مقایسه اثربخشی درمان مبتنی بر ذهن‌‌آگاهی و درمان راه‌حل‌محور کوتاه‌مدت بر احساس انسجام زنان مبتلا به مولتیپل اسکلروزیس

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری، گروه مشاوره، واحد ابهر، دانشگاه آزاد اسلامی، ابهر، ایران.

2 استادیار، گروه روان‌شناسی، واحد ابهر، دانشگاه آزاد اسلامی، ابهر، ایران.

چکیده

مقدمه: پژوهش حاضر با هدف تعیین اثربخشی درمان مبتنی بر ذهن‌آگاهی و درمان راه‌حل‌محور کوتاه‌مدت بر احساس انسجام بیماران مبتلا به MS صورت گرفت.
مواد و روش‌ها: روش این پژوهش، نیمه تجربی با طرح پیش‌آزمون- پس‌آزمون و پیگیری با گروه کنترل بود. جامعه آماری پژوهش را زنان مبتلا به MS شهر تبریز که در سال 1398 عضو انجمن MS بودند تشکیل دادند. 30 نفر با استفاده از نمونه‌گیری هدفمند انتخاب، و به‌صورت تصادفی در سه گروه درمان مبتنی بر ذهن‌‌آگاهی، درمان راه‌حل‌محور کوتاه‌مدت و کنترل قرار گرفتند. ابزار اندازه‌گیری، پرسشنامه احساس انسجام فلنسبرگ بود. گروه‌های آزمایشی درمان را به ‌ترتیب در 8 و 6 جلسه 5/1 ساعته دریافت کردند. داده‌ها توسط آزمون تحلیل واریانس آمیخته با اندازه‌گیری مکرر و آزمون تعقیبی بونفرونی تجزیه و تحلیل شدند.
یافته‌ها:  میانگین و انحراف معیار احساس انسجام گروه درمان مبتنی بر ذهن‌‌آگاهی در پیش‌آزمون 72/3±10/50، گروه درمان راه‌حل‌محور کوتاه‌مدت 66/3±60/49 و گروه کنترل 36/3±20/49 بود.درمان­های مبتنی بر ذهن‌‌آگاهی (52/3±20/55) و راه‌حل‌محور کوتاه‌مدت (98/2±50/55) در مقایسه با گروه کنترل (58/3±80/48)، احساس انسجام بیماران را در پس­آزمون افزایش دادند (001/0>p). در مرحله پیگیری، اثر درمان مبتنی بر ذهن‌‌آگاهی 40/3±40/50 و درمان راه‌حل‌محور کوتاه‌مدت 10/3±10/55 بر احساس انسجام 77/3±90/16 ماندگار بود (001/0>p). تأثیر درمان مبتنی بر ذهن‌‌آگاهی و درمان راه‌حل‌محور کوتاه‌مدت بر احساس انسجام در مراحل پس‌آزمون و پیگیری یکسان بود (05/0>p).
نتیجه‌گیری: درمان مبتنی بر ذهن‌‌آگاهی و درمان راه‌حل‌محور کوتاه‌مدت احتمالاً سبب کاهش استرس و در نتیجه مقابله بهتر با بیماری و افزایش احساس انسجام بیماران مبتلا به MS شده است.

کلیدواژه‌ها


عنوان مقاله [English]

The Effectiveness of Mindfulness-Based Therapy and Short-Term Solution-Focused Therapy on the Sense of Coherence of Women with Multiple Sclerosis

نویسندگان [English]

  • F Nasirnejhad 1
  • J Pouyamanesh 2
  • Gh Fathi aghdam 2
  • A Jafari 2
1 Ph.D. Student, Dept of Counseling, Abhar Branch, Islamic Azad University, Abhar, Iran.
2 Assistant Prof, Dept of Psychology, Abhar Branch, Islamic Azad University, Abhar, Iran.
چکیده [English]

Introduction: Because MS affects both the body and mind, people with MS need to be treated by both pharmacological and psychological interventions. Psychological interventions involve using a variety of counseling and psychotherapy approaches, including mindfulness-based therapy and short-term solution-focused therapy. The purpose of this study was to compare the efficacy of mindfulness-based therapy and short-term solution-focused therapy on sense of coherence in MS patients.
Materials and Methods: This study used a quasi-experimental method with pre-test, post-test, follow up, and the control group. The population under study consisted of all women with MS in Tabriz who were members of MS Society in Tabriz in 2019. In total, 30 women were selected by purposive sampling as the participants and randomly divided into three groups; the mindfulness-based therapy, short-term solution-focused therapy, and control the group. The participants in the three groups were tested by Flensberg Sense of Coherence Questionnaire before, after, and four months after the treatment. The members of both experimental groups received their own treatment respectively in 8 and 7 sessions each lasting 1.5 hours. The collected data were analyzed by repeated measures ANOVA and Bonferroni post hoc test.
Results: The mean scores of sense of coherence for the mindfulness-based treatment group, the short-term solution-focused treatment group, and the control group on the posttest were 50.10±3.72, 49.60±3.66, and 49.20±3.36, respectively. The results showed that the mindfulness-based therapy (55.20±3.52) and short-term solution-focused therapy (55.50±2.98) compared to the control group (48.80±3.58) increased the sense of coherence in MS patients on the posttest (p=0.001). Besides, the effect of mindfulness-based therapy (50.40±3.40) and short-term solution-focused therapy (55.10±3.10) on the sense of coherence (16.90±3.77) persisted in the follow-up phase (p <0.001). It was also shown that the mindfulness-based therapy and short-term solution-based therapy did not show any significant differences in terms of their effects on the feeling of cohesion at posttest and follow-up phases (p <0.05).
Conclusion: It was found that the mindfulness-based therapy, and the slow discovery of exceptions in the life of the MS patients in short-term solution-focused therapy reduced the patients' stress and thus enabling them to better cope with their illness, This in turn increased the sense of coherence in patients with MS. Based on the findings of this study, it can be concluded that mindfulness-based therapy and short-term solution-focused therapy increased the sense of coherence of MS patients.

کلیدواژه‌ها [English]

  • Mindfulness-based Therapy
  • Short-term Solution-Focused Therapy
  • Sense of Coherence
  • Multiple Sclerosis
  • Women
  1. National Multiple Sclerosis Society. WHAT IS MS?  [Cited 2019 Oct 22]. Available from: https://www.nationalmssociety.org/
  2. Huang WJ, Chen WW, Zhang X. Multiple sclerosis: pathology, diagnosis and treatments. Experimental and therapeutic medicine 2017;13(6):3163-6.
  3. Talebzadeh M, Asemi M. National Assessment of patients with Multiple Sclerosis. Fourth International Congress of MS: Iran 2011; 152-154. [Persian].
  4. Tsang BK, Macdonell R. Multiple sclerosis: Diagnosis, management and prognosis. AFP 2011; 40(12):948-955.
  5. Ysrraelit MC, Fiol MP, Gaitán MI, Correale J. Quality of life assessment in multiple sclerosis: different perception between patients and neurologists. Frontiers in neurology 2018;8:729.
  6. Grabler MR, Weyen U, Juckel G, Tegenthoff M, Mavrogiorgou-Juckel P. Death anxiety and depression in amyotrophic lateral sclerosis patients and their primary caregivers. Frontiers in neurology 2018;9:1035.
  7. Stern B, Socan G, Rener-Sitar K, Kukec A, Zaletel-Kragelj L. Validation of the Slovenian version of short sense of coherence questionnaire (SOC-13) in multiple sclerosis patients. Slovenian Journal of Public Health 2019;58(1):31-9.
  8. Oraki M, Sami P. The Effect of Mindfulness Integrated Behavior- Cognitive Therapy on psychological well-being and quality of life among multiple sclerosis patients. Health Psychology 2017; 5(20):34-47. [Persian]
  9. Piedmont RL, Magyar-Russell G, DiLella N, Matter S. Sense of coherence: Big five correlates, spirituality, and incremental validity. Current Issues in Personality Psychology 2014; 2(1):1-9.
  10. Sardu C, Mereu A, Sotgiu A, Andrissi L, Jacobson MK, Contu P. Antonovsky’s Sense of Coherence Scale: cultural validation of SOC questionnaire and socio-demographic patterns in an Italian population. Clinical practice and epidemiology in mental health: CP & EMH 2012;8:1-6.
  11. Schapiro RT. Managing the symptoms of multiple sclerosis. 1nd ed. New York: Demos; 2007: 71-2.
  12. Prochaska J A, Norkras JC. Psychotherapy systems. Translated by Yahya Seyed Mohammadi. 8nd ed.  Tehran: Ravan Publishing; 2019:154-309.[Persian]
  13. Tickell A, Ball S, Bernard P, Kuyken W, Marx R, Pack S, et al. The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in real-world healthcare services. Mindfulness 2020; 11:279–290.
  14. Michalak J, Burg J, Heidenreich T. Don't forget your body: Mindfulness, embodiment, and the treatment of depression. Mindfulness 2012;3(3):190-9.
  15. Ghodspour Z, Najafi M, Rahimian Boogar I. Effectiveness of Mindfulness-Based Cognitive Therapy on Psychological Aspects of Quality of Life, Depression, Anxiety, and Stress Among Patients With Multiple Sclerosis. Practice in Clinical Psychology 2018;6(4):215-22. [Persian]
  16. Pagnini F, Phillips D, Bosma CM, Reece A, Langer E. Mindfulness, physical impairment and psychological well-being in people with amyotrophic lateral sclerosis. Psychology & Health 2015;30(5):503-17.
  17. Shabani M. The Effectiveness of Mindfulness-Based Cognitive Therapy on Decreasing Depression and Sense of Coherence in Diabetic Patients. Fourth International Conference on Recent Innovations in Psychology, Counseling and Behavioral Sciences; 2017 JUN 15; Tehran, Iran. 1992; 102-9. [Persian]
  18. Darskhan M, Vaziri S. The effectiveness of mindfulness-based stress reduction on the sense of psychological integrity and coping style in patients with asthma. Andisheh va rafter 2017; 11(42):47-56. [Persian]
  19. Kim H. (dissertation). Client growth and alliance development in solution-focused brief family therapy. New York: Buffalo; 2006: 44-5.
  20. Wand T. Mental health nursing from a solution focused perspective. International Journal of Mental Health Nursing 2010;19(3):210-9.
  21. Mirhashemi M, Najafi F. Efficacy of solution-centered therapy on resiliency and sense of coherence among patients with multiple sclerosis. MSJIAUTMB 2014;24(3):175-81. [Persian]
  22. Hosseini Tabatabaei R, Bolghan-Abadi M, Bazargan M. Investigating the Effectiveness of Group-Based Psychotherapy on Interpersonal Problems in Patients with Multiple Sclerosis. The Horizon of Medical Sciences 2018;24(4):294-300. [Persian]
  23. Takalu MTM, Hosseini SA, Khankeh H. Effectiveness Solution-Focused Therapy Group, to Reduce Stress, Anxiety and Depression in Caregivers of Patients with Multiple Sclerosis. Modern Care Journal 2017;14(4) e10696.
  24. Javadian SN, Emami T. The comparison of the effect of the number of aerobic and yoga sessions on physical self–description components of female university students.Harakat 2009; (2):127-45. [Persian]  
  25. Tyszka AC, Farber RS. Exploring the relation of health-promoting behaviors to role participation and health-related quality of life in women with multiple sclerosis: a pilot study. American Journal of Occupational Therapy 2010;64(4):650-9.
  26. Flensborg-Madsen T, Ventegodt S, Merrick J. Sense of coherence and health. The construction of an amendment to Antonovsky's sense of coherence scale (SOC II). The Scientific World Journal 2006;6:2133-9.
  27. Flensborg-Madsen T, Ventegodt S, Merrick J. Sense of coherence and physical health. A cross-sectional study using a new scale (SOC II). The scientific world Journal 2006;6:2200-11.
  28. Eteshamzadeh P, Sabri NR, Memarbashi AM. The Relationship between Sense of Coherence and Job Performance with Mediating Mental Health and Coping Strategies. JPMM 2013; 3(13):83-95. [Persian]
  29. Segal Z V, Williams J M, Teasdale J D. Mindfulness Based cognitive therapy for depression. 3nd ed. New York: The Guilford Press; 2013:86.
  30. De Shazer S. Words were originally magic. 1nd ed. New York: Norton; 1994:30.
  31. Antonovsky A. The salutogenic model as a theory to guide health promotion. Health promotion international 1996;11(1):11-8.
  32. Matousek R, Dobkin PL. Weathering storms: a cohort study of how participation in a mindfulness-based stress reduction program benefits women after breast cancer treatment. Current Oncology 2010;17(4):62-70.
  33. Weissbecker I, Salmon P, Studts JL, Floyd AR, Dedert EA, Sephton SE. Mindfulness-based stress reduction and sense of coherence among women with fibromyalgia. Journal of Clinical Psychology in Medical Settings 2002;9(4):297-307.
  34. Pichot T. Looking beyond depression.  Handbook of Solution-Focused Brief Therapy. 1nd ed. New York: Haworth; 2007: 61.