مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و طرحواره درمانی بر خودکارآمدی و خودشفقتی زنان بعد از عمل هیسترکتومی

محورهای موضوعی : زن و خانواده

سیما فرزانه ¹ , توکل موسی زاده ² , وکیل نظری ³

1 - دانشجوی دکتری روانشناسی، گروه روانشناسی ، واحد اردبیل ، دانشگاه آزاد اسلامی ، اردبیل، ایران
2 - استادیار ، گروه روانشناسی، واحد اردبیل ، دانشگاه آزاد اسلامی، اردبیل، ایران ( نویسنده مسئول ) [e-mail]
3 - استادیار ، گروه روانشناسی ، واحد اردبیل ، دانشگاه آزاد اسلامی، اردبیل ، ایران

تاریخ دریافت : 1400/02/28 تاریخ پذیرش : 1400/08/03 تاریخ انتشار : 1401/09/01

کلید واژه: خودکارآمدی, طرحواره درمانی, درمان مبتنی بر پذیرش و تعهد, خودشفقتی, هیسترکتومی,

چکیده مقاله :

هیسترکتومی دومین جراحی شایع است که به طور عمده برای آسیب‌های رحمی خوش خیم در زنان انجام می‌شود. هدف از انجام پژوهش حاضر مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و طرحواره درمانی بر خودکارآمدی و خودشفقتی زنان بعد از عمل هیسترکتومی بود. روش پژوهش حاضر، نیمه آزمایشی با طرح پیش آزمون- پس آزمون با گروه کنترل بود. جامعه آماری این تحقیق را کلیه زنان هیسترکتومی شده در شهر اردبیل در سال ۱۳۹۹ تشکیل می‌دهند. از این میان تعداد 45 نفر به‌صورت نمونه گیری در دسترس انتخاب و پس از جایگزینی تصادفی در سه گروه آزمایشی و گروه کنترل مورد مطالعه قرار گرفتند (در هر گروه 15 نفر) انتخاب شد. داده های آزمودنی ها به وسیله مقیاس خودکارآمدی شرر و همکاران (1982) و خودشفقتی نف (۲۰۰۳) جمع آوری شد. مدت جلسات درمانی آموزش مبتنی بر پذیرش و تعهد (8 جلسه 90 دقیقه‌ای) و آموزش طرحواره درمانی (8 جلسه 90 دقیقه‌ای) بود که به صورت فردی و هفته‌ی یکبار انجام شد جهت تجزیه‌وتحلیل داده ها از آزمون کوواریانس چندمتغیره با استفاده از نرم‌افزار SPSS25 استفاده شد. یافته ها نشان داد که تفاوت آماری معنی‌داری بین میانگین نمرات دو گروه آزمایش و کنترل، در نمره کل متغیر خودکارآمدی (508/34=F) و متغیر خودشفقتی (378/94=F) وجود داشت. همچنین، در مقایسه درمان مبتنی بر پذیرش و تعهد با طرحواره درمانی بر خودکارآمدی و خودشفقتی مشخص گردید اثربخشی درمان پذیرش و تعهد در افزایش خودکارآمدی نسبت به طرحواره درمانی بیشتر است اما اثربخشی هر دو درمان در بهبود خودشفقتی یکسان می‌باشد. با توجه به اثربخش بودن پروتکل های درمان مبتنی بر پذیرش و تعهد و طرحواره درمانی بر متغیرهای پژوهش، این دو نوع درمان را می‌توان در کنار دیگر مداخلات روان‌شناختی بکار گرفت.

چکیده انگلیسی:

Hysterectomy is the second most common surgery performed mainly for benign uterine injuries in women. The aim of this study was to compare the effectiveness of acceptance and commitment therapy and schema therapy on the self-efficacy and self- Self-compassion of women after hysterectomy. The method of the present study was quasi-experimental with a pretest-posttest design with a control group. The statistical population of this study consists of all hysterectomized women in Ardabil in 2020. From among them, 45 people were selected by available sampling and Randomly assigned into three groups including two experimental groups and one control group in three experimental groups and control group (15 people in each group). Subjects' data were collected using the self- Questionnaire of Scherer et al (1982) and Self-compassion of Neff (2003) scales.The duration of the treatment sessions For  acceptance and commitment group was acceptance and commitment (8 sessions of 90 minutes) and schema therapy training (8 sessions of 90 minutes) which was done individually and once a week. Multivariate covariance test using SPSS25 software was used to analyze the data. The results showed that there was a statistically significant difference between the mean scores of the experimental and control groups in the total score of the self-efficacy variable (F = 34.508) and the self- compassion variable (F = 94.378) Also, comparing acceptance and commitment therapy with schema therapy on self-efficacy and self-compassion it was found that the effectiveness of acceptance and commitment therapy in increasing self-efficacy is higher than schema therapy, but the effectiveness of both treatments in improving self-compassion is the same. Due to the effectiveness of treatment protocols based on acceptance and commitment and schema therapy on research variables, these two types of treatment can be used along with other psychological interventions..

منابع و مأخذ:

1. Aalami, M., Taimory, S., & Ahi, G. (2020). The Effectiveness of an Integrated Approach of Schema Therapy based Acceptance and Commitment Therapy on Marital Conflicts and Divorce Tendency in Divorce Applicant Couples. Journal of Research in Behavioural Sciences, 18(1), 132-141. (Text in Persian).


2. Delavar A. (1390). Theoretical and practical foundations of research in humanities and social sciences. (Edition 2), Tehran: Roshd. (Text in Persian).


3. Aytur, S.A., Ray, K.L., Meier, S.K., Campbell, J., Gendron, B., Waller, N., & Robin, D. A. (2021). Neural mechanisms of acceptance and commitment therapy for chronic pain: A network-based fMRI approach. journal of Frontiers in humanneuroscience, 15(1), 1-13


4. Bach, B., Lockwood, G., & Young, J. E. (2018). A new look at the schema therapy model: organization and role of early maladaptive schemas. Journal of Cognitive behaviour therapy, 47(4), 328-349.


5. Bacon, T., Farhall, J., & Fossey, E. (2014). The active therapeutic processes of acceptance and commitment therapy for persistent symptoms of psychosis: clients' perspectives. Journal of Behavioural and Cognitive Psychotherapy, 42(4), 402-420.


6. Barati Bakhtiari, Siamak (2007). Investigating the simple and multiple relationship of self-efficacy, self-esteem and self-discovery variables with academic performance in third year students of the new secondary system of Ahvaz city. Master Thesis in Educational Psychology, Shahid Chamran University of Ahvaz. (Text in Persian).


7. Barati, A., Ebrahimi, M. I., & Firoozeh, Z. (2021). Comparison of the effectiveness of gestalt coaching training and acceptance and commitment-based therapy on emotional intelligence and self-efficacy. Journal of Research in Behavioural Sciences, 18(4), 930-940. (Text in Persian).


8. Basharpoor, S. (2014). Psychometric properties of the Persian version of the self compassion scale in university students. Journalof Research in Psychological Health, 7 (2), 66-75. (Text in Persian).


9. Bou­Zgheib, N. (2021). Major Intraoperative Injuries during Hysterectomy: Prevention, Recognition and Management. Journal of Gynecologic Surgery, 37(3), 188–189.


10. Chin, C. H., Tseng, L. M., Chao, T. C., Wang, T. J., Wu, S. F., & Liang, S. Y. (2021). Self-care as a mediator between symptom-management self-efficacy and quality of life in women with breast cancer. Journal of PloS one, 16(2), 1-10.


11. Chio, F. H., Mak, W. W., & Ben, C. L. (2021). Meta-analytic review on the differential effects of self-compassion components on well-being and psychological distress: The moderating role of dialecticism on self-compassion. Journal of Clinical Psychology Review, 85(3), 101-986.


12. Ding, D. C., Tsai, I. J., Hsu, C. Y., Wang, J. H., Lin, S. Z., & Sung, F. C. (2018). Risk of hypertension after hysterectomy: a population‐based study. BJOG: An International Journal of Obstetrics & Gynaecology, 125(13), 1717-1724.


13. Doroudian, N., Madahi, M.I., &Khalatbari, J. (2018). Comparison of the effectiveness of cognitive-behavioral therapy and acceptance and commitment therapy on emotional regulation and self-efficacy of women with social anxiety. Journal of Cultural and Educational Quarterly of Women and Family, 13 (44), 89-108. (Text in Persian).


14. Farokhi, H., Ansarishahidi, M., Rezayi, H., abrahemi, A., & arbkheradmand, J. (2019). Comparing the Effectiveness of Schema Therapy, Acceptance and Commitment Therapy on Pain Acceptance, Pain Self-Efficacy in Spinal Column Surgery Patients. Journal of Applied Psychological Research, 10 (4), 89-96. (Text in Persian).


15. Ghasem-Abadi E, Khalatbari J, Ghorban-Shiroudi Sh, Rahmani MA. Effectiveness of Schema and Commitment Therapy, Compassion-based Therapy, and Dialectical Behavior Therapy on Marital Conflict among Married Women in Social. Salamat Ijtimai (Community Health). 2019; 6(2):157-64. DOI: http://doi.org/10.22037/ch.v6i2.23231. (Text in Persian).


16. Gudenkauf, LM., Antoni, MH., Stagl, J.M., Lechner, S.C., Jutagir, D.R., Bouchard, L.C. & et al. (2015). Brief cognitive–behavioral and relaxation training interventions for breast cancer: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 83(4): 677-688.


17. Hayes, S.C., & Strosahl, K.D. (2004). A practical guide to acceptance and commitment therapy: Springer Science & Business Media.


18. Jain, S., Pansare, S. (2021) Psychological impact of pre-operative education on post-operative health in patients undergoing elective hysterectomy. The New Indian Journal of OBGYN, 8(1): 33-8.


19. Jones, K. M., Brown, L., Houston, E. E., & Bryant, C. (2021). The role of self-compassion in the relationship between hot flushes and night sweats and anxiety. Journal of Maturitas, 144(2), 81-86.


20. Khashouei, M.M., Ghorbani, M., & Tabatabaei, F. (2016). The effectiveness of acceptance and commitment therapy (ACT) on self-efficacy, perceived stress and resiliency in type II diabetes patients. Global Journal of Health Science, 9(5), 18-26. (Text in Persian).


21. Kim, M. O., Yu, M., Ju, S. J., Kim, K. S., Choi, J. H., & Kim, H. J. (2013). Depression cognition and health promoting behaviors of smoking and non-smoking college students. Korean Journal of Health Education and Promotion, 30(3), 35-46.


22. Kim, S., & Hmielowski, J. D. (2017). The Influence of Self-efficacy in Medical Drama Television Programming on Behaviors and Emotions that Promote Cervical Cancer Prevention. American journal of health behavior, 41(6), 719-727.


23. Köhle, N., Drossaert, C. H., Jaran, J., Schreurs, K. M., Verdonck-de Leeuw, I. M., & Bohlmeijer, E. T. (2017). User-experiences with a web-based self-help intervention for partners of cancer patients based on acceptance and commitment therapy and self-compassion: a qualitative study. BMC Public Health, 17(1), 1-16.


24. Mathias, B., Parry-Jones, B., & Huws, J. C. (2014). Individual experiences of an acceptance-based pain management programme: an interpretative phenomenological analysis. Journal of Psychology & health, 29(3), 279-296.


25. Matoff, M. (2018). Circumstances to integrate acceptance and commitment therapy with short-term psychodynamic psychotherapies. Journal of Cogent psychology, 5(1), 1453595.


26. Moradhaseli, M., Shams Esfandabad‎, H., Kakavand, A. (2016). The Effect of Cognitive Behavior Therapy on Weight ‎Efficacy of Life Style in Female Students. Clinical Psychology Studies, 6(22), 1-19. (Text in Persian).


27. Mousavi Tile Bani, M., Ahadi, H., & Sabet, M. (2021). The effectiveness of acceptance and commitment-based therapy on psychological well-being and self-efficacy of schoolchildren with low vision. Journal of Preventive Medicine, 8(1), 32-23. (Text in Persian).


28. Neff, K. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Journal of Self and identity, 2(2), 85-101.


29. Peeters, N., Stappenbelt, S., Burk, W. J., van Passel, B., & Krans, J. (2021). Schema therapy with exposure and response prevention for the treatment of chronic anxiety with comorbid personality disorder. British Journal of Clinical Psychology, 60(1), 68-76.


30. Qasem-Abadi, E., Khalatbari, J., Ghorban-Shiroudi, S. H., & Rahmani, M. A. (2019). Effectiveness of schema and commitment therapy, compassion-based therapy and dialectical behavior therapy on marital conflict among married women in Social Emergency Services of Tonekabon and Ramsar. Journal of Social Health, 6(2), 157-164. (Text in Persian).


31. Sarı, S., & Gençöz, F. (2019). Women's experiences of group intervention with schema therapy techniques: A qualitative process analysis. Counselling and Psychotherapy Research, 19(3), 301-310.


32. Seyyedsharifi, M., Navabi Nezhad, S., farzad, V. (2019), Comparison of the effectiveness of emotional - focused and schema therapy approach on the self-Efficacy of parenting in mothers of the household head. Psychological sciences, 18(76), 407-415. (Text in Persian).


33. Shekhar, C., Paswan, B., & Singh, A. (2019). Prevalence, sociodemographic determinants and self-reported reasons for hysterectomy in India. Journal of Reproductive health, 16(1), 1-16.


34. Sherer, M., Maddux, J. E., Mercandante, B., Prentice-Dunn, S., Jacobs, B., & Rogers, R. W. (1982). The self-efficacy scale: Construction and validation. Journal of Psychological reports, 51(2), 663-671.


35. Thimm, J.C. (2017). Relationships between early maladaptive schemas, mindfulness, self-compassion, and psychological distress. International Journal of Psychology and Psychological Therapy, 17(1), 3-17.


36. Tirch, D., Schoendorff, B., & Silberstein, L. R. (2014). The ACT practitioner's guide to the science of compassion: Tools for fostering psychological flexibility. New Harbinger Publications.


37. Treaster, M. (2018). Self-Compassion and Physical Health-Related Quality of Life in Cancer: Mediating Effects of Control Beliefs and Treatment Adherence.


38. Van Den End, A., Dekker, J., Beekman, A. T., Aarts, I., Snoek, A., Blankers, M., & Thomaes, K. (2021). Clinical Efficacy and Cost-Effectiveness of Imagery Rescripting Only Compared to Imagery Rescripting and Schema Therapy in Adult Patients With PTSD and Comorbid Cluster C Personality Disorder: Study Design of a Randomized Controlled Trial. Journal of Frontiers in Psychiatry, 12(1), 314-328.


39. Wang, F., Li, C., Li, S.L. (2014). Integrated interventions for improving negative emotions and stress reactions of young women receiving total hysterectomy. International journal of clinical and experimental medicine, 7(1), 331-336.


40. Zhang, C. Q., Leeming, E., Smith, P., Chung, P. K., Hagger, M. S., & Hayes, S. C. (2018). Acceptance and commitment therapy for health behavior change: a contextually-driven approach. journal of Frontiers in psychology, 8(1), 1-6


41. Zielińska-Więczkowska, H. (2017). Correlations between satisfaction with life and selected personal resources among students of Universities of the Third Age. Journal of Clinical interventions in aging, 12(1), 1391-1399.