮑﯿﻢ ﺷﻬﺮ اﺻﻔﻬﺎن در ﺳﺎل 1399-1398 ﺑﻮد. ﻧﻤﻮﻧﻪ ﭘﮋوﻫﺶ ﺷﺎﻣﻞ 45 ﻧﻔﺮ ﺑﯿﻤﺎر ﻣﺒـﺘﻼ ﺑـﻮد ﮐﻪ ﺑﻪ روش ﻧﻤﻮﻧﻪﮔﯿﺮي در دﺳﺘﺮس اﻧﺘﺨﺎب ﺷﺪﻧﺪ. ﻫﺮ دو ﻣﺪاﺧﻠﻪ ﺑﻪ ﻣﺪت 8 ﺟﻠﺴﻪ )90 دﻗﯿﻘﻪاي( ﺑﺮاي ﻫﺮ دو ﮔﺮوه آزﻣﺎﯾﺶ در ﻓﺎﺻﻠﻪ زﻣﺎﻧﯽ دو ﻣﺎه اﺟـﺮا ﺷﺪ. از ﭘﺮﺳﺸﻨﺎﻣﻪﻫﺎي ادراك ﺑﯿﻤﺎري ﺑﺮادﺑﻨﺖ و ﻫﻤﮑﺎران و ﺗﻨﻈﯿﻢ ﺷﻨﺎﺧﺘﯽ ﻫﯿﺠﺎن ﮔﺎرﻧﻔﺴﮑﯽ و ﮐﺮاﯾﺞ و ﺑﺮﮔﻪ اﻃﻼﻋﺎت ﺟﻤﻌﯿﺖ ﺷﻨﺎﺧﺘﯽ ﺑـﺮاي ﮔـﺮدآوري ﯾﺎﻓﺘﻪﻫﺎ اﺳﺘﻔﺎده ﺷﺪ. ﺑﺮاي ﺗﺤﻠﯿﻞ دادهﻫﺎ از آزﻣﻮن ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪ ﻣﺘﻐﯿﺮه و ﺗﮏ ﻣﺘﻐﯿﺮه اﺳﺘﻔﺎده ﺷﺪ. ﻧﺮماﻓﺰار ﻣﻮرداﺳﺘﻔﺎده SPSS ﻧﺴﺨﻪ 19 ﺑﻮد. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﮐﻪ ﻣﺪاﺧﻼت درﻣﺎﻧﯽ ﻓﺮاﺗﺸﺨﯿﺼﯽ و ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ اﻓﺰاﯾﺶ ادراك ﺑﯿﻤﺎري و ﮐﺎﻫﺶ راﻫﺒﺮدﻫﺎي ﻏﯿﺮاﻧﻄﺒﺎﻗﯽ ﺗﺄﺛﯿﺮ ﻣﻌﻨـﺎداري ﻧﺪاﺷﺘﻪ اﺳﺖ. درﻣﺎن ﻓﺮاﺗﺸﺨﯿﺺ و ﭘﺬﯾﺮش و ﺗﻌﻬﺪ در اﻓﺰاﯾﺶ راﻫﺒﺮدﻫﺎي اﻧﻄﺒﺎﻗﯽ ﺗﺎﺛﯿﺮ داﺷﺘﻨﺪ )P<0/05(. ﻧﺘﯿﺠﻪﮔﯿﺮي: درﻣﺎﻧﮕﺮان ﻣﯽﺗﻮاﻧﻨﺪ ﺑﺎ اﺳﺘﻔﺎده از ﻣﺪاﺧﻼت ﻣﺬﮐﻮر روشﻫﺎي ﻣﺆﺛﺮي ﺟﻬﺖ ﺑﻬﺒﻮد وﺿﻌﯿﺖ ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﺳﻨﺪروم روده ﺗﺤﺮﯾﮏﭘﺬﯾﺮ اﺗﺨﺎذ ﮐﻨﻨﺪ ﮐﻪ اﺛﺮﺑﺨﺸﯽ درﻣﺎنﻫﺎي ﺧﻮد را ارﺗﻘﺎء ﺑﺨﺸﻨﺪ.

Aim and Background: Irritable bowel syndrome is the most common, costly and debilitating type of disorder among functional gastrointestinal disorders. The aim of this study was to compare the effectiveness of trans-diagnostic treatment and acceptance and commitment therapy and the control group on emotion regulation and illness perception in patients with irritable bowel syndrome. Methods and Materials: The present research was quasi-experimental and pretest-posttest with a control group. The statistical population of this study included all of the patients with irritable bowel syndrome referred to Poursina Hakim Center of Isfahan during 2019-2020. The sample researchconsisted of 45 infected patients that were selected by available sampling method. In addition, they were randomly placed in two experimental groups (15 patients in each group) and one control group (with 15 patients). Integrated trans-diagnostic intervention of Barlow (2011) was done for the first experimental group during 8 session (90min). On the other hand, acceptance and commitment therapy of Hayes (2002) was done for the second experimental group during 8 session (90min) in two months interval and the control group did not receive any intervention. From the Broadbent et al.'s illness perception questionnaire and the Garnefski & Kraaij (2006) cognitive- emotion regulation and demographic data sheet were used to collect the findings. Multivariate and univariate analysis of covariance were used to analyze the data. The software used was SPSS version 19. Findings: The results showed that trans-diagnostic therapeutic interventions and acceptance and commitment did not have a significant effect on increasing illness perception and reducing non-adaptive strategies. Trans diagnostic treatment and acceptance and commitment had affected on increasing adaptive strategies (P <0.05). Conclusions: Therapists can adopt effective methods by using above- mentioned interventions in order to improve the condition of patients having irritable bowel syndrome to increase the efficacy of their treatments.