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اثربخشی درمان مبتنی بر پذیرش و تعهد بر ادراک استرس، انعطافپذیری شناختی و عملکرد روانی مبتلایان به آسم | ||
| روانشناسی سلامت | ||
| دوره 14، شماره 55، آذر 1404، صفحه 41-56 اصل مقاله (1.22 M) | ||
| نوع مقاله: علمی- پژوهشی | ||
| شناسه دیجیتال (DOI): 10.30473/hpj.2025.74525.6245 | ||
| نویسندگان | ||
| محمدباقر کجباف* 1؛ مسلم سیاهپوش منفرد2 | ||
| 1استاد، گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه اصفهان، اصفهان، ایران. | ||
| 2دانشجوی دکتری، گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه اصفهان، اصفهان، ایران. | ||
| چکیده | ||
| مقدمه: پژوهش حاضر با هدف بررسی اثربخشی درمان مبتنی بر پذیرش و تعهد (Acceptance and Commitment Therapy؛ ACT) بر استرس ادراک شده، انعطافپذیری شناختی و عملکرد روانی در میان بیماران مبتلا به آسم انجام شد. آسم نهتنها یک وضعیت مزمن تنفسی است، بلکه اختلالی محسوب میشود که بار روانشناختی قابلتوجهی بر افراد وارد میکند و غالباً منجر به افزایش استرس، راهبردهای مقابلهای ناسازگار و کاهش کیفیت زندگی میگردد. بنابراین، پرداختن به جنبههای روانشناختی بیماری در کنار درمانهای پزشکی، از اهمیت بسزایی برخوردار است. روش: این مطالعه شبهآزمایشی با طرح پیشآزمون-پسآزمون و گروه کنترل بود. جامعه شامل بیماران مبتلا به آسم مراجعهکننده به کلینیکهای خرمآباد در سال ۱۴۰۲ بود که با نمونهگیری هدفمند انتخاب و بهصورت تصادفی در دو گروه آزمایش و کنترل (هرکدام ۱۵ نفر) گمارده شدند. گروه آزمایش طی هشت جلسه درمان گروهی مبتنی بر ACT شرکت کرد و گروه کنترل فقط مراقبتهای معمول پزشکی را دریافت نمود. دادهها با استفاده از مقیاسهای PSS، CFI و DASS-21 در دو مرحله گردآوری و با آزمونهای t و تحلیل کوواریانس چندمتغیره (MANCOVA) در نرمافزار SPSS-26 تحلیل شد. یافتهها: میانگین سنی شرکتکنندگان در گروه آزمایش ۳۴/۱ ± ۱۱/۵ سال و در گروه کنترل ۳۱/۸ ± ۱۴/۲ سال بود. نتایج آزمون t همبسته نشان داد که پس از مداخلهی ACT، شرکتکنندگان گروه آزمایش کاهش معناداری در استرس ادراکشده و افزایش معناداری در انعطافپذیری شناختی و کارکرد روانشناختی نشان دادند (P < 0.05). در مقابل، در گروه کنترل هیچ تغییر معناداری مشاهده نشد. همچنین نتایج آزمون t مستقل نشان داد که بین دو گروه در پسآزمون تفاوت معناداری وجود داشت. تحلیل کوواریانس چندمتغیره (MANCOVA) نشان داد که حدود ۶۷/۷ درصد از تغییرات مشاهدهشده در متغیرهای وابسته، به مداخلهی ACT نسبت داده میشود. نتیجهگیری: یافتهها نشان داد که درمان مبتنی بر ACT یک مداخلهی روانشناختی مؤثر برای بیماران مبتلا به آسم است. درمان ACT با کاهش استرس ادراکشده و افزایش انعطافپذیری شناختی، موجب بهبود کارکرد روانشناختی و ارتقای بهزیستی کلی میگردد. این نتایج بر اهمیت ادغام مداخلات روانشناختی مبتنی بر ACT در برنامههای جامع مدیریت آسم تأکید دارد، بهگونهای که هر دو بُعد جسمی و روانشناختی بیماری بهطور همزمان مورد توجه قرار گیرند. پیشنهاد میشود پژوهشهای آینده با نمونههای بزرگتر و در بازههای زمانی طولانیتر، پایداری اثرات درمان پذیرش و تعهد را در بیماریهای مزمن تنفسی بررسی کنند. | ||
| کلیدواژهها | ||
| درمان پذیرش و تعهد (ACT)؛ آسم؛ انعطافپذیری شناختی؛ عملکرد روانی | ||
| عنوان مقاله [English] | ||
| Cognitive Flexibility and Psychological Function in Asthmatics | ||
| نویسندگان [English] | ||
| Kajbaf Mohammad Bagher1؛ Moslem Siahpoush monfared2 | ||
| 1Professor of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran. | ||
| 2Ph.D. Student in Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran | ||
| چکیده [English] | ||
| Objective: The present study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on perceived stress, cognitive flexibility, and psychological functioning among patients with asthma. Asthma is not only a chronic respiratory condition but also a disorder that exerts a profound psychological burden on individuals, often leading to heightened stress, maladaptive coping strategies, and diminished quality of life. Therefore, addressing psychological aspects alongside medical treatment is of paramount importance. Method: This research employed a quasi-experimental design with pre-test and post-test assessments and a control group. The study population comprised asthma patients who attended specialized asthma and allergy clinics in Khoramabad during 2022. Using purposive sampling, 30 eligible participants were selected based on specific inclusion and exclusion criteria. The inclusion criteria required having a confirmed asthma diagnosis within the past year, being between 20 and 45 years of age, willingness and ability to regularly attend therapeutic sessions, and sufficient literacy to respond to questionnaires. Exclusion criteria included absence from more than two therapeutic sessions, lack of cooperation, unwillingness to continue participation, comorbid medical or psychological conditions, substance abuse, or incomplete responses to research instruments. Participants were randomly assigned into two equal groups (n = 15 per group). The experimental group received eight structured sessions of group-based ACT, while the control group continued to receive only routine medical treatment. Data were collected using three standardized self-report measures: the Perceived Stress Scale (PSS), the Cognitive Flexibility Inventory (CFI), and the Depression-Anxiety-Stress Scale (DASS-21). Pre-test questionnaires were administered to both groups before the intervention, and post-tests were administered after completion of the therapeutic sessions. Statistical analyses were conducted using descriptive indicators, paired and independent t-tests, as well as multivariate analysis of covariance (MANCOVA) via SPSS version 26. Results: The average age of participants was 39.76 ± 11.05 years in the experimental group and 39.66 ± 9.74 years in the control group. The results of paired-sample t-tests indicated that, following the ACT intervention, participants in the experimental group experienced statistically significant improvements in perceived stress, cognitive flexibility, and psychological functioning (P<0.05). In contrast, no significant changes were observed within the control group. Furthermore, independent t-test results confirmed that there were no significant differences between the two groups in pre-test scores, ensuring initial homogeneity. Assumptions of normality and equality of variances were also met, as confirmed by the Kolmogorov-Smirnov and Levene’s tests (P>0.05). MANCOVA results revealed significant between-group differences in the post-test phase, favoring the experimental group, with an effect size (Eta squared) of 0.66. This suggests that approximately 66% of the observed changes in outcome measures were attributable to the ACT intervention. Conclusion: The findings demonstrate that Acceptance and Commitment Therapy is an effective psychological intervention for asthma patients. By reducing perceived stress and enhancing cognitive flexibility, ACT contributes to improved psychological functioning and overall well-being. These results underscore the importance of integrating psychological therapies such as ACT into comprehensive asthma management programs, thereby addressing both physical and psychological dimensions of the illness. Future research is recommended to replicate these findings with larger samples and to explore the long-term effects of ACT in chronic respiratory conditions. | ||
| کلیدواژهها [English] | ||
| Acceptance and Commitment Therapy, Asthma, Cognitive Flexibility, Mental Function | ||
| مراجع | ||
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