اثربخشی گروه‌درمانی شناختی رفتاری بر اضطراب و عزت نفس بیماران مبتلا به مولتیپل اسکلروزیس

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس ارشد روان‌شناسی بالینی، مرکز مشاوره تخصصی رهیاب، مشهد، ایران

2 دکترای روان‌شناسی بالینی، دانشیار دانشگاه حکیم سبزواری، سبزوار، ایران

چکیده

مقدمه: پژوهش حاضر به منظور بررسی اثربخشی گروه­­درمانی شناختی رفتاری بر اضطراب و عزت نفس بیماران مبتلا به مولتیپل اسکلروزیس (MS) انجام شد.
روش­کار: در این کارآزمایی بالینی با طرح پیش­آزمون-پس­آزمون با گروه شاهد، 20 بیمار مبتلا به مولتیپل اسکلروزیس با نمونه­گیری در دسترس از انجمن بیماران مبتلا به مولتیپل اسکلروزیس شهر مشهد در سال 1395 انتخاب و به طور تصادفی به دو گروه 10 نفری آزمون و شاهد تقسیم شدند. گروه آزمون در 10 جلسه هفتگی 2 ساعته تحت گروه­درمانی شناختی رفتاری قرار گرفتند و گروه شاهد این درمان را دریافت نکردند. در پیش­آزمون و پس­آزمون پرسش­نامه­های اضطراب بک (BAI) و عزت نفس کوپراسمیت (CSEI) بر دو گروه اجرا شد. تحلیل داده­ها با روش تحلیل کواریانس و آزمون تی صورت گرفت.
یافته­ها: گروه­درمانی شناختی رفتاری به طور معنی­داری منجر به کاهش اضطراب (001/0>P) و افزایش عزت نفس کلی (001/0>P)، عزت نفس عمومی (002/0=P)، عزت نفس خانوادگی (005/0=P) و عزت نفس شغلی- تحصیلی (003/0=P) گروه آزمون در مقایسه با گروه شاهد می­شود ولی تفاوت معنی­داری در نمرات عزت نفس اجتماعی (388/0=P) بین دو گروه مشاهده نشد.
نتیجه­گیری: گروه­درمانی شناختی رفتاری منجر به کاهش اضطراب و افزایش عزت نفس بیماران مبتلا به مولتیپل اسکلروزیس می­شود. 

کلیدواژه‌ها

موضوعات


  1. World Health Organization. Preventing chronic diseases: A vital investment. (2005). [cited 8 Jan 2009]. Available from: http://www.who.int/chp/chronic_disease_report/full_report.pdf
  2. Miller J. Multiple sclerosis. In: Ronald P. (editor). Merritt's text book of neurology. 10th Philadelphia: Lippincott and Wilkins; 2000.
  3. Coleman CI, Sidovar MF, Roberts MS, Kohn C. Impact of mobility impairment on indirect costs and health-related quality of life in multiple sclerosis. Plos One 2013; 8(1): 1-8.
  4. Bethoux F, Bennett S. Evaluating walking in patients with multiple sclerosis. Int J MS Care 2011; 13(1): 4-14.
  5. Harizchi Ghadim S, Ranjbar kuchsaryi F, Talebi M, Zakaria M. [Effects of ''written emotional expression" on anxiety and depression in patients with multiple sclerosis]. Iranian journal of neurology 2013; 8: 465-75. )Persian)
  6. Randolph JJ, Arnett PA. Depression and fatigue in relapsing/remitting MS: the role of symptomatic variability. Mult Scler 2005; 11(2): 186-90.
  7. Ziemssen T. Multiple sclerosis beyond EDSS: depression and fatigue. J Neural Sci 2009; 277(1): 27-41.
  8. Janssens A, Doorn PA, Boer JB, Meche FGA, Passchier J, Hintzen RQ. Impact of recently diagnosed multiple sclerosis on quality of  life, anxiety, depression and distress of  patients  and  Acta Neurological Scandinavica 2003; 108(6): 389-95.
  9. Irvine H, Davidson C, Hoy K, Lowe-Strong A. Psychosocial adjustment to multiple sclerosis: exploration of identity redefinition. Disabil Rehabil 2009; 31(8): 599-606.
  10. Wood B, Van Der Mei IA, Ponsonby AL, Pittas F, Quinn S, Dwyer T, et al. Prevalence  and concurrence of anxiety, depression and fatigue over time in multiple sclerosis. Mult Scler 2013; 19(2): 217-24.
  11. Buljevac D, Hop WCJ, Reedeker W, Jassen ACJW, Vander Menche  FGA, Vandooren  PA,  et al. Self-reported stress full life events exacerbations in multiple sclerosis prospective study. Br Med J 2003; 327: 646.
  12. Keppel CC, Crowe SF. Changes to body image and self-esteem following stroke in young adults. Neuropsychol Rehabil 2000; 10(1): 15-31.
  13. Miyahara M, Piek J. Self-esteem of children and adolescents with physical disabilities: quantitative evidence from meta-analysis. J Dev Phys Disabil 2006; 18(3): 219-34.
  14. Cooper-Evans S, Alderman N, Knight C, Oddy M. Self-esteem as a predictor of psychological distress after severe acquired brain injury: an exploratory study. Neuropsychol Rehabil. 2008; 18(5-6): 607-26.
  15. Avanci JQ, AS SN, Oliveira RVC. Transcultural adaptation of self-esteem scale for adolescents. Psycol Reflex Crit 2007; 20(3): 397-405.
  16. Donnellan MB, Trzesniewski KH, Robins RW. Self-esteem. Enduring Issues and Controversies. Oxford, UK: Wiley-Blackwell; 2011.
  17. Mendes MF, Tilbery CP, Balsimelli S, Moreira MA, Barao-Cruz AM. [Depression in relapsing remitting multiple sclerosis]. Arq Neuropsiquiatr 2003; 61(3): 591-5. (Portugese)
  18. Wojtynaa E, Zycinska J, Stawiarska P. The influence of cognitive-behavior therapy on quality of life and self-esteem in women suffering from breast cancer. Rep Pract Oncol Radiother 2007; 12(2): 109-17.
  19. Gomes NS, Silva SR. Evaluation of the self-esteem of women who had undergone breast cancer surgery. Text context nursing, Florianópolis 2013; 22(2): 509-16.
  20. De Sá Novato T, Alves Grossi S.A, Kimura M. Quality of life and self-esteem of adolescents with diabetes mellitus. Acta Paul Enferm 2008; 21(4): 562-7.
  21. Kalpakjian CZ, Tate DG, Kisala PA, Tulsky DS. Measuring self-esteem after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Self-esteem item bank and short form. J Spin Cord Med 2016; 38(3): 377-85.
  22. Vickery CD, Evans CC, Lee JE, Sepehri A, Jabeen LN. Multilevel modeling of self-esteem change during acute inpatient stroke rehabilitation. Rehabil Psychol 2009; 54(4): 372-80.
  23. Fraser C. The relationship between self-efficacy, self-esteem, hope, and disability in individuals with multiple sclerosis. Sigma Theta Tau Int 2005; 12(3): 150-7.
  24. Juth V, Smyth JM, Santuzzi AM. How do you feel? Self-esteem predicts affect, stress, social interaction, and symptom severity during daily life in patients with chronic illness. J Health Psychol 2008; 13(7): 884-94.
  25. Garfield AC, Lincoln NB. Factors affecting anxiety in multiple sclerosis. Disabil Rehabil 2012; 34(24): 2047-52.
  26. Free ML. Cognitive therapy in groups: Guidelines and resources for practice. 1st John Wiley and Sons; 1999.
  27. Hays PA, Iwamassa GY. Culturally responsive cognitive-behavioral therapy: Assessment, practice, and supervision. Washington, DC: American Psychological Association; 2006.
  28. Leahy R, Holland S, Mcginne L. Treatment plans and interventions for depression and anxiety disorders. London: Guilford; 2012.
  29. Hoseyni S. [The effect of group cognitive therapy in reducing depression and increasing mental health of patients with multiple sclerosis]. MS. Dissertation. Tehran: Alzahra University; 2005. (Persian)
  30. Famil Sharifian Y, Khalili M, Hasanzadeh Pashang S, Kamarzarin H, Taghizadeh ME. [The study of effectiveness of cognitive behavioral group on mental health among primary MS patients]. The Journal of Urmia University of Medical Sciences 2013; 24(9): 652-64. (Persian)
  31. Khezri-Moghadam N, Ghorbani N, Bahrami-Ehsan H, Rostami R. [Efficacy of group therapy on reduction of psychological signs of  multiple sclerosis patients]. Journal of clinical psychology 2012; 4(13): 13-22. (Persian)
  32. Zende Talab HR, Norouzi HM. Effects of educational interventions on self-esteem of multiple sclerosis patients. Quarterly of the horizon of medical sciences 2014; 20(2): 121-6.
  33. Bishop M, Stenhoff DM, Shepard L. Psychosocial adaptation and quality of life in multiple sclerosis: Assessment of the disability centrality model. J Rehabil 2007; 73(1): 3-12.
  34. Bieling PJ, McCabe RE, Antony MM. Cognitive- behavioral therapy in groups. London: Guilford; 2006
  35. Beck AT, Steer RA. Beck Anxiety Inventory Manual. San Anto: Psychological Corporation; 1990.
  36. Osman A, Hoffman J, Barrios FX, Kopper BA, Breitenstein JL, Hahn SK. Factor structure, reliability, and validity of the  Beck Anxiety Inventory in adolescent psychiatric inpatients. J Clin Psychol 2002;  58: 443-56.
  37. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1998; 56: 893-7.
  38. Kaviani H, Mousavi AS. [Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI)]. Tehran University Medical Journal 2008; 65(2): 136-40. (Persian)[
  39. Rafiei M, Seifi A. [An investigation into the reliability and validity of Beck Anxiety Inventory among the university students]. Thought and behavior in clinical psychology 2013; 7: 43-50. (Persian)
  40. Besharat M, Farhadi M, Mirzakmsfidy R. The reliability and validity of homesickness. Journal of science and technology. 2005; 4(3): 38-45.
  41. Cooper S. Manual of Self-Esteem Inventories. Alto., California: Counseling Psychologists Press; 1989.
  42. Ahmed SM, Valliant PM, Swindle D. Psychometric properties of coppersmith self-esteem inventory. Percept Mot Skills 1985; 61(3): 1235-41.
  43. Brinkman H, Segure MT, Solar RM. Adaptation, standardization and development of norms for coppersmith’s self-esteem inventory. Revisit Chilean Psychol 1989; 10(1): 63-71.
  44. Coopersmith S. The antecedents of self-esteem. Palo Alto, CA: Consulting Psychologists Press Inc; 1967.
  45. Shahni Yelagh M, Michaeli N, Shokrkan H, Haghighe J. [The prevalence of child abuse and prediction of parents through public health, adjustment, self-esteem and academic performance, demographic variables abused and non-abused girls students in Ahwaz]. Journal of education and psychology of Shahid Chamran University of Ahwaz 2007; 3(1-2): 167-94. (Persian)
  46. Ghobaribanab B, Hejaze M. [The relationship between assertiveness and self-esteem in gifted and normal students]. Research on exceptional children 2007; 7(3): 299-316. (Persian)
  47. Keikhay Farzaneh AR, Khakpour H, Keikhay Farzaneh MM, Khalatbari J. [Effect of cognitive-behavioral group therapy on addict's self-confidence and their attitude toward drugs]. Quarterly of the horizon of medical sciences 2013; 18(4): 185-9. (Persian)
  48. Pahlavanzadeh P, Abbasi S, Alimohammadi N. [The effect of group cognitive behavioral therapy on stress, anxiety, and depression of women with multiple sclerosis]. Iranian journal of nursing and midwifery research 2017; 22(4): 271-5. (Persian)
  49. Hozhir F, Ahadi H, Poorshahbaz A, Rezaee M. [Effectiveness of cognitive behavior therapy on change cognitive representations of illness and promotion of emotional states in patients with multiple sclerosis]. Journal of Kermanshah University of Medical Sciences 2010; 15(6):415-26. (Persian)
  50. Mokhtari S, Neshatdoost HT, Molavi H. [The study the effectiveness of cognitive-behavioral therapy in group on depression and somatic complaint among multiple sclerosis patients]. Journal of psychology and educational sciences of Isfahan University 2008; 47: 242-51. (Persian)
  51. Sinclair VG, Scroggie J. Effects of a cognitive behavioral program for women with multiple sclerosis. J Neurosci Nurs 2005; 37(5): 249-76.
  52. Omrani S, Mirzaeian B, Aghabagheri H, Hassanzadeh R, Abedini M. [Effectuality of cognitive-behavioral therapy on the life expectancy of patients with multiple sclerosis]. Journal of Mazandaran University of Medical Sciences 2012; 22: 58-65. (Persian)
  53. Moss-Morris R, Dennison L, Landau S, Yardley L, Silber E, Chalder T. A randomize controlled trial of cognitive behavioral therapy (CBT) for adjusting to multiple sclerosis (the MS trial): Does CBT work and for whom does it work? J Consult Clin Psychol 2013; 81(2): 251-62.
  54. Van Kessel K, Willoughby E, Johnson MH. A randomized controlled trial of cognitive behavior therapy for multiple sclerosis fatigue. Psychosom Med 2008; 70: 205-13.
  55. Landoni MG, Giordano MT, Guidetti GP. Group psychotherapy experiences for people with multiple sclerosis. J Neurol Virol 2000; 6: 168-71.
  56. Kiany J, Pakizeh A, Ostovar A, Namazi C. [Effectiveness of cognitive behavioral group therapy (C.B.G.T) in increasing the self-esteem and decreasing the hopelessness of β-thalassemia adolescent]. Iranian south medical journal 2010; 13(4): 241-52. (Persian)[
  57. Sharifi Neyestanak ND, Ghodoosi Boroojeni M, Seyedfatemi N, Heydari M, Hoseini AF. [Self-esteem and its associated factors in patients with multiple sclerosis]. Iranian journal of nursing 2012; 25: 14-22. (Persian)