مقایسه اثربخشی آموزش کاهش استرس مبتنی بر ذهن آگاهی و آموزش متمرکز بر شفقت بر سبک های مقابله با استرس در بیماران مبتلا به بیماری عروق کرونر قلب

نوع مقاله : مقاله پژوهشی

نویسندگان

1 Ph.D. student in counseling, Mashhad Branch, Islamic Azad University, Mashhad, Iran.

2 Department of Education Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran.

3 Department of Education Sciences, Qouchan Branch, Islamic Azad University, Qouchan, Iran.

4 Department of Mathematics and Statistics, Mashhad Branch, Islamic Azad University, Mashhad, Iran.

چکیده

مقدمه: این پژوهش با هدف مقایسه اثربخشی آموزش کاهش استرس مبتنی بر ذهن آگاهی (MBSR) و آموزش متمرکز بر شفقت (CFT) بر سبک های مقابله با استرس در بیماران مبتلا به بیماری عروق کرونر انجام شد.
روش  کار: جامعه آماری این مطالعه بالینی را کلیه بیماران مبتلا به بیماری عروق کرونر قلب مراجعه کننده به کلینیک قلب و عروق سامان مشهد در تیر تا مرداد 1400 تشکیل می دادند که 45 بیمار به روش داوطلبانه انتخاب شدند. آنها به طور تصادفی در دو گروه آزمایش و یک گروه کنترل قرار گرفتند. گروه‌های آزمایشی MBSR را بر اساس طرح آموزشی Kabat-Zinn (2005) یا CFT بر اساس طرح آموزشی گیلبرت (2009) در 8 جلسه دریافت کردند. شرکت کنندگان پرسشنامه سبک های مقابله با استرس لازاروس و فولکمن (1988) را تکمیل کردند. داده ها با استفاده از آزمون تحلیل واریانس مختلط با اندازه گیری های مکرر و نرم افزار SPSS-23 مورد تجزیه و تحلیل قرار گرفت.
یافته ها: نتایج نشان داد که آموزش مبتنی بر شفقت باعث افزایش سبک مقابله مستقیم و خویشتن داری و کاهش سبک مقابله ای اجتنابی و سبک مقابله ای گریز-اجتنابی می شود. MBSR سبک مقابله با مسئولیت، حل مسئله برنامه ریزی شده، ارزیابی مجدد مثبت و سبک مقابله فرار-اجتناب را به طور قابل توجهی کاهش می دهد (P<01/0). همچنین اثربخشی MBSR بر مسئولیت پذیری به طور معنی داری بیشتر از CFT بود (05/0 P<).
نتیجه‌گیری: به نظر می‌رسد که آموزش کاهش استرس مبتنی بر ذهن‌آگاهی و آموزش متمرکز بر شفقت می‌تواند وضعیت روانی بیماران مبتلا به بیماری عروق کرونر را بهبود بخشد.

کلیدواژه‌ها


  1.  

    1. Dahale ABC, Menon JT. A narrative review of the relationship between coronary heart disease and anxiety. Iran J Psychiatry Behav Sci 2017; 11(3): e7722.
    2. Joseph P, Raman Kutty V, Mohan V, Kumar R, Mony P, Vijayakumar K, et al. Cardiovascular disease, mortality, and their associates with modifiable risk factors in a multi-national South Asia cohort: a PURE substudy. Eur Heart J 2022; 43(30): 2831-40.
    3. Svensson T, Inoue M, Sawada N, Charvat H, Iwasaki M, Sasazuki S, et al. for the JPHC Study Group. Coping strategies and cancer incidence and mortality: The Japan Public Health Center-based prospective study. Cancer Epidemiol 2016; 40(3): 126-33.
    4. Wang H, Xia Q, Xiong Z, Li Z, Xiang W, Yuan Y, et al.The psychological distress and coping styles in the early stages of the 2019 coronavirus disease (COVID-19) epidemic in the general mainland Chinese population: A web-based survey. PLoS One 2020; 15(5): e0233410.
    5. Masiran R, Ismail S, Ibrahim Na, Tan KA, Andrew B, Seng Choi C, et al. Associations between coping styles and psychological stress among medical students at Universiti Putra Malaysia. Curr Psychol 2018; 40(3): 101-12.
    6. Apriliyani I, Maryoto M. The relationship between coping mechanisms and stress levels in thesis writing among undergraduate nursing students. Advances in health sciences research 2020; 20(9): 64-67.
    7. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.
    8. Leszko M, Iwański R, Jarzębińska A. The relationship between personality traits and coping styles among first-time and recurrent prisoners in Poland. Front Psychol 2020; 10(2): 29-69.
    9. Williams RB, Barefoot JC, Schneiderman N. Psychosocial risk factors for cardiovascular disease: More than one culprit at work. JAMA 2003; 290(16): 2190-92.
    10. Kriakous SA, Elliott KA, Lamers C, Owen R. The effectiveness of mindfulness-based stress reduction on the psychological functioning of healthcare professionals: A systematic review. Mindfulness 2021; 13(12): 1-28.
    11. Cladder-Micus MB, Speckens A, Vrijsen JN, Donders AR, Becker ES, Spijker J. Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial. Depress Anxiety 2018; 35(10): 914-24.
    12. Svendsen JL, Osnes B, Binder PE, Dundas I, Visted E, Nordby H, et al. Trait self-compassion reflects emotional flexibility through an association with high vagally mediated heart rate variability. Mindfulness 2016; 7(5): 1103-13.
    13. Butz S, Stahlberg D. The relationship between self-compassion and sleep quality: An overview of a seven-year German Research Program. Behav Sci 2020; 10(3): 64.
    14. Finlay-Jones A, Boyes M, Perry Y, Sirois F, Lee R, Rees C. Online self-compassion training to improve the wellbeing of youth with chronic medical conditions: protocol for a randomized control trial. BMC Public Health 2020; 6(20): 106.
    15. Chavanon ML, Meyer T, Belnap BH, Huang Y, Abebe KZ, Rollman BL, et al. Emotion regulation in patients with heart failure: Its relationship with depressive symptoms and rehospitalization. J Psychosom Res 2019; 2: 10-98.
    16. Appleton AA, Kubzansky, LD. Emotion regulation and cardiovascular disease risk. In: Gross JJ. (editor). Handbook of emotion regulation. New Jersey: Guilford; 2014: 596-612.
    17. Delavar A. [The research method in psychology and educational sciences]. Tehran: Virayesh; 2020. (Persian)
    18. Vaghee S, Mirazaei AA, Modarres Gharavi M, Ebrahimzadeh S. [The effect of relationship skills on coping styles of nursing students in stressful situations]. The quarterly journal of Faculty of Nursing and Midwifery of Mashhad 2011; 1(1): 91-102. (Persian)
    19. Brooki Milan H, Kamarzarrin H, Zare H. [The effectiveness of cognitive-behavioral therapy on improvement of coping styles and addiction symptoms in substance dependent patients]. The scientific quarterly journal of research in addiction 2014; 8: 143-55. (Persian)
    20. Toosi F, Alipoor A, Hashemi T, Babapour Kheiraddin J. [The relationship between coping styles and happiness in university students]. The scientific quarterly journal of Tabriz University 2010; 18(4): 71-86. (Persian)
    21. Kabat-Zinn J. Coming to our senses: Healing ourselves and the world through mindfulness. NewYork: Hyperion; 2005: 52.
    22. Gilbert P. Introducing compassion focused therapy. Adv Psychiatr Treat 2009; 15(4): 199-208.

          23. Izanloo M, Peyvandi P, Borjali A, Sirafi MR, Mohsenzadeh Y. Comparison of the effectiveness of         compassion-focused therapy and mindfulness-based stress reduction on cognitive emotion regulation among patients with coronary heart disease. Journal of vessels and circulation 2020; 1(3): 31-39.

    1. Karimi M, Emadi SZ, Mohsenzadeh Y, Izanloo M. Comparison the effectiveness of compassionate treatment and mindfulness stress reduction treatment in reducing symptoms-type D Personality in patients with heart coronary arteries. Journal of vessels and circulation 2021; 2(4): 161-69.
    2. Shokoohi Nejad N, Bayat MR, Zanganeh Motlagh F. Comparing the effectiveness of cognitive therapy based on mindfulness and compassion therapy on automatic negative thoughts, psychological symptoms, pain intensity, and quality of life in patients with fibromyalgia. Journal of Arak University of Medical Sciences 2021; 25(1): 156-73.
    3. Ghahremani Ochghaz M, Mohammadkhani P, Hatami M, Mohammadrezaei R. [Comparing compassion-based therapy and mindfulness-based cognitive therapy to reduce fear of compassion and self-criticism in people with heart failure]. Contemporary psychology 2020; 15(1): 123-37. (Persian)
    4. Amirkhani M, Ghorban Shiroodi S, Zarbakhsh Bahri MR, Seyyed Ali Naghi SA. [Comparative effectiveness of compassion-based therapy and mindfulness-based stress reduction on psychological flexibility of HIV patients of Imam Khomeini hospital]. Management strategies in health system 2021; 6(2): 103-16. (Persian)
    5. Haji Aliani V, Bahrami Ehsan H, Noferesti A. [The effect of cognitive therapy based on mindfulness on coping styles, depression and suicidal thoughts in university students]. Journal of psychological sciences 2020; 19: 1557-68. (Persian)
    6. Yahyai Gh, Moshkbid Haghighi M, Jamshasb M. [The efficacy of mindfulness-based group training on aggression and stress coping styles in students]. Proceeding of the Sixth International Conference of School, Tehran, Iran, 2020. (Persian)
    7. Babak A, Motamedi N, Mousavi SZ, Ghasemi Darestani N. Effects of mindfulness-based stress reduction on blood pressure, mental health, and quality of life in hypertensive adult women: A randomized clinical trial study. J Tehran Heart Cent 2022; 17(3): 127-33.
    8. Thai Bui TH, Trang Nguyen TN, Dung Pham H, Thanh Tran C, Hien Ha T. The mediating role of self-compassion between proactive coping and perceived stress among students. Sci Prog 2021; 104(2): 1-14.
    9. Dev V, Fernando NT, Consedine NS. Self-compassion as a stress moderator: A cross-sectional study of 1700 doctors, nurses, and medical students. Mindfulness 2020; 11: 1170-81.
    10. Germer CK, Neff KD. Self‐compassion in clinical practice. J Clin Psychol 2013; 69(8): 856-67.