مقایسه اثربخشی طرحواره درمانی با درمان شناختی- رفتاری و دارودرمانی در کاهش درد بیماران مبتلابه آرتریت روماتوئید دارای اضطراب و افسردگی و راهبردهای مقابله‌ای ناسازگار
محورهای موضوعی : روانشناسیپیمان آرامش صدیق 1 , مجید بحرینیان 2 * , احمد منصوری 3
1 - دانشجوی دکتری، دانشگاه ازاد اسلامی واحد بیرجند، بیرجند، ایران peyman.aramesh1970@gmail.com , tell: 09124094375
2 - (نویسنده مسئول)، استاد گروه روانشناسی بالینی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران tell: 09127786737, bahrainian@birjand.iau.ac.ir
3 - استادیار، گروه روانشناسی، واحد نیشابور، دانشگاه آزاد اسلامی، نیشابور، ایران a.mansouri@iau-neyshabur.ac.ir
کلید واژه: آرتریت روماتوئید, اضطراب, افسردگی, راهبردهای مقابله‌ای, درمان شناختی_رفتاری, طرحواره درمانی,
چکیده مقاله :
چکیده مقدمه: آرتریت روماتوئید شایع‌ترین بیماری خود ایمنی التهابی مزمن است. عوامل اجتماعی و استرس طولانی در ابتلا به آرتریت روماتویید تاثیر دارد. درد و محدودیت حرکت در این بیماران می تواند اضطراب و افسردگی مضاعف ایجاد کند. هدف پژوهش حاضر بررسی مقایسه اثربخشی طرحواره درمانی، درمان شناختی رفتاری با دارو درمانی درکاهش درد و ابعاد درد در بیماران مبتلا به آرتریت روماتوئید دارای اضطراب وافسردگی و راهبردهای مقابله ایی ناسازگار است. روش پژوهش : این پژوهش از نوع نیمه آزمایشی با طرح پیش‌آزمون و پس‌آزمون و پیگیری با گروه گواه بود جامعه آماری کلیه بیماران مبتلا به آرتریت روماتوئید دارای اضطراب و افسردگی شهرتهران مراجعه کننده به کلینیک روماتولوژی بیمارستان امام خمینی شهر تهران در سه ماهه بهار1400 بودند. 60 نفرداوطلب، به روش نمونه گیری هدفمندانتخاب شد. نمونه ها طبق جدول کوهن درسه گروه بیست نفره تقسیم بندی شدند. برای جمع‌آوری داده‌ها از پرسش‌نامه‌های استاندارد افسردگی، اضطراب، پرسشنامه تجدید نظر شده درد، استفاده شد. تحلیل داده‌ها با استفاده از آزمون تحلیل واریانس چند متغیری با اندازه گیری مکرر در سطح معناداری 05/0 با نرم افزار SPSS نسخه 26انجام شد. یافته‌ها: نتایج نشان داد، رواندرمانی ها در کاهش درد موثرهستند وطرحواره‌درمانی موثرترین روش در کاهش درد شناختی و درد متنوع بیماران مبتلا به آرتریت روماتوئید دارای اضطراب و افسردگی و راهبرهای مقابله‌ای ناسازگار بود( 0.05> P) نتیجه‌گیری: استفاده از رواندرمانی ها در کنار دارو درمانی نسبت به دارودرمانی به تنهایی می تواند موثرواقع شود و به کاهش درد بیماران مبتلا به روماتوئید آرتریت، از طریق درمان اضطراب وافسردگی واصلاح راهبردهای مقابله ایی کمک کند. همچنین بین طرحواره درمانی و درمان شناختی_رفتاری با دارودرمانی در کاهش درد حسی بیماران مبتلابه آرتریت روماتوئید تفاوت معنادار وجود ندارد. اما بین طرحواره درمانی و درمان شناختی_رفتاری با دارودرمانی در کاهش درد عاطفی و شناختی بیماران مبتلابه آرتریت روماتوئید تفاوت معنادار وجود دارد.
Abstract Introduction: Rheumatoid arthritis is the most common chronic inflammatory autoimmune disease. Social factors and prolonged stress have an effect on Rheumatoid arthritis. Limitation of movement in these patients can cause mental disorders, especially anxiety and depression. The purpose of this study is to compare the effectiveness of short-term dynamic psychotherapy, schema therapy, cognitive behavioral therapy with drug therapy in reducing pain and pain dimensions in patients with rheumatoid arthritis with anxiety, depression and coping strategies. Research method: The research method was semi-experimental with a pre-test and post-test design and follow-up with the control group. The statistical population was all patients with rheumatoid arthritis with anxiety and depression in Tehran, who referred to the rheumatology clinics of Imam Khomeini Hospital in Tehran in the spring of 2014. There are 60 volunteers selecting by purposive sampling technique. According to Cohen's table the sample were divided into group of 20 people. We use Standard Depression questionnaires, anxiety, and Revised McGill pain questionnaire for collecting data. Data analysis has been done by using multivariate analysis of variance with repeated measurement at a significant level of 0.05 through SPSS version 26. Results: The results showed that psychotherapies are effective in reducing pain, and schema therapy was the most effective method in reducing cognitive pain and various pain in patients with rheumatoid arthritis who have anxiety and depression and inconsistent coping strategies Conclusion: The use of psychotherapies along with drug therapy can be more effective than drug therapy alone and can help reduce the pain of patients with rheumatoid arthritis by treating anxiety and depression and correcting coping strategies.
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