اثربخشی درمان پذیرش و تعهد بر کاهش افسردگی و فقدان لذت‌جویی بیماران سرطانی مرحله‌ی آخر

نوع مقاله: مقاله پژوهشی

نویسندگان

1 استادیار، گروه علوم تربیتی، دانشگاه فرهنگیان ایران، تهران، ایران

2 کارشناسی ارشد روانشناسی بالینی، دانشگاه آزاد اسلامی واحد اهواز، اهواز، ایران

10.22075/jcp.2020.18847.1742

چکیده

مقدمه: هدف این پژوهش، تعیین اثربخشی درمان پذیرش و تعهد بر افسردگی و فقدان لذت جویی بیماران سرطانی شهر اهواز بود.
روش: جامعه­ ی آماری شامل کلیه­ ی بیماران سرطانی مرحله­ ی آخر شهر اهواز بود که از این میان 30 نفر با روش نمونه­ گیری دردسترس انتخاب شد. ابزار مورد استفاده شامل خرده­ مقیاس افسردگی از پرسشنامه­ ی 90-SCL و پرسشنامه‌ی فقدان لذت­ جویی هامیلتون بود. برای گروه آزمایش، 8 جلسه­ ی 90 دقیقه­ ای هفتگی برنامه­ ی درمان پذیرش و تعهد اجرا شد و گروه گواه هیچ­گونه مداخله­ ای دریافت نکرد. برای تحلیل داده­ ها از روش­های آمار استنباطی تحلیل کواریانس چندمتغیری و تک متغیری استفاده شد.
یافته­ ها: نتایج MANCOVA و ANCOVA نشان داد که درمان پذیرش و تعهد باعث کاهش میزان افسردگی و فقدان لذت­ جویی بیماران سرطانی مرحله‌ی آخر می­شود.
نتیجه­ گیری: به طور کلی، می‌توان گفت که درمان پذیرش و تعهد برای افزایش ظرفیت لذت­ جویی در افراد دچار سرطانی که با مرگ مواجه هستند، اثربخش است و توصیه می‌شود.

کلیدواژه‌ها


عنوان مقاله [English]

Effectiveness of Acceptance & Commitment Therapy on Depression and Anhedonia among Patients with Terminal Stage Cancer

نویسندگان [English]

  • Ayatolah Karimi Baghmalek 1
  • Arash Jelodari 2
  • Foroogh Mahigir 1
1 Assistant professor, department of Counseling and psychology, Farhangian University, Tehran, Iran
2 M.A. in clinical counseling, Azad University of Ahvaz
چکیده [English]

Introduction: The research aimed to examine effectiveness of Cognitive-Behavioral Therapy (CBT) on depression and anhedonia among patients with terminal stage cancer in Ahvaz.
Method: The statistical population included all patients with terminal stage cancer of Ahvaz among whom 30 were recruited using randomized sampling method. The participants filled out the depression subscale of SCL-90 and Snaith-Hamilton's Anhedonia Questionnaire. The treatment group received 8 weekly sessions of ACT intervention each lasting 90 mins, while the control group received no intervention. The data were analyzed using MANCOVA and ANCOVA.
Results: The results of analyses by MANCOVA and ANCOVA showed that ACT decreased patients' depression and anhedonia.
Conclusion: Generally, it could be concluded that the acceptance and commitment therapy was effective for improving the capability to feel joy among cancer patients facing death and is recommended.

کلیدواژه‌ها [English]

  • Acceptance & Commitment Therapy
  • depression
  • anhedonia
  • cancer
 
1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing; 2013.
2. World Health Organization. Health statistics and information systems. 2017: Retrieved from http://www.who.int/healthinfo/survey/whoqol-qualityoflife/en/ accessed in 11/10/2017.
3. Executive Manual for Register and Report Cancer Cases.vch.iums.ac.ir/uploads/ncr_guideline.pdf; 2006. [Persian]
4. Onyeka TC. Psychosocial issues in palliative care: A review of five cases. Indian J Palliat Care 2010; 16(3): 123-8.
5. Shapiro SL, Lopez AM, Schwartz GE, et al.. Quality of life and breast cancer: relationship to psychosocial variables. J ClinPsychol 2001; 57(4): 501-19.
6. Mohd-Sidik S, Akhtari-Zavare M, Periasamy U, et al. Effectiveness of chemotherapy counselling on self-esteem and psychological affects among cancer patients in Malaysia: Randomized controlled trial. Pat Educat Counsel 2018; 101(5): 862-871.
7. Thomsen KR, Whybrow PC, Kringelbach ML. Reconceptualizinganhedonia: novel perspectives on balancing the pleasure networks in the human brain. Front BehavNeurosci 2015; 9: 1-23.
8. Christensen GT, Maartensson S, Osler M. The association between depression and mortality – a comparison of survey- and register-based measures of depression. J Affec Dis 2017; 210: 111-4.
9. Jia H, Zack MM, Gottesman II, Thompson WW. Associations of Smoking, Physical Inactivity, Heavy Drinking, and Obesity with Quality-Adjusted Life Expectancy among US Adults with Depression. Value Healt 2018; 21(3): 364-71.
10. Santini ZI, Koyanagi A, Tyrovolas S, Mason C, Maria Haro J. The association between social relationships and depression: A systematic review. J Affec Dis 2015; 175(1): 53-65.
11. Hayes SC, Luoma, JB, Bond FW, Masuda A, Lillis J. Acceptance and Commitment Therapy: Model, processes and outcomes. Behav Res Therap 2015; 44(1): 1-25.
12. Hayes SC. Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies – Republished Article. BehavTherap 2016; 47(6): 869-85.
13. Bastami M, Goodarzi N, Dowran B, Taghva A. Effectiveness of treatment acceptance and commitment therapy (ACT) on the reduction of depressive symptoms of military personnel with type 2 diabetes mellitus. Ebnesina 2015; 18: 11-9. [Persian]
14. Mahdavi A, Aghaei M, Aminnasab V, et al. The Effectiveness of Acceptance-Commitment Therapy (ACT) on Perceived Stress, Symptoms of Depression, and Marital Satisfaction in Women With Breast Cancer. Arch Breast Canc 2017; 4(1): 16-23. https://doi.org/10.19187/abc.20174116-23
15. Derogatis LR, Cleary PA. Confirmation of the dimensional structure of the scl‐90: A study in construct validation. J ClinPsychol 1977; 33(4): 981-9.
16. Mosalanezhad L, Kheshti A, Gholami E. The assessing mental Health in pregnancy and relative psychopathologic factor in Jahrom. J Med Uni Pars 2007; 5(3-4): 23-9. [Persian]
17. Snaith RP, Hamilton M, Morley S, Humayan A, Hargreaves D, Trigwell PA. A scale for the assessment of hedonic tone the Snaith–Hamilton Pleasure Scale. Brit J Psychiat 1995; 2(167): 99-103.
18. Siadatian S, Ghamarani A. The Investigation of Validity and Reliability of Snaith–Hamilton Anhedonia Scale (Shaps) in the Students of Isfahan University. JRUMS. 2013; 12(10): 807-18. [Persian]
19. González-Fernández S, Fernández-Rodríguez C. Acceptance and Commitment Therapy in Cancer: Review of Applications and Findings; 2018.
20. Fashler SR, Weinrib AZ, Azam MA, Katz J. The Use of Acceptance and Commitment Therapy in Oncology Settings: A Narrative Review. Psychol Rep 2018; 121(2): 229-52.
21. Farokhzadian AA, Andalib L, Yousefvand M. The effectiveness of acceptance and commitment therapy on reducing depression in Cancer Patients. CPAP. 2019; 17(1): 45-52. [Persian]
22. Hajsadeghi Z, BassakNejad S, Razmjoo S. The Effectiveness of Acceptance and Commitment Group Therapy on Depression and Anxiety among women with breast Cancer. PSJ. 2017; 15(4): 42-9. [Persian]
23. Dehghani B, Neshatdoost HT, Abedi MR, Mokarian F. The Effect of Acceptance and Commitment Therapy on Depression and Psychological Flexibility in Women with Breast Cancer. Zahedan J Res Med Sci 2015; 7: 29-33.
24. Andrykowski MA, Lykins E, Floyd A. Psychological Health in Cancer Survivors. SemOncolNurs 2012; 24(3): 193-201.
25. Hayes S. Acceptance and commitment therapy: Cognitive delusion. Translated by Dusti P, Ahmadi F. Tehran: FaragirHegmataneh Press. 2016; [Persian]
26. Hughes LS, Clark J, Colclaugh JA, Dale E, McMillan D. Acceptance and Commitment Therapy (ACT) for Chronic Pain. Clin J Pain 2017; 33(6): 552