اثربخشی رواندرمانی گروهی شناختی رفتاری چند مؤلفه ای بر شدت بی خوابی و کیفیت خواب بیماران مبتلا به سرطان پستان پس از عمل جراحی

نویسندگان
نجمه شفاعت
شاهرخ مکوند حسینی
علی محمد رضایی
دانشگاه سمنان
10.29252/rph.11.2.82
چکیده
هدف از این مطالعه بررسی اثربخشی گروه درمانی شناختی-رفتاری چند مؤلفه ای بر شدت بی خوابی و کیفیت خواب بیماران مبتلا به سرطان پستان پس از عمل جراحی بود. با استفاده از روش نمونه گیری در دسترس و انتصاب تصادفی با احتساب معیارهای ورود و خروج از نمونه، نمونه ای به حجم 30 نفر انتخاب و در دو گروه آزمایش و کنترل (15 نفر آزمایش و 15 نفر کنترل) قرار گرفتند. معیارهای ورود و خروج کنترل شدند و پرسشنامه کیفیت خواب پیتزبورگ، شاخص شدت بی خوابی مورین در سه مرحله )پیش آزمون، پس آزمون و پی گیری( توسط همه آزمودنی ها تکمیل شد. پروتکل شش جلسه ای گروه درمانی شناختی-رفتاری چند مؤلفه ای تنها بر روی گروه آزمایش اجرا گردید، درحالیکه گروه گواه تنها جلسات ملاقات ساده با رواندرمانگر داشتند. داده ها از پرسشنامه ها استخراج شد و با استفاده از آزمون آماری تحلیل کواریانس چند متغیری تحلیل شدند. تفاوت های معناداری در میانگین کیفیت خواب درمراحل پس آزمون و پی گیری و نیز در شدت بی خوابی در مرحله پی گیری، میان دو گروه بدست آمد و میانگین گروه آزمایش پایین تر از گروه کنترل بود. گروه درمانگری شناختی- رفتاری چند مؤلفه ای باعث بهبود شدت بی خوابی و کیفیت خواب بیماران مبتلا به سرطان پستان پس از عمل جراحی می شود و به منظور بهبود مشکلات خواب آنان توصیه می گردد.
کلیدواژه‌ها
گروه درمانی
درمان شناختی رفتاری
درمان چند مؤلفه ای
بی خوابی
سرطان پستان

عنوان مقاله English

Effectiveness of Multi-components Cognitive-behavioral Therapy on Insomnia Intensity and Quality of sleep among Breast Cancer Patients after Surgery

نویسندگان English

Najmeh Shafaat
Shahrokh Makvand Hosseini
Ali Mohammad Rezaei
Semnan university
چکیده English

The aim of the current research was to examine the effectiveness of group multi-components cognitive-behavior therapy on insomnia severity and quality of sleep of breast cancer patients after surgerical operation. Applying an available sampling procedure and randome assignment method for assigning group samples, a sample of 30 breast cancer patients (experimental=15, control= 15) were selected. The criteria of inclusion and exclusion were checked for and the Pittsburgh Sleep Quality Index (PSQI) and Insimnia Severity Inventory (ISI) were completed by all subject in three occasions (pre, post and follow-up stages). The six session’s therapy protocol were conducted on experimental group, whereas another group received only simple meeting with the therapist. Data extracted from questionnaires and analysed using Multivariate Analysis of Covariance (MANCOVA). Significant differences were revealed for insomnia severity in the follow up stage, and for quality of sleep in the post-test and follow-up stages, between two groups with decreased mean scores in the experimental group than contol.Multi-components Cognitive-behavioral therapy could improve insomnia severity and sleep quality of patients with breast cancer after surgery and is recommended for these patients to resolve their insomnia problems.

کلیدواژه‌ها English

: insomnia
cognitive behavioral therapy
multi component therapy
breast cancer
1. Van Houdenhove L, Buyse B, Gabriëls L, Van den Bergh O. Treating primary insomnia: clinical effectiveness and predictors of outcomes on sleep, daytime function and health-related quality of life. Journal of clinical psychology in medical settings. 2011;18(3):312-21.
2. Czeisler CA. Sleep deficit. Harvard Bus Rev. 2006;84:53-9.
3. Smith MT, Huang MI, Manber R. Cognitive behavior therapy for chronic insomnia occurring within the context of medical and psychiatric disorders. Clinical psychology review. 2005;25(5):559-92.
4. Fiorentino L, Ancoli-Israel S. Insomnia and its treatment in women with breast cancer. Sleep medicine reviews. 2006;10(6):419-29.
5. Ginsburg M, Quirt C, Ginsburg A, MacKillop WJ. Psychiatric illness and psychosocial concerns of patients with newly diagnosed lung cancer. CMAJ: Canadian Medical Association Journal. 1995;152(5):701.
6. Sarna L. Correlates of symptom distress in women with lung cancer. Cancer Practice. 1992;1(1):21-8.
7. MPs SS, MPs JB, MPs HI. Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep. 2001;24(5):583.
8. Kryger M. A woman's guide to sleep disorders: McGraw Hill Professional; 2004.
9. Fortner BV, Stepanski EJ, Wang SC, Kasprowicz S, Durrence HH. Sleep and quality of life in breast cancer patients. Journal of pain and symptom management. 2002;24(5):471-80.
10. Fiorentino L, McQuaid JR, Liu L, Natarajan L, He F, Cornejo M, et al. Individual cognitive behavioral therapy for insomnia in breast cancer survivors: a randomized controlled crossover pilot study. Nature and science of sleep. 2009;2010:1.
11. Neylan TC. Time to disseminate cognitive behavioral treatment of insomnia: comment on “efficacy of brief behavioral treatment for chronic insomnia in older adults”. Archives of internal medicine. 2011;171(10):895-6.
12. Morin C, Blais F, Savard J. Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia? Behaviour research and therapy. 2002;40(7):741-52.
13. Rumble ME, Keefe FJ, Edinger JD, Porter LS, Garst JL. A pilot study investigating the utility of the cognitive-behavioral model of insomnia in early-stage lung cancer patients. Journal of pain and symptom management. 2005;30(2):160-9.
14. Espie CA. Stepped care”: a health technology solution for delivering cognitive behavioral therapy as a first line insomnia treatment. Sleep. 2009;32(12):1549-58.
15. Koffel EA, Koffel JB, Gehrman PR. A meta-analysis of group cognitive behavioral therapy for insomnia. Sleep medicine reviews. 2015;19:6-16.
16. Harvey AG, Sharpley AL, Ree MJ, Stinson K, Clark DM. An open trial of cognitive therapy for chronic insomnia. Behaviour Research and Therapy. 2007;45(10):2491-501.
17. Quesnel C, Savard J, Simard S, Ivers H, Morin CM. Efficacy of cognitive-behavioral therapy for insomnia in women treated for nonmetastic breast cancer. Journal of consulting and clinical psychology. 2003;71(1):189.
18. Edinger JD, Carney CE. Overcoming insomnia: A cognitive-behavioral therapy approach, therapist guide: Oxford University Press; 2014.
19. Savard J, Simard S, Ivers H, Morin CM. Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, part I: Sleep and psychological effects. Journal of Clinical Oncology. 2005;23(25):6083-96.
20. Savard J, Simard S, Ivers H, Morin CM. Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, part II: Immunologic effects. Journal of Clinical Oncology. 2005;23(25):6097-106.
21. Espie CA, Inglis SJ, Tessier S, Harvey L. The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: implementation and evaluation of a sleep clinic in general medical practice. Behaviour research and therapy. 2001;39(1):45-60.
22. Jacobs GD, Pace-Schott EF, Stickgold R, Otto MW. Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison. Archives of internal medicine. 2004;164(17):1888-96.
23. Morgan K, Dixon S, Mathers N, Thompson J, Tomeny M. Psychological treatment for insomnia in the management of long-term hypnotic drug use: a pragmatic randomised controlled trial. Br J Gen Pract. 2003;53(497):923-8.
24. Edinger JD, Sampson WS. A primary care" friendly" cognitive behavioral insomnia therapy. SLEEP-NEW YORK THEN WESTCHESTER-. 2003;26(2):177-84.
25. Edinger JD, Means MK, Carney CE, Krystal AD. Psychomotor performance deficits and their relation to prior nights' sleep among individuals with primary insomnia. SLEEP-NEW YORK THEN WESTCHESTER-. 2008;31(5):599.