دانشور پزشکی

دانشور پزشکی

مقایسه اثربخشی شناخت درمانی مبتنی بر ذهن آگاهی و درمان مثبت نگر ایرانی-اسلامی بر فاجعه پنداری درد و شدت علائم زنان مبتلا به سندرم روده تحریک پذیر

نوع مقاله : مقاله پژوهشی

نویسندگان
عارفه عرفان
اصغر آقایی
محسن گل پرور
گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه آزاد اسلامی، واحد اصفهان(خوراسگان)، اصفهان، ایران
10.22070/daneshmed.2021.12916.0
چکیده
مقدمه و هدف: سندرم روده‌ی تحریک‌پذیر  شایع‌ترین، پرهزینه‌ترین و ناتوان کننده‌ترین اختلال عملکردی دستگاه گوارش است. عوامل روان شناختی تأثیر عمیقی بر شروع، طول مدت و شدت این بیماری دارد. این پژوهش با هدف مقایسه اثر بخشی شناخت درمانی مبتنی بر ذهن آگاهی و درمان مثبت نگر ایرانی– اسلامی بر فاجعه پنداری درد و شدت علائم در زنان مبتلا به سندرم روده تحریک انجام شد.
مواد و روش ها: روش پژوهش حاضر، نیمه تجربی و طرح پژوهش سه گروهی دو مرحله ای (پیش آزمون و پس آزمون) بود. نمونه مورد مطالعه شامل 45 نفر از زنان مبتلا به سندرم روده تحریک پذیر در دامنه سنی 18 تا 50 سال در سال 1398 بودند که به روش نمونه گیری هدفمند مبتنی بر ملاک‌های ورود و خروج نتخاب و با انتساب تصادفی در سه گروه (دو گروه آزمایش و یک گروه کنترل) جایگزین شدند. برای سنجش متغیرهای پژوهش از ابزار تشخیصی ROME III، مصاحبه‌ی ساختار یافته‌ی تشخیصی برای ) DSM-V-RV SCID-I)، پرسشنامه فاجعه پنداری درد (PCS) و پرسشنامه شدت علائم سندرم روده تحریک پذیر (BSS-FS) در مراحل پیش آزمون و پس آزمون استفاده شد. گروه شناخت درمانی مبتنی بر ذهن آگاهی و درمان مثبت نگر ایرانی اسلامی به مدت 8 جلسه تحت درمان قرار گرفتند و گروه کنترل در لیست انتظار باقی ماندند. داده‌ها با استفاده از نرم افزار SPSS23  و تحلیل کوواریانس تحلیل شدند.
نتایج: نتایج نشان داد که بین شناخت درمانی مبتنی بر ذهن آگاهی با درمان مثبت نگر ایرانی-اسلامی و گروه کنترل در پس آزمون در متغیر فاجعه پنداری درد تفاوت معنادار وجود دارد (p <0/01). و همچنین بین شناخت درمانی مبتنی بر ذهن آگاهی و درمان مثبت نگر ایرانی-اسلامی با گروه کنترل در متغیر شدت علائم  تفاوت معنادار وجود دارد(p <0/01)، اما بین دو درمان با یکدیگر تفاوت معناداری به دست نیامد(p>0/05).
نتیجه‌گیری: بر پایه یافته‌های این پژوهش، به نظر می‌رسد که شناخت درمانی مبتنی بر ذهن آگاهی و درمان مثبت نگر ایرانی-اسلامی می‌تواند به عنوان درمان‌های روانشناختی بر کاهش فاجعه پنداری و شدت علائم در زنان مبتلا به  سندرم روده تحریک پذیر استفاده شود.
کلیدواژه‌ها
شناخت درمانی مبتنی بر ذهن آگاهی
درمان مثبت نگر ایرانی-اسلامی
فاجعه پنداری درد
شدت علائم
سندرم روده تحریک پذیر
  1. Bhattarai Y, Muniz Pedrogo DA, Kashyap PC. Irritable bowel syndrome: a gut microbiota-related disorder? American Journal of Physiology Gastrointestinal Liver Physiology 2017; 312(1):52-62.
  2. Jasper F, Egloff B, Roalfe A, Witthöft M. Latent structure of irritable bowel syndrome symptom severity. World Journal of Gastroenterology 2015; 21(1):292-300.
  3. Stasi C, Bellini M, Gambaccini D, Duranti E, Bortoli N, Fani B, Albano E, Russo S, Sudano I, Laffi G, Taddei S, Marchi S, Bruno RM. Neuroendocrine Dysregulation in Irritable Bowel Syndrome Patients: A Pilot Study. Journal of Neurogastroenterology and Motility 2017; 23(3): 428-434.
  4. Basnayake Ch. Treatment of irritable bowel syndrome. Austtralian Prescriber an Independent Review 2018; 41(5): 145–149.
  5. Grundmann O, Yoon SL. Complementary and alternative medicines in irritable bowel syndrome: an integrative view. World Journal of Gastroenterollogy  2014; 20(2):346-362.
  6. Adarvishi S, Zarea K, Asadi M, Mahmoodi M, GhasemiDeh Cheshmeh M, Khodadadi A, Hardani F. Effect of Problem Solving Training on Anxiety in Patients with IBS. Preventive Care in Nursing and Midwifery Journal 2016; 5(2): 22-32.
  7. Ballou S, Bedell A, Keefer L. Psychosocial impact of irritable bowel syndrome: A brief review. World Journal of Gastrointestinal Pathophysiology 2015; 6(4): 120-123.
  8. Lackner JM, Gudleski GD, Ma CX, Dewanwala A, Naliboff B. Representing the IBSOS Outcome Study Research Group. Fear of GI symptoms has an important impact on quality of life in patients with moderate-to-severe IBS. American Journal of Gastroenterology 2014; 109(11): 1815-1823.
  9. Shah K, Ramos-Garcia M, Bhavsar J, Lehrer P. Mind-body treatments of irritable bowel syndrome symptoms: An updated meta-analysis. Behavior Research and Therapy 2020; 128:1-12.
  10. Shafiei F, Amini fasakhoudi M. Efficacy of mindfulness-based stress reduction on reducing catastrophizing and pain intensity in patients suffering chronic musculoskeletal pain. Journal Anesthesiology and Pain 2017; 7(2):1-10.
  11. Stanculete MF, Matu S, Pojoga C, Dumitrascu DL. Coping strategies and irrational beliefs as mediators of the health-related quality of life impairments in irritable bowel syndrome. Journal of Gastrointestinal and Liver Diseases 2015; 24(2): 159-164.
  12. Gerson MJ, Gerson C, Chang L, Corazziari E, Dumitrascu DL, Ghoshal UC, et al. A Multi-National Investigation of Attachment, Catastrophizing and Negative Pain Beliefs in Irritable Bowel Syndrome. Gastroenterology Journal 2013; 144(5): 490-500.
  13. Gaylord SA, Whitehead WE,Coble RS, Faurot KR, Palsson OS, Garland EL, et al. Mindfulness for irritable bowel syndrome: protocol development for a controlled clinical trial. BMC Complementary and Alternative Medicine 2009; 28(9):24.
  14. ljotsson B, Andreewitch S, Hedman E, Ruck C, Andersson G, Lindefors N. Exposure and mindfulness based therapy for irritable bowel syndrome--an open pilot study. Journal of Behavior Therapy and Experimental Psychiatry 2010; 41(3): 90-185.
  15. Lackner JM, Quigley BM, Blanchard EB. Depression and abdominal pain in IBS patients: the mediating role of catastrophizing. Psychosomatic Medicine 2004; 66(3): 435-441.
  16. Ballou S, Keefer L. Psychological Interventions for Irritable Bowel Syndrome and Inflammatory Bowel Diseases. Clinical and Translational Gastroenterology 2017; 8(1): 1-7.
  17. Bishop SR. What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine 2002; 64(1):71-83.
  18. Grossman P, Tiefenthaler-Gilmer U, Raysz A, Kesper U. Mindfulness training as an intervention for fibromyalgia: evidence of ostintervention and 3-year follow-up benefits in well-being. Psychotherapy and Psychosomatics 2007; 76 (4):226-233.
  19. Michalak J, Burg J, Heidenreich T. Don't Forget Your Body: Mindfulness, Embodiment, and the Treatment of Depression. Mindfulness 2012; 3:190–199.
  20. Shirazitehrani A R, Gholamrezaee S. Effectiveness of Mindfulness based Stress Reduction on the Mental Health of Mothers who have Educable Mentally Retarded Children. Journal of Exceptional Education 2016; 9 (137) :5-16
  21. Zomorodi S, Rasoulzadeh Tabatabaei SK, Arbabi M, Ebrahimi Daryani N, Azad Fallah P. Comparison of the effectiveness of cognitive-behavior therapy and mindfulness based therapy on the decrease in symptoms of patients who suffer from irritable bowel syndrome. Govaresh 2013; 18(2): 88-94.
  22. Hashemi F, Gorji Y. Effectiveness of group Mindfulness Based Stress Reduction consultation of severity of physical symptoms in women with irritable bowel syndrome. Medical - Surgical Nursing Journal 2016; 5(1): 32-39.
  23. Ljótsson B, Falk L, Vesterlund AW, Hedman E, Lindfors P, Rück C, Hursti T, Andréewitch S, Jansson L, Lindefors N, Andersson G. Internet-delivered exposure and mindfulness based therapy for irritable bowel syndrome--a randomized controlled trial. Behavior Research and Therapy 2010; 48(6):531-539.
  24. Gaylord SA, Palsson OS, Garland EL, Faurot KR, Coble RS, Mann JD, Frey W, Leniek K, Whitehead WE. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. The American Journal of Gastroenterology 2011; 106 (9):1678-1688.
  25. Moghtadaei K, Kafi M, Afshar H, Ariapouran S, Daghaghzadeh H, Pourkazem T. Effectiveness of mindfulness-based cognitive group therapy on somatic symptoms in women with irritable bowel syndrome. Journal Research Behavior Sciences 2013; 10(7): 698-708.
  26. Seligman MEP. Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment. New York: Free Press; 2002.
  27. Rashid T.2009. Positive interventions in clinical practice. Journal Clinical Psychology 2002; 65(5): 461-466.
  28. Gall M, Gall J, Borg W.  [Educational Research: An Introduction]. 3rd ed. Tehran, Iran: Samt Publication 2008.
  29. Jamshidian QalehShahi P, Aghaei A, Golparvar M.  Comparing the Effect of Iranian Positive Therapy and Acceptance -Commitment Therapy on Depression, Anxiety and Stress of Infertile Women in Isfahan City. Journal of Health Promotion Management 2017; 7(3): 8-16.
  30. Jamshidian QalehShahi P, Aghaei A, Golparvar M. Comparison of effect iranian – islamic positive therapy with acceptance and commitment therapy on psychological well-being of infertile women in isfahan city. Nursing and Midwifery Journal 2017; 15(1): 48-57.
  31. Heitkemper M, Jarrett M. Overlapping conditions in women with irritable bowel syndrome. Urologic Nursing 2005; 25(1):25-30.
  32. Safaee A, Khoshkrood-Mansoori B, Pourhoseingholi M A, Moghimi-Dehkord B, Pourhoseingholi A, Habibi M et al . Prevalence of Irritable Bowel Syndrome: A Population Based Study. Studies in Medical Sciences 2013; 24 (1): 17-23.
  33. First M B, Williams J B W, Karg R S, Spitzer R L.Structured Clinical Interview for DSM-5 Research Version SCID-5-RV 2017.
  34. Sullivan M J L, Bishop S, Pivik J. The Pain Catastrophizing Scale: Development and validation. Psychological Assessment 1995; 7: 524-532.
  35. davoodi I, zargar Y mozafari pour E, nargesi  F, mola K. The Relationship between Pain Catastrophizing, Social Support, pain-related Anxiety, Coping Strategies and Neuroticism, with Functional Disability in Rheumatic patients. Quarterly Journal of Health Psychology  Spring 2012; 1(1) 59 -73.
  36. Boyce P, Gilchrist J, Talley NJ, Rose D.Cognitive-behaviour therapy as a treatment for irritable bowel syndrome: a pilot study. The Australian and New Zealand Journal of Psychiatry 2000; 34(2):300-309.
  37. Solati Dehkordy K, Adibi P, Ghamarani A. The Effects of Cognitive – Behavior Therapy and Drug Therapy on Quality of Life and Symptoms. Journal of Kerman University of Medical Sciences 2012; 19(1): 94-103.
  38. Kamkar A, Golzary M, Farrokhi N, Aghaee S. The Effectiveness of Cognitive – Behavioral Stress Management on Symptoms of Patients with Irritable Bowel Syndrome. Armaghane danesh 2011; 16 (4): 300-310.
  39. Abdolghadery M, Kafee M, Saberi A, Aryapouran S. The Effectiveness of Mindfulness-based Cognitive Therapy (MBCT) and Cognitive Behavior Therapy (CBT) on Decreasing Pain, Depression and Anxiety of Patients with Chronic Low Back Pain. Journal of Shahid Sadoughi University 2014; 21 (6): 795-807.
  40. Norouzi A, Fakhri M, Talebi R, Roshandel G, Mohammadi R. Effectiveness of Mindfulness – Based Cognitive Therapy on coping style and gastrointestinal symptoms in patients with Irritable Bowel Syndrome. Jorjani Biomedicine Journal 2018; 5 (2): 100-108.
  41. Shirani M, Manshaee Gh. Effectiveness of Positive Psychology Interventions on Pain Catastrophizing and Life Expectancy of Women with Breast Cancer. Journal Research Behavior Sciences 2018; 16(3): 400-407.
  42. Bagheri S, Sajjadian I. Effectiveness of Mindfulness-Based Stress Reduction treatment on the Severity of Sympoms and Pain Catastrophizing in Students with Premenstrual Dysphoric Disorder. European Journal of Anaesthesiology Pain 2018; 9(1): 52-65.
  43. Tarkeshdooz Sh, Sanagouye-Moharer Gh. The Effectiveness of Mindfulness-Based Stress Reduction on Catastrophizing and Pain Perception among Adolescents with Leukemia. Community Health 2019; 6(3): 305- 313.
  44. Abdolghaderi M, Kafi S M, Saberi A, Ariaporan S.  Research Paper: Effectiveness of Mindfulness-Based Cognitive Therapy on Hope and Pain Beliefs of Patients with Chronic Low Back Pain. Caspian Journal of Neurological Sciences 2018; 4(1):18-23.
  45. Mohamadi J, Ghazanfari F, Drikvand FM. Comparison of the Effect of Dialectical Behavior Therapy, Mindfulness Based Cognitive Therapy and Positive Psychotherapy on Perceived Stress and Quality of Life in Patients with Irritable Bowel Syndrome: a Pilot Randomized Controlled Trial. The Psychiatric Quarterly 2019; 90(3):565-578.
  46. Sepanta M, Shirzad M, Bamdad S. The Effectiveness of Mindfulness-Based Cognitive Therapy on Catastrophizing and Anxiety associated with Pain in Adolescents with Leukemia. International Journal of Body, Mind and Culture 2019; 6(1): 27-34.
  47. Namjoo S, Borjali A, Seirafi M, Assarzadegan F. Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group. Anesthesiology and Pain Medicine 2019; 9(5): 1-10.
  48. Ehde D M, Alschuler K N, Day M A, Ciol M A, Kaylor M L, Altman J K, Jensen M P. Mindfulness-based cognitive therapy and cognitive behavioral therapy for chronic pain in multiple sclerosis: a randomized controlled trial protocol. Trials 2019; 20(774): 1-12.
  49. Van Vliet KJ, Foskett AJ, Williams JL, Singhal A, Dolcos F, Vohra S. Impact of a mindfulness-based stress reduction program from the perspective of adolescents with serious mental health concerns. Child and Adolescent Mental Health 2017; 22(1):16-22.
  50. Colle KF, Vincent A, Cha SS, Loehrer LL, Bauer BA, Wahner-Roedler DL. Measurement of quality of life and participant experience with the mindfulness-based stress reduction program. Complementary Therapies in Clinical Practice 2010; 16(1):36-40.
  51. Sevinc G, Hölzel BK, Hashmi J, Greenberg J, McCallister A, Treadway M, Schneider ML, Dusek JA, Carmody J, Lazar SW. Common and Dissociable Neural Activity After Mindfulness-Based Stress Reduction and Relaxation Response Programs. Psychosomatic Medicine 2018; 80(5):439-451.
  52. Asadollahi F, Neshatdoost H T, Kalantary M, Mehrabi H A, Afshar H, Daghaghzadeh H. Effectiveness of spiritual therapy on somatic symptoms in female patients with irritable bowel syndrome. International Journal of Behavioral Sciences 2014; 12(3): 317-327.
  53. Naddafnia L, Ebrahimi A, Neshatdoost H, Talebi H. Comparison of Effectiveness of Cognitive Behavioral Therapy and Spiritual Therapy on Symptoms Intensity, Quality of Life, in Patients with Irritable Bowel Syndrome. Journal Research Behavior Sciences 2019; 17(2): 291-302.
  54. Ebrahimi A, Neshatdoost HT, Mousavi SG, Asadollahi GA, Nasiri H. Controlled randomized clinical trial of spirituality integrated psychotherapy, cognitive-behavioral therapy and medication intervention on depressive symptoms and dysfunctional attitudes in patients with dysthymic disorder. Advanced Biomedical Research 2013; 29(2):1-7.
  55. Akuchekian Sh, Jamshidian Z , Maracy MR, Almasi A, Davarpanah Jazi A H. Effectiveness of Religious-Cognitive-Behavioral Therapy on Religious Oriented Obsessive Compulsive Disorder and its Co-morbidity. Journal of Isfahan Medical School 2011; 28(114): 801-811.
  56. Paukert AL, Phillips LL, Cully JA, Romero C, Stanley MA. Systematic review of the effects of religion-accommodative psychotherapy for depression and anxiety. Journal of Contemporary Psychotherapy 2011; 41(2):99-108.   
  57. Drossman DA, Camilleri M, Mayer EA, Whitehead WE. AGA technical review on irritable bowel syndrome. Gastroenterology Journal 2002; 123: 2108-2131.
  58. Ruscheweyh R, Nees F, Marziniak M, Evers S, Flor H & Knecht S. Pain catastrophizing and painrelated emotions: Influence of age and type of pain. Clinical Journal Pain 2011; 27(7): 578-586.
دانشور پزشکی
دوره 29، شماره 3 - شماره پیاپی 154
مرداد و شهریور 1400
صفحه 42-56