بررسی تأثیر آموزش مدیریت استرس مبتنی بر رویکرد شناختی-رفتاری بر کاهش اضطراب، اجتناب شناختی و بهبود کیفیت زندگی مرتبط با سلامت در بیماران مبتلا به درد مزمن

نویسندگان
محسن جلالی 1
مریم سیاری مرکیه 2
سیده رقیه سیدآقایی احمدی 2
ثریا نصیری 3
1 استادیار روان شناسی بالینی،دانشکده علوم انسانی و اجتماعی، دانشگاه گلستان،گرگان، ایران.
2 گروه روانشناسی سلامت ، واحد گرگان، دانشگاه آزاد اسلامی ،گرگان،ایران‌.
3 کارشناسی ارشدروان شناسی عمومی،واحدسمنان،دانشگاه آزاد اسلامی،سمنان،ایران.
چکیده
هدف این پژوهش بررسی اثربخشی آموزش مدیریت استرس مبتنی بر رویکرد شناختی-رفتاری بر اضطراب، اجتناب شناختی و کیفیت زندگی مرتبط با سلامت در بیماران مبتلا به درد مزمن بود. این مطالعه نیمه‌آزمایشی با طرح پیش‌آزمون-پس‌آزمون و پیگیری همراه با گروه کنترل انجام شد. جامعه آماری شامل بیماران مبتلا به درد مزمن شهر تهران در نیمه دوم سال 1402 بود. از میان آن‌ها، 30 بیمار به روش نمونه‌گیری هدفمند انتخاب و به‌طور تصادفی در گروه‌های آزمایش و کنترل قرار گرفتند. گروه آزمایش در 10 جلسه آموزش مدیریت استرس مبتنی بر رویکرد شناختی-رفتاری (حاجیلو و همکاران، 1397) شرکت کردند. برای ارزیابی تأثیر مداخله، مقیاس اضطراب بک (1990)، مقیاس اجتناب شناختی سکستون و داگاس (2004)، و پرسشنامه کیفیت زندگی مرتبط با سلامت (2003) در سه مرحله پیش‌آزمون، پس‌آزمون و پیگیری استفاده شد. تحلیل کوواریانس چندمتغیره نشان داد که این مداخله به‌طور معناداری موجب کاهش اضطراب و اجتناب شناختی و افزایش کیفیت زندگی مرتبط با سلامت بیماران شد (P<0.05). نتایج نشان می‌دهد آموزش مدیریت استرس مبتنی بر رویکرد شناختی-رفتاری می‌تواند به‌عنوان یک مداخله مؤثر برای بهبود سلامت روان و کیفیت زندگی بیماران مبتلا به درد مزمن مورد استفاده قرار گیرد.
کلیدواژه‌ها
اموزش مدیریت استرس مبتنی بر رویکرد شناختی رفتاری
اضطراب
اجتناب شناختی
کیفیت زندگی مرتبط با سلامت
درد مزمن

عنوان مقاله English

Investigating the effect of stress management training based on cognitive-behavioral approach on reducing anxiety, cognitive avoidance, and improving health-related quality of life in patients with chronic pain

نویسندگان English

Mohsen Jalali 1
Maryam Sayari Markieh 2
Seyedeh Roghayeh Seyed Aghaei Ahmadi 2
Soraya Nasiri 3
چکیده English

The aim of this study was to examine the effectiveness of cognitive-behavioral stress management training on anxiety, cognitive avoidance, and health-related quality of life in patients with chronic pain. This semi-experimental study used a pre-test-post-test design with follow-up and a control group. The statistical population consisted of patients with chronic pain in Tehran during the second half of 2023. Thirty patients were selected using purposive sampling and randomly assigned to the experimental and control groups. The experimental group participated in 10 sessions of cognitive-behavioral stress management training (Hajilu et al., 2018). To evaluate the impact of the intervention, the Beck Anxiety Inventory (1990), the Sexton and Dugas Cognitive Avoidance Scale (2004), and the Health-Related Quality of Life Questionnaire (2003) were administered at pre-test, post-test, and follow-up stages. Multivariate analysis of covariance revealed that the intervention significantly reduced anxiety and cognitive avoidance while improving health-related quality of life (P<0.05). The results suggest that cognitive-behavioral stress management training can be an effective intervention for improving the mental health and quality of life of patients with chronic pain.

کلیدواژه‌ها English

Stress management training based on the cognitive behavioral approach
Health Anxiety
cognitive avoidance
health-related quality of life
Chronic pain
1. Amani, H., Habibi Kleiber, R., Fereid, A., & Sheikh-Alizadeh, S. (2020). The role of emotion regulation and cognitive avoidance in predicting exam anxiety in female students. Ravish Psychology Journal, 10(5), 138-129
2. Bagheri Sheykhangafshe F, Tajbakhsh K, Savabi Niri V, Nakhostin Asef Z, Fathi-Ashtiani A. The Efficacy of Cognitive-behavioral Therapy on Psychological Distress and Coping Strategies of Employees with Chronic Low Back Pain. Iranian J Health Sci 2023; 11(2): 99-108.
3. Baghery Sheikhangofsheh, F., Farahani, H., Dehghani, M., & Fathi Ashtiani, A. (2023). A systematic review of the relationship between mental health and chronic pain in children and adolescents. Rafsanjan University of Medical Sciences Journal, 22(6), 617-636.
4. Baghery Sheikhangofsheh, F., Farahani, H., Dehghani, M., & Fathi Ashtiani, A. (2023). A systematic review of the relationship between mental health and chronic pain in children and adolescents. Rafsanjan University of Medical Sciences Journal, 22(6), 617-636
5. Bahrami, P., Farzandeh, E. (2021). Addiction tendencies in adolescents from divorced families, compatible families, and incompatible families. 7th International Conference on Psychology and Social Sciences.
6. Barroso J, Madisetti M, Mueller M. A feasibility study to develop and test a cognitive behavioral stress management mobile health application for HIV-related fatigue. J Pain Symptom Manage 2022; 59(2): 242-53.
7. Basaknejad, S., Moieni, N., & Mehrabizadeh Honarmand, M. (2010). The relationship between post-event processing and cognitive avoidance with social anxiety in students. Journal of Behavioral Sciences, 4(4), 340-335.
8. Bazargan, A. (2016). Introduction to qualitative and mixed research methods. Didar Publication.
9. Beam Ch, Dinescu D, Emery R (2022) A Twin Study on Perceived Stress, Depressive Symptoms, and Marriage , Journal of Health and Social Behavior, https://doi.org/10.1177/0022146516688242
10. Behrami Koohshahi, S., Golshani, F., Baghdasarian, A., & Ghobari-Panah, A. (2023). The structural model of chronic pain based on mindfulness, social support, and life events with the mediating role of psychological distress. Journal of Nursing and Midwifery, 21(7), 530-541.
11. Biria, D., Bediyeh, M., Rabei, Z., & Shokrollahi, M. (2023). Effectiveness of cognitive analytical therapy on anxiety sensitivity and catastrophizing of pain in patients with chronic pain and alexithymia. Tooleh Behzisti Journal, 22(6), 62-75.
12. Bozorgi Z (2019) The Effectiveness of schema therapy on general health, ruminating and social loneliness of divorce Women , Journal of Psychological Achievement, 4(2)
13. Duares R, Khafif T, Neto F (2020) Effectiveness of Cognitive Behavioral Couple Therapy on Reducing Depression and Anxiety Symptoms and Increasing Dyadic Adjustment and Marital Social Skills: An Exploratory Study , The Family Journal , https://doi.org/10.1177/1066480720902410
14. Ghaffarzadeh Almasi, N., Hajializadeh, K., & Tajeri, B. (2021). Effectiveness of Stress Management and Acceptance and Commitment Therapy in Psychological Capital among Patients with Type 2 Diabetes. Razavi Int J Med., 9(2): e1009.
15. Haraldstad K, Christophersen KA, Helseth S. Health-related quality of life and pain in children and adolescents: a school survey. BMC Pediatr 2021; 17(1): 1-8
16. Izadmehr, A. (2020). The effectiveness of acceptance and commitment therapy on mental health and resilience in children of divorced parents. 6th International Conference on School Psychology.
17. Jallali, A., Pourhossein, R., & Ali Pour, A. (2021). Comparing the effectiveness of stress management methods based on cognitive-behavioral approach and self-care education, and the combination of both, on health-related quality of life in individuals with type 2 diabetes. Journal of Health Psychology, 11(44).
18. Johansson M, Marcusson-Clavertz D, Gunnarsson C, Olsson I, Kaldo V, Bratt A. Feasibility and preliminary evaluation of internet-based compassion and cognitive–behavioral stress-management courses for health care professionals: A randomized controlled pilot trial. Internet Interventions 2022; 30(1): 1-10
19. Mahmood Ali Lou, M., Shahjouei, T., & Hashemi, Z. (2010). Comparison of intolerance to uncertainty, cognitive avoidance, negative orientation towards problems, and positive beliefs about worry between patients with generalized anxiety disorder and normal individuals. Journal of Scientific Research in Psychology, 5(20).
20. MahmoodPour A, Rayesh N, Ghanbarian E (2021) Effectiveness of acceptance and commitment therapy (ACT) on emotional regulation and loneliness of divorced women in Iran , doi: 10.1111/jmft.12492. Epub 2021
21. Manjazi, F., Asadpour, S., & Rasouli, M. (2020). The impact of group counseling based on stress management education on reducing psychological distress in children of divorced parents. Applied Psychological Research Journal.
22. Markert C, Gomm C, Ehlert U, Gaab J, Nater UM. Effects of cognitive-behavioral stress management training in individuals with functional somatic symptoms–an exploratory randomized controlled trial. Stress 2022; 22(6): 696-706.
23. Mofid, M., Nazari, A., & Ahmadian, A. (2023). Effectiveness of stress management education on depression and health-related quality of life in female prisoners in Isfahan. Women’s Research Journal, 5(1).
24. Motakeffar M, Bakhshi Pour A, Ghasemi Motlagh M. Comparison of the effectiveness of mindfulness-based cognitive therapy and emotion-oriented therapy on self-care behaviors and sexual function in patients with type 2 diabetes. Journal of Sabzevar University of Medical Sciences 2022; 29(1): 131-41.
25. Moteqi, S., Rahimian-Bogar, S., Moradi, S., & Satodeh Asl, N. (2023). The effectiveness of online cognitive-behavioral stress management training on blood sugar control and sexual functioning problems in married women with diabetes during the COVID-19 pandemic: A semi-experimental study. Rafsanjan University of Medical Sciences Journal, 22(4), 333-348.
26. Nakhaei-Moghadam, R., Bahriniyan, S. A., & Nasiri, M. (2023). The effectiveness of mindfulness on mental well-being, attachment styles, and health anxiety in patients with chronic pain. Journal of Medical School, 66(6).
27. Noroozi, Z., Hamidian, S., Khajeddin, N., Mehrabi Zadeh Honarmand, M., Zargar, Y., Rashidi, H., & Dolatshahi, B. (2022). Improving Depression, and Quality of Life in Patients with Type 2 Diabetes: Using Group Cognitive Behavior Therapy. Iranian journal of psychiatry, 12(4), 281–286.
28. Pour naghash S (2019) Impulsivity, and Marital Adjustment , Journal of Psychiatry Depression & Anxiety , DOI:10.24966/PDA-0150/100020
29. Rehman K, Akash MSH. (2023). Mechanism of generation of oxidative stress and pathophysiology of type 2 diabetes mellitus: how are they interlinked? J Cell Biochem., 118:3577–3585.
30. Sahranavard, S., Esmaeili, A., Salehiniya, H., & Behdani, S. (2023). The effectiveness of group training of cognitive behavioral therapy-based stress management on anxiety, hardiness and self-efficacy in female medical students. J Educ Health Promot., 15;8:49.
31. Shokrollahi, M., Hashemi, S. I., Mehrabizadeh Honarmand, M., Zargar, Y., & Naami, A. Z. (2020). Comparing the effectiveness of emotion-focused therapy and cognitive analytical therapy on anxiety sensitivity, catastrophizing pain, experimental avoidance, and emotion regulation in patients with chronic pain and alexithymia. Behavioral Sciences Research Journal, 19(4), 739-752.
32. Tang WX, Zhang LF, Ai YQ, Li ZS. Efficacy of Internet-delivered cognitive-behavioral therapy for the management of chronic pain in children and adolescents: A systematic review and meta-analysis. Medicine 2023; 97(36): 12061.
33. Yang X, Pan A, Gong J, Wen Y, Ye Y, Wu JH, Pan XF, Yang CX. (2021) Prospective associations between depressive symptoms and cognitive functions in middle-aged and elderly Chinese adults. J Affect Disord. 2020; 263:692–97. 10.1016/j.jad.2019.11.048