مقايسه اثربخشي آموزش تنظيم هيجان و درمان مبتني بر پذيرش و تعهد بر نارسايي شناختي و اجتناب هيجاني در بيماران مبتلا به MS

Comparison of the effectiveness of Emotion Regulation Skill Training and Acceptance and Commitment Therapy on Cognitive Failures and Emotional Avoidance in Patients with M.S

زﻣﯿﻨﻪ و ﻫﺪف: ﻣﻮﻟﺘﯿﭙﻞ اﺳــﮑﻠﺮوزﯾﺲ ﯾﮏ ﺑﯿﻤﺎري ﻣﺰﻣﻦ ﭘﯿﺸــﺮوﻧﺪه ﺳــﯿﺴــﺘﻢ اﻋﺼــﺎب ﻣﺮﮐﺰي اﺳــﺖ و از ﻋﻼﺋﻢ و ﻧﺸـﺎﻧﻪﻫﺎي آن درد و ﮐﺎﻫﺶ ﻇﺮﻓﯿﺖ ﻋﻤﻠﮑﺮدي ﻣﯽﺑﺎﺷـﺪ. اﯾﻦ ﭘﮋوﻫﺶ ﺑﺎ ﻫﺪف ﻣﻘﺎﯾﺴـﻪ اﺛﺮﺑﺨﺸـﯽ آﻣﻮزش ﺗﻨﻈﯿﻢ ﻫﯿﺠﺎن و درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ ﻧﺎرﺳﺎﯾﯽ ﺷﻨﺎﺧﺘﯽ و اﺟﺘﻨﺎب ﻫﯿﺠﺎﻧﯽ در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ MS اﻧﺠﺎم ﮔﺮﻓﺖ. ﻣﻮاد و روشﻫـﺎ: ﭘﮋوﻫﺶ ﺣـﺎﺿـــﺮ از ﻧﻮع ﻧﯿﻤـﻪﺗﺠﺮﺑﯽ ـﺑﺎ ﻃﺮح ﭘﯿﺶآزﻣﻮن- ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي ﺑﻮد. آزﻣﻮدﻧﯽﻫـﺎ ﺑـﺎ داﻣﻨـﻪ ﺳـــﻨﯽ 20-40 ﺳـــﺎل و ﺑـﺎ ﻣﻘﯿـﺎس ـﻧﺎﺗﻮاﻧﯽ ﺟﺴـــﻤـﺎﻧﯽ )EDSS( ﯾـﮏ ﺗـﺎ 5 /5و ﻫـﺪﻓﻤﻨـﺪاﻧـﻪ و داوﻃﻠﺒـﺎﻧـﻪ اﻧﺘﺨـﺎب و ﺑﻪﺻﻮرت ﺗﺼﺎدﻓﯽ ﺑﻪ ﮔﺮوهﻫﺎي ﺗﺠﺮﺑﯽ و ﮐﻨﺘﺮل ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﻫﺮ دو ﮔﺮوه در ﻣﺮﺣﻠﻪ ﭘﯿﺶآزﻣﻮن- ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي 2 ﻣﺎﻫﻪ ﺑﻪ ﭘﺮﺳــﺶﻧﺎﻣﻪﻫﺎي ﻧﺎرﺳــﺎﯾﯽ ﺷــﻨﺎﺧﺘﯽ ﺑﺮادﺑﻨﺖ و ﻫﻤﮑﺎران و اﺟﺘﻨﺎب ﻫﯿﺠﺎﻧﯽ ﮐﻨﺪي و ﻫﻤﮑﺎران ﭘﺎﺳــﺦ دادﻧﺪ. دادهﻫﺎي ﺟﻤﻊآوري ﺷﺪه ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮماﻓﺰار SPSSﻧﺴﺨﻪ 23 و روش ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ آﻣﯿﺨﺘﻪ ﺑﺎ اﻧﺪازهﮔﯿﺮي ﻣﮑﺮر ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ ﺣﺎﺻﻞ از ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮي ﺑﺎ اﻧﺪازهﮔﯿﺮي ﻣﮑﺮر ﻧﺸﺎن داد ﮐﻪ آﻣﻮزش راﻫﺒﺮدﻫﺎي ﺗﻨﻈﯿﻢ ﻫﯿﺠـﺎﻧﯽ و درﻣـﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘـﺬﯾﺮش و ﺗﻌﻬـﺪ ﺑﺮ ﮐـﺎﻫﺶ ﻧـﺎرﺳـــﺎﯾﯽ ﺷـــﻨـﺎﺧﺘﯽ و اﺟﺘﻨـﺎب ﻫﯿﺠـﺎﻧﯽ ﺑﯿﻤـﺎران ﻣﻮﻟﺘﯿﭙـﻞ اﺳــﮑﻠﺮوزﯾﺲ ﻣﺆﺛﺮ اﺳــﺖ )0 /001≤P(. ﺑﺎزﺑﯿﻨﯽ دﯾﺪاري ﻧﻤﻮدارﻫﺎي اﺛﺮﺑﺨﺸــﯽ و اﻧﺪازه ﺿــﺮﯾﺐ ﺗﺄﺛﯿﺮ ﻧﯿﺰ ﺑﯿﺎﻧﮕﺮ ﺛﺒﺎت ﻣﺪاﺧﻠﻪﻫﺎ در ﻣﺮﺣﻠﻪ ﭘﯿﮕﯿﺮي ﺑﻮدﻧﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﺑﺮاﺳــﺎس ﻧﺘﺎﯾﺞ اﯾﻦ ﭘﮋوﻫﺶ ﻣﯽﺗﻮان از آﻣﻮزش راﻫﺒﺮدﻫﺎي ﺗﻨﻈﯿﻢ ﻫﯿﺠﺎﻧﯽ و درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ در ﮐﻨﺎر ﻣﺪاﺧﻼت داروﯾﯽ ﺑﺮاي ﮐﺎﻫﺶ ﻧﺎرﺳــﺎﯾﯽ ﺷــﻨﺎﺧﺘﯽ و اﺟﺘﻨﺎب ﻫﯿﺠﺎﻧﯽ ﺑﯿﻤﺎران ﻣﻮﻟﺘﯿﭙﻞ اﺳــﮑﻠﺮوزﯾﺲ در ﻣﺮاﮐﺰ درﻣﺎﻧﯽ اﺳﺘﻔﺎده ﮐﺮد.

Multiple sclerosis is a chronic progressive disease of the central nervous system and is characterized by symptoms of pain and decreased functional capacity. The aim of this study was to compare the effectiveness of emotion regulation skill training and acceptance and commitment therapy on cognitive failures and emotional avoidance in patients with MS. Materials and Methods: The present study was a quasi-experimental with a pretest-posttest and follow-up design. Subjects with a age range of 20-20 years and expanded disability status scale (EDSS) of one to 5.5 were selected purposefully and voluntarily and randomly divided into experimental and control groups. In the pre-test-post-test phase and the 2-month follow-up, both groups answered Broadbent and et al. cognitive failure questionnaires and Kennedy et al. emotional avoidance. The collected data were analyzed using SPSS software version 23 and covariance analysis method with repeated measurements. Results: The results of multivariate analysis of covariance with repeated measurements showed that emotion regulation skill training and acceptance and commitment therapy is effective in reducing cognitive Failures and emotional avoidance of multiple sclerosis patients (p<0.001). A review of the effectiveness of the graphs and the size of the impact factor also showed the stability of the interventions in the follow-up phase. Conclusion: Based on the results of this study, we can use the emotion regulation skill training and acceptance and commitment therapy along with drug interventions to reduce cognitive failures and emotional avoidance of multiple sclerosis patients in medical centers.