مقایسه اثربخشی درمان شناختی مبتنی بر مدل فرانظری و فراشناخت درمانی بر کنترل فکر و کاهش درد در بیماران مبتلا به درد مزمن

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی دانشگاه پیام نور، تهران، ایران

2 استاد، گروه روانشناسی دانشگاه پیام نور، تهران، ایران

3 دانشیار، گروه روانشناسی عمومی دانشگاه آزاد واحد تهران مرکز، تهران، ایران

چکیده

مقدمه: هدف این پژوهش مقایسه اثربخشی درمان شناختی مبتنی بر مدل فرانظری و فراشناخت درمانی بر کنترل فکر و کاهش درد در بیماران مبتلا به درد مزمن بود.
روش: این پژوهش از نوع نیمه­آزمایشی و با طرح پیش­آزمون و پس­آزمون با گروه کنترل بود. جامعه پژوهش شامل همه بیماران مبتلا به درد مزمن بالای 30 سال بود که در سال 1394 به مراکز درمانی تحت پوشش بیمارستان دکتر قلی پور بوکان مراجعه کردند. از میان مراجعه­کنندگان به این مراکز 105 بیمار واجد ملاک­های ورود به صورت تصادفی در گروه­های آزمایش و گروه کنترل قرار گرفتند. گروه­های آزمایش هشت جلسه ی 90 دقیقه­ای دریافت نمودند. برای جمع­آوری داده­ها از مقیاس درد مک­گیل و کنترل فکر  ولز و دیوس استفاده شد.
یافته­ها: نتایج تحلیل کوواریانس چند متغیری نشان داد بین سه گروه در نمرات پس­آزمون کنترل فکر و کاهش درد تفاوت معنی­داری وجود داشت. نتایج آزمون تعقیبی بیانگر اثربخشی بیشتر و پایدارتر مدل فرانظری نسبت به مدل فراشناختی هم در پس­آزمون و هم پیگیری دو ماهه بر کنترل فکر و کاهش درد بود.
نتیجه­گیری: برحسب نتایج حاصل از این پژوهش مداخله فرانظری کنترل فکر و کاهش درد بیماران مبتلا به درد مزمن را بیشتر افزایش داد. بنابراین متخصصان بهداشت روانی می­توانند از این درمان جهت ارتقا کنترل فکر و کاهش درد بیماران استفاده کنند.

کلیدواژه‌ها


عنوان مقاله [English]

Appraisal of Effectiveness and Comparison of Cognitive Therapy Based on Meta-Theoretical Models and Meta-Cognitive Therapy on Thought Control and Reducing the Pain in Patients Suffering from Chronic Pain

نویسندگان [English]

  • A Mostafaie, 1
  • H Zare, 2
  • A Alipour, 2
  • V Farzad, 3
1 دانشجوی دکتری روانشناسی دانشگاه پیام نور، تهران، ایران
2 استاد، گروه روانشناسی دانشگاه پیام نور، تهران، ایران
چکیده [English]

Introduction:Theaim of this study was to examin and compare the effectiveness of cognitive therapy Based on meta-theoretical models and meta-cognitive therapy on thought control and reducing the pain in patients suffering from chronic pain.
Method: This study was quasi-experimental with pretest-posttest and control group. The statistical population included all chronic pain patients aged over 30 years old who referred to Shahid Gholipur Hospital’s centers of Bukan city for treatment in 2015. 105 patients with chronic pain were selected among those who referred to these centers and assigned into the experimental and control groups randomly. The experimental groups received eight sessions of 90-minutes. The McGill Pain Questionnaire and Wells Score were used to collect data.
Results: The Results of multiple analysis of covariance indicated that there was a significant difference between three groups in posttest scores of thought control and reducing the pain. The results of post hoc test indicated more effective and more reliable effectiveness of meta-transtheoretical therapy rather than meta-cognitive model in post-test and follow-up of two months on thought control and reducing the pain.
Conclusion:  According to the results of this study, meta-transtheoretical therapy more increased in thought control and reducing the pain. Thus, mental health expert can use this treatment method for increasing patients’ thought control and reducing the pain

کلیدواژه‌ها [English]

  • Cognitive Therapy Based on Transtheoretical model
  • Metacognition Therapy
  • Thought Control
  • Pain
  • Patients Suffering from Chronic Pain

1- Sarafynv E. health Psychology Translation Abhari and colleagues. Tehran: Publications roshd. 2013. [Persian].

2- Hazinski MF.Analgesia, sedation, and neuromuscular blockade. 3rd ed. Chapter 5:Nursing care of the critically ill child. Elsevier Mosby. 2013; 78.

3- McCracken, L.M .Learning to live with the pain:acceptance of pain predicts adjustment in persons with chronic pain. 1998; 74: 21– 27.

4- Sanderson, C. A.  Health psychology. New York: Willy. 2003.

5- Falvo, D. Medical and psychosocial aspects of chronic illness and disability. Jones and Batlett publishers. 2005.

6- Pampallona S, Bollini P, Tibaldi G, Kupelinck B, Munizza C. Combined pharmacotherapy and psychological treatment for depression: A systematic review. Arch Gen Psychiatry. 2004; 61(7): 714-9

7- Kremer E, Atkinson JH. Pain measurement: construct validity of the affective dimension of the McGill Pain Questionnaire with chronic benign pain patients. Pain 1981;11: 93-100

8- Hayes, A.M., & Feldman, G. Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy.Clinical Psychology: Science and Practice. 2004; 11: 255–62.

9- Luciano J. V., Guallar J. A., Aguado J., López-del-Hoyo Y., Olivan B., Magallón R., et al.  Effectiveness of group acceptance and commitment therapy for fibromyalgia: a 6-month randomized controlled trial (EFFIGACT study). Pain. 2014; 155(4): 693–702.

10- Wells A. Emotional disorders and metacognition: Innovative cognitive therapy. 6th ed .UK: Wiley & Sons. 2000.

11- Wells, A., & Mathews,G. Modeling cognittive in emotional . Behav iour Research and Therapy. 1996; 34: 811-88.

12- Wells A, Papageorgiou C. Brief cognitive therapy for social phobia: A case series. Behaviour Research and Therapy. 2001; 39(2): 713–20

13- Parra-Delgado, M., & Latorre-Postigo, J.M. Effectiveness of Mindfulness-Based Cognitive Therapy in theTreatment of Fibromyalgia: ARandomized Trial. Cognitive therapy and research. 2013; 37: 1015–26.

14- Grossman, P., Tiefenthaler-Gilmer, U., Raysz, A., & Kesper,U. Mindfulness training as an intervention for fibromyalgia: evidence of post intervention and 3-year follow up benefits in well-being. Psychotherapy and Psychosomatics. 2007; 76(4): 226–33.

15- McCracken, L.M., & Thompson, M. Components of Mindfulness in patients with chronic pain. Journal of Psychopathology and Behavioral Assessment. 2009; 31: 75–82

16- Schmertz, S.K., Anderson, P.L., & Robins, D.L. The relation between self-report mindfulness and performance on tasks of sustained attention. Journal of Psychopathology and Behavioral Assessment. 2009; 31: 60–6.

17- Frewen, P.A., Evans, E.M., Maraj, N., Dozois, D.J.A., & Partridge, K. Letting go: Mindfulness and negative automatic thinking. Cognitive Therapy and Research. 2012; 32: 758–74.

18- Schütze, R., Rees, C., Preece, M., & Schütze, M. Low Mindfulness Predicts Pain Catastrophizing in a Fear- Avoidance, Model of Chronic Pain. 2010; 148: 120-27.

19- Mecacci, L., Righi, S., & Rocchetti, G. Cognitive failures and circadian typology. Personality and Individual Differences. 2006; 37: 107-13.

20- Lobban, F. Haddock, E. Einderman, P. & Wells, A. The role metacopinitive beliefs in auditory hallucination. Personality and Individual Differences. 2002; 32(6): 1351-63.

21- Parra-Delgado, M., & Latorre- Postigo, J.M. Effectiveness of Mindfulness- Based Cognitive Therapy in the Treatment of Fibromyalgia: A Randomized Trial. Cognitive therapy and research. 2013; 37: 1015–26.

22- Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. American Journal of Health Promotion. 1997; 12(1): 38-48. BSTRACT/FREE Full Text

23- Green J. The role of theory in evidence-based health promotion practice. Health education research. 2000; 15(2): 125-9.

24- Eva van Leer, Edie R. Hapner, Nadine P. Connor. Transtheoretical model of health behavior change applied to voice therapy. J Voice. 2008; 22(6): 688-98.

25- Glanz K, Rimer KB, Lewis MF. Health behavior & health education; theory, research and practice. 3rd edition. San Francisco: Jossey-Bass. 2002; 93-154.

26- Bandura, A. Perceived self-efficacy in cognitive development and functioning. Education psychology. 1993; 28(2): 117-48.

27- Weinman J, Petrie KJ, Moss-Morris R, Horne R. The illness perception questionnaire: a new method for assessing the cognitive representation of illness. Psychology and health. 1996; 11: 431-45.

28- Jafari M, Shahidi Sh. Abedin A. Comparing the effectiveness of treatments transtheoretical And cognitive-behavioral On improving Automatically Avoid with substance dependency in adolescent boys. Behavioral Sciences Research. 2009; 7(1): 1-11. [Persian].

29- Dolan SL, Martin RA, Rohsenow DJ. Self-efficacy for cocaine abstinence: pretreatment correlates and relationship to outcomes. Addict Behav. 2008; 33(5): 675-88.

30- prochaska JO, Redding CA, Evers  KE. The Transtheoretical  Model  and  Stage  of Change.In:Glanz K , RimerBk , Lewis FM,(Eds). Health  Behavior  and Health Education. Theory, Research, and Practice. San Francisco;Jossey-Bass Publishers. 2002; 99-120.

31- Prvchska J, Norcross j. Theories of Psychotherapy. Translation Yahya Syed Mohammad Tehran: Publications roshd. 2011. [Persian].

32- Diniz, I.; Duarte, M.; Peres, K.; de Oliveira, E.; Berndt, A. Active commuting by bicycle: Results of an educational intervention study. J. Phys. Act. Health. 2015; 12: 801–7.

33- Molina-García, J.; Castillo, I.; Queralt, A.; Sallis, J.F. Bicycling to university: Evaluation of a bicycle-sharing program in spain. Health Promote. Inter. 2013; 30: 350–8.

34- Mundorf, N.; Redding, C.A.; Fu, T.; Paiva, A.; Brick, L.; Prochaska, J.O. Promoting sustainable transportation across campus communities using the transtheoretical model of change. Commun. Commons. 2013; 427–38.

35- Dworkin RH, Turk DC, Revicki DA, Harding G, Coyne KS, Peire-sandner S, . Development and initial validation of an expanded and revised version of the short-form McGill pain Questionaire (sf-mpq-2). Pain. 2009; 144(1-2): 35-42.

36- Zare H, AbdollaZadeh H. Measurement scales In cognitive psychology, Tehran: Publications ayiizh. 2012. [Persian].

37- Bartholomew, L.K.K.; Parcel, G.S.S.; Kok, G.; Gottlieb, N.H.H. Planning Health Promotion Programs; Wiley: San Franscisco, CA, USA. 2010.

38- Dadsetan A JS. Investigate the role of cognitive emotion in behavior of patients with rheumatoid Retry. Fifth Congress of Psychosomatic. 2013.

39- Scharloo M, Kaptein A, Weinman J, Bergman W, Vermeer B, Rooijmans H. Patients’ illness perceptions and coping as predictors of functional status in psoriasis: a 1‐year follow‐up. British Journal of Dermatology. 2000; 142: 899-907.

40- McCracken LM, Velleman SC. Psychological flexibility in adults with chronic pain: a study of acceptance, mindfulness, and values-based action in primary care. Pain. 2010; 148: 141-7.

41- Morone NE, Lynch CS, Greco CM, Tindle HA, Weiner DK. “I felt like a new person.” The effects of mindfulness meditation on older adults with chronic pain: qualitative narrative analysis of diary entries. The Journal of Pain. 2008; 9: 841-8

42- Sullivan MJL, Thorn B, Haythornthwaite J, Keefe F, Martin M, Bradley L, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clinical J Pain. 2001; 17: 52–64.

43- Litt MD, Kadden RM, Kabela-Cormier E, Petry NM. Coping skills training and contingency management treatments for marijuana dependence: Exploring mechanisms of behavior change. Addict. 2008; 103(4): 638-48.