اثربخشي درمان مبتني بر پذيرش و تعهد بر انعطاف‌پذيري روان‌شناختي و نشخوار فكري در بيماران با درد غيرقلبي قفسه‌سينه

The Effectiveness of acceptance and commitment therapy on psychological flexibility and rumination in patients with non-cardiac chest pain

زمينه و هدف: علل متنوعي مي‌تواند موجب بروز درد قفسه سينه شود؛ كه معمولاً علل رواني كمتر مورد توجه قرار مي‌گيرند، از اين رو واجد اهميت بيشتري در تشخيص و درمان هستند؛ بنابر اين پژوهش حاضر با هدف تعيين اثربخشي درمان مبتني بر پذيرش و تعهد بر انعطاف‌پذيري رواني و نشخوار فكري در بيماران با درد غيرقلبي قفسه‌سينه انجام شد. روش بررسي: اين پژوهش از نوع نيمه‌آزمايشي به صورت پيش‌آزمون، پس‌آزمون و پيگيري دو ماه بعد با گروه كنترل بود. نمونه پژوهش به صورت در دسترس و شامل تعداد 40 بيمار مراجعه كننده به يكي از بيمارستان‌هاي شهر تهران بود كه پس از ورود به طرح، به‌طور تصادفي در دو گروه آزمايش و كنترل قرار گرفتند. آزمودني‌ها به دو پرسشنامه انعطاف‌پذيري روان‌شناختي و نشخوار فكري (هوكسما و مارو) پاسخ دادند. گروه آزمايش تحت 8 جلسه درمان مبتني بر پذيرش و تعهد قرار گرفتند. سپس نتايج با آزمون‌هاي آماري تي دو گروه مستقل، تحليل واريانس با اندازه‌گيري مكرر و آزمون تعقيبي بونفروني و با استفاده از نرم‌افزار SPSS نسخه 23 بررسي شد. يافته‌ها: يافته‌ها نشان داد كه پس از مداخله، ميانگين نمرات مقياس نشخوار فكري كاهش (0٫001

Background & Objective: Chest pain is one of the common complaints of individuals in referring to therapeutic centers. Generally, examinations characterized show that this pain has a non-cardiac origin. Various factors can cause chest pain for instance pulmonary disorders, digestive disorders, neck arthritis pain and especially psychological factors, which is usually less commonly considered to the cause of mental illness. Therefore, psychological factors are more important in diagnosis and treatment. These factors can cause a negative effect on daily life of patients who have this problem in the form of fatigue, anxiety, depression, dissatisfaction with life and fear of death. Therefore, patients have low ability to do their routines. Mainly, patients do minimize physical activity to reduce their pain. In other words, this problem causes the immobility and impairment or disrupt of physical, social and occupational functioning of them. New research explains the causality, treatment and etiology most of the physical disorders including pain, in the form of "bio-psychosocial" theories. Thus, both of physical and mental therapy should be considered in the treatment process. Therefore, aim of present study was to investigate the effectiveness of acceptance and commitment therapy on psychological flexibility and rumination in patients with non-cardiac chest pain. Methods: This study was a semi-experimental and clinical intervention, pre, post and follow up test for two months after first visit, with a control group. The research sample was available and included 40 patients referred to one of Tehran's hospitals who were randomly divided into two experimental and control groups (experimental group included 7 women, 13 men and control group included 9 women and 11 men). Subjects responded to two questionnaires, AAQ-II questionnaires and rumination (Hoeksma and Muro). Results were analyzed by T test with independent groups, variance with repeated measurements and Bonferroni method. Using SPSS version 23 software. Results: After intervention, in the treatment group mean scores of rumination scales decreased and psychological flexibility increased and in control group mean scores of rumination score increased and psychological flexibility decreased. This supremacy was maintained in the followup after two months in treatment group (p<0.001). Conclusion: Results of this study suggested that acceptance and commitment therapy was effective on psychological flexibility and rumination in patients with non-cardiac chest pain and results of treatment were stable. Therefore, proper diagnosis and treatment could produce desired results and creates satisfactory in these patients. In the other words with this treatment, patients obtain the missing power for movement.