اثربخشی مداخله شناخت درمانی مبتنی بر ذهن آگاهی بر نگرش به مرگ و امیدواری زنان مبتلا به سرطان سینه: یک کارآزمایی بالینی تصادفی شده

نوع مقاله : مقاله پژوهشی

نویسندگان

1 روانشناسی سلامت، مرکز توسعه پژوهش‌های بالینی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران.

2 . گروه روانشناسی سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی اصـفهان، اصفهان، ایران و مرکز تحقیقات علوم رفتاری، دانشگاه علوم پزشکی اصـفهان، اصفهان، ایران

3 . روانشناسی سلامت، مرکز توسعه پژوهش‌های بالینی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران.

4 . گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه اصفهان، اصفهان، ایران

5 مرکز تحقیقات علوم رفتاری، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه و هدف: سرطان علاوه بر اثرات جسمانی می تواند آثار روانشناختی عمیقی بر فرد بگذارد. مواجهه با سرطان به نوعی مواجهه با مرگ قریب الوقوع است که می‌تواند نگرش به مرگ، احساس اضطراب و ناامیدی را تحت تأثیر قرار دهد. لذا این پژوهش با هدف بررسی اثربخشی مداخله شناخت درمانی مبتنی بر ذهن آگاهی بر نگرش به مرگ و امیدواری زنان مبتلا به سرطان سینه انجام شد.
مواد و روش ها: پژوهش حاضر از نوع نیمه آزمایشی با گروه کنترل و مراحل پیش آزمون، پس آزمون و پیگیری بود. جامعه آماری پژوهش را کلیه زنان مبتلا به سرطان سینه شهر اصفهان تشکیل دادند که به روش نمونه گیری در دسترس تعداد 36 نفر در سال 1400 از بیمارستان سیدالشهدا انتخاب شدند. ابزار پژوهش پرسشنامه نیم رخ نگرش به مرگ وونگ، رکر و گس، پرسشنامه امیدواری اشنایدر بود. جلسات شناخت‌درمانی مبتنی بر ذهن آگاهی در قالب 8 جلسه 90 دقیقه‌ای بر اساس مدل کابات زین ارائه شد.  از تحلیل واریانس اندازه‌گیری‌های مکرر با استفاده از نرم افزار SPSS-26 استفاده شد.
نتایج: نتایج پژوهش نشان داد که شناخت درمانی مبتنی بر ذهن آگاهی در مرحله پس آزمون تاثیری بر نگرش نسبت به مرگ نداشت(05/0p>) با اینحال در مرحله پیگیری این مداخله موثر بود(05/0p<). همچنین شناخت درمانی مبتنی بر ذهن آگاهی بر امیدواری موثر بود(05/0p<).
نتیجه گیری: نتایج این پژوهش نشان داد که شناخت درمانی مبتنی بر ذهن‌آگاهی در کوتاه‌مدت تأثیری معنادار بر نگرش نسبت به مرگ نداشت، اما در مرحله پیگیری تأثیر مثبتی را نشان داد. این یافته‌ها بیانگر آن است که با توجه به پیچیده بودن مقوله نگرش نسبت به مرگ به نظر می رسد که اثرات مداخله آزمایشی نیاز به پردازش های سطح بالاتری داشته است که در مرحله پیگیری خود را نشان داد. علاوه بر این، تأثیر مثبت شناخت درمانی مبتنی بر ذهن‌آگاهی بر امیدواری، اهمیت استفاده از این رویکرد را در بهبود وضعیت روانی زنان مبتلا به سرطان سینه برجسته می‌کند. پیشنهاد می‌شود متخصصان سلامت روان از این روش در درمان بیماران صعب‌العلاج استفاده کرده و تحقیقات بیشتری درباره پایداری نتایج انجام شود.
Background and Objective
In addition to physical effects, cancer can have profound psychological effects on an individual. Facing cancer is, in a way, confronting the imminence of death, which can influence attitudes toward death, anxiety, and hopelessness.This study aims to investigate the effectiveness of mindfulness-based cognitive therapy Intervention on the attitude towards death and hope of women with breast cancer.
Materials and Method
The present study was a quasi-experimental study with a control group and pre-test, post-test and follow-up stages. The statistical population of the study consisted of women with breast cancer in Isfahan, 36 of whom were selected by convenience sampling from Seyed al-Shohada Hospital in 2021. The research instruments were the Wong Death Attitude Profile Questionnaire and the Schneider Hope Questionnaire. Mindfulness-based cognitive therapy sessions were presented in the form of 8 90-minute sessions based on the Kabat-Zinn model. Repeated measures analysis of variance was used using SPSS-26 software.
Results
The results of the study showed that mindfulness-based cognitive therapy had no effect on attitudes towards death in the post-test phase (p>0.05), however, it was effective in the follow-up phase of this intervention (p<0.05). Also, mindfulness-based cognitive therapy was effective on hope (p<0.05).
Conclusion
The results of this study indicated that Mindfulness-Based Cognitive Therapy (MBCT) did not have a significant short-term effect on attitudes toward death but demonstrated a positive impact in the follow-up phase. These findings suggest that, given the complexity of attitudes toward death, the effects of the intervention may require higher-level cognitive processing, which became evident during the follow-up phase. Furthermore, the positive impact of MBCT on hope highlights the importance of utilizing this approach to improve the psychological well-being of women with breast cancer. It is recommended that mental health professionals incorporate this method in the treatment of patients with life-threatening illnesses and conduct further research on the sustainability of its outcomes.

کلیدواژه‌ها

عنوان مقاله [English]

The effectiveness of mindfulness-based cognitive therapy Intervention on attitudes toward death and hope in women with breast cancer: A randomized clinical trial

نویسندگان [English]

  • Gholamreza Talebi 1
  • reza Bagherian-Sararoudi 2
  • hassn rezaei_ jamaloei 3
  • Hamidreza Oreyzi 4
  • Pegah Pegah Bagherian-Sararoudi 5
1 Assistant Professor of Health Psychology, Clinical Research Development Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
2 Professor, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. And Professor, Department of Health Psychology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor of Health Psychology, Clinical Research Development Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
4 Prof, Department of Psychology, School of Educational Sciences and Psychology, Isfahan University, Isfahan, Iran.
5 Medical Intern, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background and Objective
Cancer, in addition to its physical effects, can have profound psychological impacts on individuals. Facing cancer is, in a way, facing imminent death, which can influence one's attitude toward death, anxiety, and feelings of hopelessness. Therefore, this study aimed to examine the effectiveness of mindfulness-based cognitive therapy (MBCT) on attitudes toward death and hope in women with breast cancer.
Materials and Methods: This study was a quasi-experimental design with a control group, including pre-test, post-test, and follow-up stages. The statistical population comprised all women with breast cancer in Isfahan, and 36 participants were selected from Seyed al-Shohada Hospital in 2021 using convenience sampling. The research tools included the Wong, Reker, and Gess Death Attitude Profile and the Snyder Hope Scale. Mindfulness-based cognitive therapy sessions were conducted in 8 sessions of 90 minutes each, based on the Kabat-Zinn model. Repeated measures analysis of variance was used for data analysis with SPSS-26 software.
Results: The results showed that mindfulness-based cognitive therapy had no significant effect on attitudes toward death in the post-test stage but had a positive effect in the follow-up stage. Additionally, this intervention had a significant effect on hope.
Conclusion: Given the complexity of the concept of attitude toward death, it seems that the effects of the intervention require higher-level processing, which manifested in the follow-up stage. The therapeutic intervention was also found to be effective in rapidly enhancing patients' feelings of hope.

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دانشور پزشکی
دوره 33، شماره 1 - شماره پیاپی 176
فروردین و اردیبهشت 1404
صفحه 1-10

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