اثربخشی طرحوارهدرمانی بر عاطفه منفی و استرس ادراک شده بیماران قلبی عروق کرونری
محورهای موضوعی : تربیتیسلمان زارعی 1 , خدیجه فولادوند 2
1 - گروه روان شناسی، دانشگاه لرستان، خرم آباد، ایران
2 - گروه روان شناسی، دانشگاه لرستان، خرم آباد، ایران
کلید واژه: بیماران قلبی عروق کرونری, عاطفهی منفی, طرحواره درمانی, استرس ادراک شده,
چکیده مقاله :
این پژوهش با هدف بررسی اثربخشی طرحواره درمانی بر عاطفه منفی و استرس ادراک شده در بیماران قلبی عروق کرونری انجام شد. روش پژوهش شبه آزمایشی با طرح پیش آزمون و پس آزمون همراه با گروه کنترل بود. جامعه آماری پژوهش بیماران قلبی عروق کرونری مراجعه کننده به بیمارستان جماران شهر تهران در سال 1397 بود که با روش نمونه گیری دردسترس 30 نفر از آن ها انتخاب و به صورت تصادفی در دو گروه آزمایش (15 نفر) و کنترل (15 نفر) قرار گرفتند. برای جمع آوری اطلاعات از مقیاس عاطفه منفی دنولت (1998) و مقیاس استرس ادراک شده کوهن و همکاران (1983) استفاده شد. پس از اجرای پیش آزمون، مداخله (طرحواره درمانی) طی 10 جلسه 50 دقیقه ای برای گروه آزمایش ارائه گردید. پس از پایان برنامه طرحواره درمانی گروهی، از هر دو گروه پس آزمون گرفته شد. داده ها با استفاده از آزمون کواریانس چندمتغیری تجزیه و تحلیل شدند. نتایج نشان داد که با کنترل اثر پیش آزمون، بین میانگین پس آزمون دو گروه آزمایش و کنترل در متغیرهای استرس ادراک شده (897/17=F) و عاطفه منفی (082/16=F) در سطح 01/0< P تفاوت معناداری وجود دارد. بر اساس نتایج پژوهش، کاربرد این روش درمانی در طرح ریزی مداخله های درمانی بیماران قلبی می تواند مفید باشد.
The purpose of this study was to evaluate the effectiveness of schema therapy on negative affect and perceived stress in coronary heart patients. The research method was quasi-experimental with pre-test and post-test with control group. The statistical population of the study consisted of all coronary heart patients referring to Jamaran hospital in Tehran in 2018 which were selected by purposeful sampling method. 30 of them were selected and randomly assigned into two groups of experimental (15 subjects) and control (15 subjects). Data were collected using the Denollet Negative Affect Inventory (1998) and Cohen et al. Perceived Stress Scale (1983). After the pre-test, intervention (Schema Therapy) was given to the experimental group in 10 sessions with duration of 50 minutes. At the end of group Schema Therapy program, post-test was taken from both groups. Data were analyzed using multivariate covariance test. The findings showed that by controlling the effect of the pretest between the means of the posttest for the experimental and the control group, there was a significant difference between the variables of perceived stress (F=17/897) and negative affect (F=16/082) at P<0/01 level. Based on the results of the present study, the application of this method can be useful in planning therapeutic interventions in cardiovascular.
Abolghasemi, A. (2009). The correlation of sense of coherence and type-D personality with health in coronary artery patients. Journal of Fundamentals of Mental Health, 11(43), 213-222. [Persian]
Ahmadi, F., Asqar-nejad-Farid, A., & Borjali, M. (2014). The comparison of patients suffering from coronary thrombosis with healthy individuals concerning early maladaptive schemas and emotion regulation strategies. Journal of Behavioral Sciences, 8(1), 55-63. [Persian]
Aldas, E. A. (2013). The effect of cognitive-behavioral group therapy on the Meta cognitions anxiety, stress and depression cardiovascular disease. World Congress of Cognitive and Behavior Therapy, Barcelona, Spain.
Azizi, Z., Aliakbari Dehkordi, M., & Alipour, A. (2019). The Effectiveness of Group Schema Therapy on Reducing Death Anxiety Syndrome in Cardiovascular Patients. Journal of Research in Behavioural Sciences, 17(2), 244-252. [Persian]
Bamber, M. R. (2006). CBT for occupational stress in health professionals: Introducing a schema-focused approach. New York: Rutledge.
Brosschot, J. F. (2010). Markers of chronic stress: Prolonged physiological activation and (un)conscious perseverative cognition. Neuroscience and Biobehavioral Reviews, 35, 46-50.
Brouwers, C., Mommersteeg, P. M., Nyklicek, I., Pelle, A. J., Westerhuis, B. L., Szabó, B. M., & Denollet, J. (2013). Positive affect dimensions and their association with inflammatory biomarkers in patients with chronic heart failure. Biological Psychology, 92(2), 220-226.
Chaddha, A., Robinson, E. A., Kline-Rogers, E., Alexandris-Souphis, T., & Rubenfire, M. (2016). Mental health and cardiovascular disease. The American Journal of Medicine, 129(11), 1145-1148.
Chauvet-Gelinier, J. C., & Bonin, B. (2017). Stress, anxiety and depression in heart disease patients: A major challenge for cardiac rehabilitation. Annals of Physical and Rehabilitation Medicine, 60(1), 6-12.
Charlson, F. J., Stapelberg, N. J., Baxter, A. J., & Whiteford, H. A. (2011). Should global burden of disease estimates include depression as a risk factor for coronary heart disease? BMC Medicine, 9:47.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-96.
Denollet, J. (1998). Personality and coronary heart disease: the type-D scale-16 (DS16). Annals of Behavioral Medicine, 20(3), 209-215.
Denollet, J. (2005).DS14: Standard assessment of negative affectivity, social inhibition and type D personality. Personality Medicine, 67, 89-97.
Dich, N., Rod, N. H. & Doan, S. N. (2020). Both High and Low Levels of Negative Emotions Are Associated with Higher Blood Pressure: Evidence from Whitehall II Cohort Study. International Journal of Behavioral Medicine, 27, 170–178.
Dickhaut, V., & Arntz, A. (2014). Combined group and individual schema therapy for borderline personality disorder: a pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 45(2), 242-251.
Farahani, H., & Arizi, H. (2009). Advanced Research Methods in Humanities. Isfahan: University of Isfahan. [Persian]
Ghashghaei, E. F., Sadeghi, M., Marandi, S. M., & Ghashghaei, S. E. (2012). Exercise-based cardiac rehabilitation improves hemodynamic responses after coronary artery bypass graft surgery. ARYA Atherosclerosis, 7, 151-156.
Grau, M., Bongard, V., Fito, M., Ruidavets, J. B., Sala, J., & Taraszkiewicz, D. (2010). Prevalence of cardiovascular risk factors in men with stable coronary heart disease in France and Spain. Archives of Cardiovascular Diseases, 103, 80-89.
Kameli, Z., Ghanbari Hashem Abadi, Bahram Ali., & Agha Mohammadin Sharbaf, Hamid Reza. (2011). The effectiveness of cognitive group therapy based on schema on modification early maladaptive schema among orphan and dysfunctional parenting adolescents' girls. Research in Clinical Psychology and Counseling, 1(1), 83-98. [Persian]
Kharamin, S., Malekzadeh, M., Aria, A., Ashraf, H., & Shirazi, H. R. G. (2018). Emotional Processing in Patients with Ischemic Heart Diseases. Open Access Macedonian Journal of Medical Sciences, 6(9), 1627-1632.
Kim, C. H., Noh, I. K., Ryu, J. M., Bae, E. J., Cho, H. J., & Kim, M. S. (2020). Canonical correlation between behavioral-psychological variables and predictors of coronary artery disease prognosis. International Journal of Environmental Research and Public Health, 17, 1608.
Kozela, M., Bobak, M., Besala, A., Micek, A., Kubinova, R., Malyutina, S., Denisova, D., Richards, M., Pikhart, H., Peasey, A., Marmot, M., & Pająk, A. (2016). The association of depressive symptoms with cardiovascular and all-cause mortality in Central and Eastern Europe: Prospective results of the HAPIEE study. European Journal of Preventive Cardiology, 23(17), 1839-1847.
Hawke, L. D., Provencher, M. D., & Parikh, S. V. (2013). Schema therapy for bipolar disorder: a conceptual model and future directions. Journal of affective disorders, 148(1), 118-122.
Li Y.D., Lin T.K., Tu Y.R., Chen, C. W., Lin, C. L., Lin, M. N., Koo, M., & Weng, C. Y. (2018). Blood pressure reactivity and recovery to anger recall in hypertensive patients with Type D personality. Acta Cardiologica Sinica, 34, 417–423.
Lin, T. K., Lin, C. L., Li, Y. D., Huang, Y., Koo, M., & Weng, C. Y. (2020). Negative Affectivity Is Associated with a Higher Systolic and Diastolic Blood Pressure in Normotensive Middle-Aged and Older Adults: A Cross-Sectional Study. Medicina, 56(4), 160.
Low, C. A., Thurston, R. C., & Matthews, K. A. (2010). Psychosocial factors in the development of heart disease in women: current research and future directions. Psychosomatic Medicine, 72, 842–854.
Mahoor, H., & Farzin Far, K. (2016). The Effectiveness of Schema Therapy on Psychological Well-Being of Mothers of Deaf Children. Journal of Sabzevar University of Medical Sciences, 24(5), 318-311.
Nordahl, H. M., & Nysæter, T. E. (2005). Schema therapy for patients with borderline personality disorder: a single case series. Journal of Behavior Therapy and Experimental Psychiatry, 36(3), 254- 264.
Ormel, J., & de Jonge, P. (2011). Unipolar depression and the progression of coronary artery disease: toward an integrative model. Psychotherapy and Psychosomatics, 80(5), 264–274.
Panahifar, S., Yousefi, N., & Amani, A. (2014). The Effectiveness of Schema-Based Couple Therapy on Early Maladaptive Schemata Adjustment and the Increase of Divorce Applicants Adaptability. Kuwait Chapter of the Arabian Journal of Business and Management Review, 3(9), 339.
Pedersen, S. S., & Denollet, J. (2006). Is Type D personality here to stay? Emerging evidence across cardiovascular disease patient groups. Current Cardiology Review Journal, 2(3), 205-213.
Phillips, K. M., Antoni, M. H., Lechner, S. C., Blomberg, B. B., Llabre, M. M., Avisar, E., Glück, S., DerHagopian, R., & Carver, C. S. (2008). Stress management intervention reduces serum cortisol and increases relaxation during treatment for Nonmetastatic breast cancer. Psychosomatic Medicine, 70, 1044-1049.
Renner, F., Lobbestael, J., Peeters, F., Arntz, A., & Huibers, M. (2012). Early maladaptive schemas in depressed patients: stability and relation with depressive symptoms over the course of treatment. Journal of Affective Disorders, 136(3), 581-90.
Rezaei, F. (2011). Schematic Therapy in Chronic Depression. Review of the 10th Annual Congress of the Iranian Psychiatrists Association, Tehran, Iran.
Riso, L. P., du Toit, P. L., Stein, D. J., & Young, J. E. (2007). Cognitive schemas and core beliefs in psychological problems: A scientist-practitioner guide. Washington: American Psychological Association.
Roest, A. M., Martens, E. J, Denollet, J., de Jonge, P. (2010). Prognostic association of anxiety post myocardial infarction with mortality and new cardiac events: a meta-analysis. Psychosomatic Medicine, 72(6), 563–569.
Saadat, S., Asghari, F., & Jazayeri, R. (2015). The relationship between academic self-efficacy with perceived stress, coping strategies and perceived social support among students of University of Guilan. Iranian Journal of Medical Education, 15, 67-78. [Persian]
Sanai, B. (2004). Psychotherapy and group counseling. Tehran: Chehr Publications. [Persian]
Sanchez-Gonzalez, M. A., May, R. W., Koutnik, A. P., & Fincham, F. D. (2015). Impact of negative affectivity and trait forgiveness on aortic blood pressure and coronary circulation. Psychophysiology, 52, 296–303.
Shen, B. J., Fan, Y., Lim, K. S. C., & Tay, H. Y. (2019). Depression, Anxiety, Perceived Stress, and Their Changes Predict Greater Decline in Physical Health Functioning over 12 Months Among Patients with Coronary Heart Disease. International Journal of Behavioral Medicine, 26(4), 352-364.
Skewes, S. A., Samson, R. A., Simpson, S. G., & Van Vreeswijk, M. (2014). Short-term group schema therapy for mixed personality disorders: a pilot study. Frontiers Psychology, 5(1), 1592-1600.
Suls, J. (2013). Anger and the heart: perspectives on cardiac risk, mechanisms and interventions. Progress in Cardiovascular Diseases, 55, 538-547.
Steptoe, A., & Kivimäki, M. (2013). Stress and cardiovascular disease: an update on current knowledge. Annual Review of Public Health, 34, 337-354.
Thayer, J. F., Yamamoto, S. S., & Brosschot, J. F. (2010). The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. International Journal of Cardiology, 141, 122–131.
Vlachakis, C., Dragoumani, K., Raftopoulou, S., Mantaiou, M., Papageorgiou, L., Champeris Tsaniras, S., & Vlachakis, D. (2018). Human Emotions on the Onset of Cardiovascular and Small Vessel Related Diseases. In vivo (Athens, Greece), 32(4), 859–870.
Von Känel, R. (2012). Psychosocial stress and cardiovascular risk – current opinion. Swiss Medical Weekly, 142, w13502.
Von Känel, R., Hari, R., Schmid, J. P., Wiedemar, L., Guler, E., Barth, J., et al. (2011). Non-fatal cardiovascular outcome in patients with posttraumatic stress symptoms caused by myocardial infarction. Journal of Cardiology, 58(1), 61–68.
Zarei, S., & Fooladvand, K. (2019). The Moderating Effect of Self- Differentiation in the Relationship between Perceived Stress and Marital Adjustment in Married Nurses. Iranian Journal of Psychiatric Nursing, 7(2), 48-55. [Persian]
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schemas therapy: A practitioner guide. New York: Guilford press.
Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F., et al. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 364(9438), 937–952.
West, L. H. (2014). The effect of cognitive-behavioral group therapy on the quality of life and perceived stress in abusing of cardiovascular disease. American Journal of Orthodontics, 131(5), 571-572.
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