اثربخشی برنامه کاهش استرس مبتنی بر ذهن آگاهی بر شاخصهای درد (پذیرش و شدت درد) و تبعیت از رژیم درمانی در بیماران مبتلا به نارسایی مزمن کلیه
الموضوعات :
بهزاد بهروز
1
(کارشناس ارشد مشاوره خانواده، دانشگاه رازی، دانشکده علوم اجتماعی، رازی، ایران. )
الکلمات المفتاحية: برنامه استرس مبتنی بر ذهنآگاهی, پذیرش درد, شدت درد, تبعیت از درمان, نارسایی کلیه,
ملخص المقالة :
هدف: این پژوهش با هدف تعیین اثربخشی برنامه کاهش استرس مبتنی بر ذهنآگاهی بر شاخصهای درد (پذیرش و شدت درد) و تبعیت از رژیم درمانی در بیماران مبتلا به نارسایی مزمن کلیه انجام شد. مواد و روشها: پژوهش نیمهآزمایشی با طرح پیشآزمون و پسآزمون با دو گروه آزمایش و کنترل بود. جامعه آماری پژوهش شامل تمامی مردان مبتلا به نارسایی مزمن کلیه مراجعهکننده به بخش بیماریهای کلیوی بیمارستان شهدا شهر کرمانشاه در سال 1402 بود که با روش نمونهگیری هدفمند تعداد 30 نفر انتخاب و در دو گروه مساوی 15 نفری جایگزین شدند. برای گردآوری اطلاعات از پرسشنامه تبعیت از رژیم درمان (سیدفاطمی و همکاران، 1397)، پذیرش درد (مک کراکن و ولز، 2004) و پرسشنامه سدت درد (مک گیل، 2009) استفاده شد. دادهها با تحلیل کوواریانس چندمتغیری و نرمافزار آماری SPSS-26 تحلیل شد. نتایج: نتایج نشان داد که برنامه کاهش استرس مبتنی بر ذهنآگاهی بر بهبود میانگین نمرۀ کل شاخصهای درد شامل پذیرش درد (017/27=F، 008/0=P و 523/0=η) و شدت درد (707/24=F، 009/0=P و 457/0=η) و هر یک از ابعاد آنها در آزمودنیهای گروه آزمایش اثربخش بوده است(01/0>P). همچنین، یافتهها نشان داد که این برنامه مداخله در مرحله پسآزمون در آزمودنیهای گروه آزمایش بر افزایش تبعیت از رژیم درمانی (486/23=F، 007/0=P و 503/0=η) مؤثر بوده است (01/0>P). نتیجهگیری: با توجه به نتایج مطالعه حاضر استفاده بیشتر درمانگران از برنامههای مداخلاتی در مراکز ارائه دهنده خدمات درمانی به بیماران مزمن در کنار دارو درمانی میتواند نتایج ارزندهای را رقم زند.
1. DeClercq V, Sweeney E. Age and sex-specific associations in health risk factors for chronic disease: evidence from the Atlantic Partnership for Tomorrow’s Health (PATH) cohort. Canadian Journal on Aging/La Revue canadienne du vieillissement. 2022; 41(2), 164-175. [https://doi.org/10.1017/S0714980821000179]
2. Cohen NM., Lifshitz A, Jaschek R, Rinott E, Balicer R, Shlush LI., et al. Longitudinal machine learning uncouples healthy aging factors from chronic disease risks. Nature Aging. 2024; 4(1), 129-144. [DOI: 10.1038/s43587-023-00536-5]
3. Stevens PE, Ahmed SB, Carrero JJ, Foster B, Francis A, Hall RK, et al.. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International. 2024; 105(4), 117-314. [DOI: 10.1016/j.kint.2023.10.018]
4. Tuttle KR, Hauske SJ, Canziani ME, Caramori ML, Cherney D, Cronin L, et al. Efficacy and safety of aldosterone synthase inhibition with and without empagliflozin for chronic kidney disease: a randomised, controlled, phase 2 trial. The Lancet. 2024; 403(10424), 379-390. [DOI: 10.1016/S0140-6736(23)02408-X]
5. Ní Néill E, Richards HL, Hennessey D, Fortune DG. Like a ticking time bomb: A qualitative study exploring the illness experiences of adults with kidney stone disease. British Journal of Health Psychology. 2023; 19(28), 705-723. [DOI: 10.1111/bjhp.12649]
6. Mallamaci F, Tripepi G. Risk Factors of Chronic Kidney Disease Progression: Between Old and New Concepts. Journal of Clinical Medicine. 2024; 13(3), 1-12. [https://doi.org/10.3390/jcm13030678]
7. Kim S, Kratz AL. A review of the use and psychometric properties of the chronic pain acceptance questionnaires. Rehabilitation Psychology. 2021; 66(1), 102. [DOI: 10.1037/rep0000342]
8. Mohamadi H, Jabalameli Sh, Haghayegh A, Ranjbarkohan Z. Structural model for pain self-efficacy based on health oriented lifestyle with mediating role of helplessness in patients with chronic pain. Daneshvar Medicine. 2021; 29(3), 118-131. [doi: 10.22070/DANESHMED.2021.13955.1042] [In Persian]
9. Bhatt P, Kukkar D,Kim KH. Fluorescent nanomaterials for the detection of chronic kidney disease. TrAC Trends in Analytical Chemistry. 2024; 9(2), 117-125. [DOI:10.1016/j.trac.2024.117572]
10. Janse RJ, Fu EL, Dahlström U, Benson L, Lindholm B, Van Diepen M, et al. Use of guideline‐recommended medical therapy in patients with heart failure and chronic kidney disease: from physician's prescriptions to patient's dispensations, medication adherence and persistence. European Journal of Heart Failure. 2022; 24(11), 2185-2195. [DOI: 10.1002/ejhf.2620]
11. Hashemi M, Haghighat S, Bagheri M, Akbari M, Niknejad R. Factors affecting adherence to the treatment in patients under hemodialysis: a qualitative content analysis. Nursing and Midwifery Journal. 2020; 18(2), 141-56. [http://unmf.umsu.ac.ir/article-1-3899-fa.html] [In Persian]
12. Rouhi M, Manzari Tavakoli A, Tajrobehkar M. Comparing the effectiveness of acceptance and commitment therapy and dialectical behavioral therapy on coherent selfknowledge, emotional regulation and life quality of hemodialysis patients. Shenakht Journal of Psychology and Psychiatry. 2023; 10 (2),131-146. [10.32598/shenakht.10.2.131] [In Persian]
13. Fisher V, Li WW, Malabu U. The effectiveness of mindfulness‐based stress reduction (MBSR) on the mental health, HbA1C, and mindfulness of diabetes patients: A systematic review and meta‐analysis of randomised controlled trials. Applied Psychology: Health and Well‐Being. 2023; 15(4), 1733-1749. [https://doi.org/10.1111/aphw.12441]
14. Akbari Gelvardi F, Teimory S, Rajaei A. Effectiveness of Mindfulness-based Stress Reduction Program in the Components of Quality of Life in Thalassemia Patients. Journal of Health Research in Community. 2022; 8 (1), 16-26. [20.1001.1.24236772.1401.8.1.2.5] [In Persian]
15. Bahrambagi Z, Lotfi Kashani F, Vaziri S. Effectiveness of mindfulness-based therapy on chronic stress and disease perception in heart patients. Medical Science Journal of Islamic Azad University. 2023; 33(1), 70-79. [10.52547/iau.33.1.70] [In Persian]
16. Garel N, Rigas C, Ben m’rad M, Bodenstein K, Joober R, Sekhon H, et al. Mindfulness-based intervention for benzodiazepine deprescription in hemodialysis patients with anxiety and depressive symptoms. Journal of Psychiatry & Neuroscience: JPN. 2023; 48(3), 149-150. [doi: 10.1503/jpn.220216]
17. Kabat-Zinn J. Mindfulness-based stress reduction (MBSR). Constructivism in the Human Sciences. 2003; 8(2), 61-73. [https://www.proquest.com/openview/fef538e3ed2210c1201ef2a946faed43/1?pqorigsite=gscholar&cbl=29080]
18. McGill, S. Low Back Disorders: Evidencebased Prevention and Rehabilitation. 2008. [https://www.amazon.com/Low-Back-Disorders-Evidence-Based-Rehabilitation/dp/1450472915]
19. Ebrahimi Dastgerdi N, Reisi Z, Rezaei S, Nikyar HR. Efficiency of Reflexive Massage on the Anxiety and Pain Intensity of The Patients with Traumatic Brain Injury. Quarterly Journal of Health Psychology. 2022; 11(41), 67-82. [https://doi.org/10.30473/hpj.2022.56045.5009] [In Persian]
20. McCracken LM, Vowles KE. Acceptance of chronic pain: component analysis and a revised assessment method. Pain. 2004; 107(1-2), 159-166. [https://doi.org/10.1016/j.pain.2003.10.012]
21. Fathi K, Shahbazi M, Koraei A, Malekzadeh M. The Effectiveness of Positive Psychology on Pain Acceptance and Control of Emotions in Cancer Patients: A Randomized Clinical Trial Study. Journal of Nursing Education (JNE). 2021; 10(4), 73-84. [http://jne.ir/article-1-1179-fa.html] [In Persian]
22. Seyed Fatemi N, Rafii F, Hajizadeh E, Modanloo M. Psychometric properties of the adherence questionnaire in patients with chronic disease: A mix method study. Journal of Semnan University of Medical Sciences (Koomesh). 2018; 20(2), 179-191. [http://koomeshjournal.semums.ac.ir/article-1-4156-fa.html] [In Persian]
23. Safarzadeh S, Sevari K. Implementation of Acceptance and Commitment Therapeutic Theory (ACT) on Anxiety Personality Trait, Alexithymia, and Adherence to treatment in Women with Breast Cancer. Clinical Psychology and Personality. 2020; 18(1), 17-27. [10.22070/CPAP.2020.2919] [In Persian]
24. Best RD, Ozmeral A, Grinberg AS, Smitherman TA, Seng EK. Pain acceptance as a change mechanism for mindfulness-based cognitive therapy for migraine. Journal of Behavioral Medicine. 2024; 13(2), 1-12. [DOI: 10.1007/s10865-024-00475-5]
25. Garland EL, Nakamura Y, Bryan CJ, Hanley AW, Parisi A, Froeliger B, et al. Mindfulness-Oriented Recovery Enhancement for veterans and military personnel on long-term opioid therapy for chronic pain: a randomized clinical trial. American Journal of Psychiatry. 2024; 181(2), 125-134. [DOI: 10.1176/appi.ajp.20230272]
26. Sheybani F, Dabaghi P, Najafi S, Rajaeinejad M. Effectiveness of Mindfulness-based Stress Reduction (MBSR) on Patients With Chronic Pain: A Randomized Clinical Trial. Iranian Journal of Psychiatry and Clinical Psychology. 2022; 28(2), 182-195. [10.32598/ijpcp.28.2.1627.2] [In Persian]
27. Haghdoost M, Sarajkhorrami N, Makvandi B. The Effectiveness of Mindfulness Based on Stress Managment on Death Anxiety, Disaster of Imagination, Acceptance and Severity of Pain in Prostat Cancer Patients. Journal of Ilam University of Medical Sciences. 2022; 29 (6), 48-58. [10.52547/sjimu.29.6.48] [In Persian]
28. Izadikhah A, Ansari Shahidi M, Rezaei Jamaloei H, Haghayegh SA. Effectiveness of Mindful Therapy on Severity of pain and Psychological well-being in the Patients with Migraine Headache. Journal of Analitical-Cognitive Psycholoy. 2022; 13(48), 55-67. [20.1001.1.28222476.1401.13.48.5.7] [In Persian]
29. Gumport NB, Dong L, Lee JY, Harvey G.. Patient learning of treatment contents in cognitive therapy. Journal of behavior therapy and experimental psychiatry. 2018; 58 (1), 51-59. [doi: 10.1016/j.jbtep.2017.08.005]
30. Kumar GV, Aghili SM, Zaree M. The Effectiveness of Mindfulness-Based Stress Reduction Training on Adherence to Medication and Proper Food Consumption in Patients with Diabetes Type 2. Iranian Journal of Health Psychology. 2022; 5(2), 17-26. [https://doi.org/10.30473/ijohp.2022.53251.1092] [In Persian]
31. Kolahi P, Salehi M, Madahi MA, Sepahmansour M. Effectiveness of mindfulness-based stress reduction program on depression and adherence to treatment in female coronary heart patients. Journal of Applied Family Therapy. 2022; 3(3), 418-436. [10.22034/AFTJ.2022.334113.1476] [In Persian]
32. Musanje K, Kamya MR, Kasujja R, Vanderplasschen W, Sinclair DL, Baluku MM, et al. The Effect of a Group-Based Mindfulness and Acceptance Training on Psychological Flexibility and Adherence to Antiretroviral Therapy Among Adolescents in Uganda: An Open-Label Randomized Trial. Journal of the International Association of Providers of AIDS Care (JIAPAC). 2024; 23 (1), 1-11 [DOI: 10.1177/23259582241236260]
33. Yıldırım Üşenmez T, Gültekin A, Erkan FM, Bayar BD, Can SY, Şanlı ME. The effect of mindfulness on medication adherence in individuals diagnosed with Schizophrenia: A cross‐sectional study. Perspectives in Psychiatric Care. 2022; 58(4), 2585-2591. [DOI: 10.1111/ppc.13098]
