مقایسه اثربخشی درمان کاهش استرس مبتنی بر ذهن آگاهی (MBSR) با روان درمانی پویشی کوتاه مدت فشرده (ISTDP) بر کاهش نشانه های وسواس و بهبود پایبندی به درمان در بیماران مبتلا به بیماری کبد چرب غیر الکلی

نویسندگان
-محمد مهدی زیدآبادی نژاد
احمد ترابی
فاطمه محمدی فر
زهرا نوری
رویا توکلی
چکیده
هدف پژوهش حاضر، مقایسه اثربخشی درمان کاهش استرس مبتنی بر ذهن‌آگاهی (MBSR) و روان‌درمانی پویشی کوتاه‌مدت فشرده (ISTDP) بر کاهش نشانه‌های وسواس و بهبود پایبندی به درمان در بیماران مبتلا به بیماری کبد چرب غیر الکلی بود. این مطالعه به روش نیمه‌آزمایشی و با طرح پیش‌آزمون-پس‌آزمون و پیگیری یک‌ماهه، با دو گروه آزمایش و یک گروه گواه اجرا شد. جامعه آماری شامل کلیه بیماران مبتلا به بیماری کبد چرب غیرالکلی مراجعه‌کننده به مراکز درمانی شهر تهران در پاییز 1404 بود که از بین آنان، ابتدا 72 نفر به شیوه نمونه‌گیری هدفمند انتخاب شده و بعد از ریزش نهایتا 45 نفر به طور تصادفی در سه گروه (هر گروه 15 نفر) قرار گرفتند. درمان‌های MBSR و ISTDP، هر یک طی هشت جلسه ۹۰ دقیقه‌ای به صورت فردی برای گروه‌های آزمایش اجرا شد و گروه گواه در لیست انتظار قرار گرفت. ابزارهای گردآوری داده‌ها شامل پرسشنامه نشانه‌های وسواس (MOCI) و مقیاس پایبندی به درمان (MMAS) بود. نتایج تحلیل واریانس با اندازه­ گیری مکرر نشان داد هر دو رویکرد MBSR و ISTDP به طور معناداری باعث کاهش نشانه‌های وسواس و افزایش پایبندی به درمان در این بیماران شدند و این تأثیرات حداقل تا یک ماه پس از مداخله پایدار باقی ماند. همچنین، آزمون تعقیبی بونفرونی نشان داد MBSR در کاهش نشانه‌های وسواس و بهبود پایبندی به درمان نسبت به ISTDP اثربخشی بیشتری داشته است .. این برتری می‌تواند ناشی از توانایی MBSR در بهبود تنظیم هیجان، کاهش استرس و افزایش خودآگاهی بدنی باشد؛ عواملی که نقش تعیین‌کننده‌ای در مدیریت بیماری‌های مزمن و رفتارهای سلامت‌محور دارند. بر این اساس، استفاده از مداخلات مبتنی بر ذهن‌آگاهی به عنوان رویکردی کارآمد در کنار سایر درمان‌های روان‌شناختی می‌تواند به ارتقای پیامدهای درمانی و بهبود کیفیت زندگی بیماران مبتلا به کبد چرب غیرالکلی کمک کند.
کلیدواژه‌ها
درمان کاهش استرس مبتنی بر ذهن آگاهی
روان‌درمانی پویشی کوتاه‌مدت فشرده
نشانه‌های وسواس
پایبندی به درمان
بیماری کبد چرب غیرالکلی

عنوان مقاله English

Comparing the Effectiveness of Mindfulness Based Stress Reduction (MBSR) and Intensive Short Term Dynamic Psychotherapy (ISTDP) on Reducing Obsessive Compulsive Symptoms and Improving Treatment Adherence in Patients with Non Alcoholic Fatty Liver Disease

نویسندگان English

Mohammad Mehdi Zeidabadinejad
ahmad torabi
fatemeh mohammadifar
zahra nori
roya tovakoli
چکیده English

The aim of the present study was to compare the effectiveness of Mindfulness‑Based Stress Reduction (MBSR) and Intensive Short‑Term Dynamic Psychotherapy (ISTDP) on reducing obsessive‑compulsive symptoms and improving treatment adherence in patients with non‑alcoholic fatty liver disease (NAFLD). This study employed a quasi‑experimental design with a pretest‑posttest and one‑month follow‑up, including two experimental groups and one control group. The statistical population comprised all patients with non-alcoholic fatty liver disease (NAFLD) who attended treatment centers in Tehran during autumn 2025. From this population, 72 individuals were initially selected using purposive sampling; after attrition, the final sample consisted of 45 participants who were randomly assigned to three groups (15 participants per group). MBSR and ISTDP were each delivered individually over eight 90‑minute sessions to the experimental groups, while the control group was placed on a waiting list. Data were collected using the Maudsley Obsessive‑Compulsive Inventory (MOCI) and the Morisky Medication Adherence Scale (MMAS). Results of repeated‑measures analysis of variance (ANOVA) indicated that both MBSR and ISTDP significantly reduced obsessive‑compulsive symptoms and improved treatment adherence, and these effects remained stable for at least one month post‑intervention. Furthermore, Bonferroni post‑hoc tests showed that MBSR was significantly more effective than ISTDP in reducing obsessive‑compulsive symptoms and improving treatment adherence (p < 0.05). This superiority may be attributed to MBSR’s capacity to enhance emotion regulation, reduce stress, and increase body awareness—factors that play a decisive role in managing chronic diseases and health‑oriented behaviors. Therefore, incorporating mindfulness‑based interventions as an effective approach alongside other psychological treatments may help improve treatment outcomes and quality of life in patients with NAFLD.

کلیدواژه‌ها English

Mindfulness Based Stress Reduction (MBSR)
Intensive Short Term Dynamic Psychotherapy (ISTDP)
Obsessive compulsive symptoms
treatment adherence
Non alcoholic fatty liver disease (NAFLD)
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