اثربخشی شناخت درمانی مبتنی بر ذهن‌آگاهی بر تحمل پریشانی، خودپنداره بدنی و بهشیاری در زنان متقاضی جراحی زیبائی

مقدمه: از آن جایی که جراحی‌ های زیبائی بیشتر برای تغییر ظاهر افراد و افزایش اعتماد به نفس آنها انجام می ‌شود، می ‌توان گفت در متقاضیان جراحی زیبائی، تحمل آشفتگی و بهشیاری پایین و خودپنداره بدنی منفی بالا است. هدف پژوهش حاضر بررسی اثربخشی شناخت درمانی مبتنی بر ذهن ‌آگاهی بر مولفه ‌های تحمل پریشانی، خودپنداره بدنی و بهشیاری در زنان متقاضی جراحی زیبائی بود. روش کار: پژوهش حاضر نیمه ‌آزمایشی با طرح پیش ‌آزمون، پس ‌آزمون با گروه کنترل بود. جامعه پژوهش را کلیه زنان متقاضی جراحی زیبائی که در شش ماه اول سال 1399 به درمانگاه زیبائی شکوفه شهر تهران مراجعه کردند، تشکیل دادند. از بین آنها 40 نفر (20 نفر در گروه) به روش نمونه‌گیری هدفمند، انتخاب شدند سپس به صورت کاملا تصادفی در دو گروه آزمایش و گروه گواه گمارده شدند. گروه آزمایش در هشت جلسه نود دقیقه‌ای، آموزش ذهن‌ آگاهی مبتنی بر شناخت درمانی را دریافت نمودند اما گروه کنترل آموزشی دریافت نکردند. برای جمع ‌آوری داده‌ها از پرسشنامه‌ های تحمل پریشانی، خودپنداره بدنی و بهشیاری استفاده شد. داده ‌ها با آزمون تحلیل کوواریانس در نرم ‌افزار آماری spss24 تحلیل شدند. یافته ‌ها: نتایج نشان داد پس از کنترل پیش ‌آزمون بین دو گروه آزمایش و کنترل در متغیر تحمل پریشانی؛ خودپنداره بدنی منفی و بهشیاری تفاوت معنادار وجود دارد. یعنی، میانگین نمرات تحمل پریشانی و بهشیاری گروه آزمایش نسبت به گروه کنترل به طور معناداری افزایش و میانگین نمرات خودپنداره بدنی منفی به طور معناداری کاهش یافته است. نتیجه‌ گیری: با توجه به تاثیر این مداخله در افزایش تحمل پریشانی و بهشیاری و کاهش خودپنداره بدنی منفی متقاضیان جراحی زیبائی می توان کارگاه ‌ها و دوره ‌های آموزشی مبتنی بر ذهن ‌آگاهی برای مشاوران مراکز و بیماران در نظر گرفته شود.

The effectiveness of mindfulness-based cognitive therapy on distress tolerance, body image, and mindfulness in women seeking cosmetic surgery

IntroductionToday, cosmetic surgery is one of the most common surgeries globally, and its use is increasing more than ever. The International Society of Cosmetic Surgery (ISAPS) announced that in 2013, more than 23 million surgical and nonsurgical methods were performed in the world. In addition, Iran is one of the 10top countries of cosmetic surgery in the world. Since cosmetic surgery is mainly done to change people ’s appearance and increase their selfconfidence, so it can be said that cosmetic surgery is the result of a specific psychological pattern. One of the possible psychological variables in cosmetic surgery applicants is negative body selfconcept (including thoughts, feelings, tendencies, and memories of the person in relation to the body). Given the ability to control and manage the low negative emotions of people seeking surgery, and the fact that people with low distress levels have difficulty regulating and controlling their emotions when exposed to stress, it may be possible to tolerate confusion (inability to embrace the experience fully). It is considered an annoying and upsetting emotion as one of the possible variables in people applying for cosmetic surgery. The concept of consciousness (a quality of consciousness that is more precisely paying attention to a particular way, that is, purposeful, present, and nonjudgmental to the inner and outer world of the mind) is probably related to the structure of the body image or concern for body image and subsequent tendency. Be involved in cosmetic surgery. On the other hand, one of the new therapeutic approaches that are significantly related to the variables of the present study is mindfulnessbased cognitive therapy. Therefore, the current research aimed to investigate the effectiveness of mindfulnessbased cognitive therapy on the components of distress tolerance, body selfconcept, and wellbeing in women seeking cosmetic surgery.MethodsThe research method was quasiexperimental with a pretestposttest design and control group. The study ’s statistical population consists of all women applying for cosmetic surgery who were referred to Shokoofeh Beauty Clinic in the first six months of 2020. Among them, 40 people (20 people for each of the experimental and control groups) were selected by the purposive sampling method and were then randomly divided into experimental and control groups. The inclusion criteria were an applicant for surgery, a high score in body selfconcept, a low score in consciousness, and distress tolerance. The exclusion criteria were comorbid psychiatric disorders, drug use, and absenteeism in more than three medical counseling sessions. The participants in the experimental group received mindfulnessbased cognitive therapy in eight ninetyminute sessions, and the participants in the control group did not receive training. Distress tolerance scale (Simons and Gaher, 2005), Littleton et al. rsquo;s Body image concern inventory (2005), and Brown and Ryan Mindful Attention Awareness Scale (2003) were used to collect data. After data collection, the collected data were analyzed by analysis of covariance in SPSS24 statistical software. ResultsThe mean and standard deviation of the age of subjects in the experimental and control groups, respectively, were 31.76 ±7.28, 32.44 ±8.16. In terms of education, in the experimental group, 12 people had diplomas, six people had bachelor ’s degrees, and two people had master ’s degrees. Ten people had diplomas in the control group, eight had bachelor ’s degrees, and two people had master ’s degrees. Before analyzing the data, the assumptions of multivariable parametric covariance analysis, KolmogorovSmirnov test was used to check the normality of the data. The results of KolmogorovSmirnov test showed that the variables of distress tolerance (Z=0.91; P=0.18), body selfconcept (Z=0.93; P=0.27), and mindfulness (Z=0.85; P=0.24), were not significant and; thus, the distribution of variables follows the normal one (P<0.05).Also, to test the assumption of homogeneity of variance matrix, covariance box test was used. The results of Box test showed (Box ’s M=4.76; P=0.512) the significance level is greater than 0.05. Therefore, the assumption of homogeneity of variance matrices is established. The results of the analysis of covariance in Table 3 showed a significant difference between the experimental and control groups in terms of distress tolerance, body selfconcept, and mindfulness. The mean scores of distress tolerance and mindfulness of the experimental group compared to the control group increased significantly, and the mean scores of body selfconcept of the experimental group compared to the control group decreased significantly.ConclusionAccording to the results of this study, it can be said that mindfulnessbased interventions are a systematic and intensive approach that aims to acquire new types of control and wisdom based on internal capabilities for relaxation, attention, awareness, and insight. Also, due to the effect of this training in increasing the tolerance of distress and consciousness and reducing the negative physical selfconcept of cosmetic surgery applicants, the results of research in this field can be used in practice in counseling centers and medical centers so that in these centers, workshops and training courses of mindfulnessbased interventions should be considered for counselors and patients. Like other studies, the present study has some limitations. For example, due to the lack of longterm access to the cosmetic surgery applicant, it was impossible to conduct a followup period to evaluate the continuity of effectiveness. Also, the sample was selected only from the cosmetic surgery applicant of Shokoofeh Clinic in Tehran, and this issue generalizes the results with caution. In line with the limitations of this study, it is suggested that in order to investigate the longterm effects of mindfulnessbased cognitive therapy, followup studies are performed, and for further generalizability, research is conducted on a larger sample size of cosmetic surgery applicants.Ethical considerationsAll subjects who received information about the study could leave the study at any time. They were assured that all information would remain confidential and would only be used for research purposes. For privacy reasons, the subjects ’ details were not recorded. In the end, all of them received informed consent.Table 1. Results of univariate analysis of covariance on posttest scores of distress tolerance, physical selfconcept, and mindfulnessVariablesSum of SquaresDfMean SquaresFPETADistress tolerance697.011697.0149.280.0010.68Physical selfconcept567.321567.3238.180.0010.51Mindfulness602.411602.4142.150.0010.58Ethical ConsiderationsCompliance with ethical guidelinesAll subjects received information about the study and could leave the study at any time. They were assured that all information would remain confidential and would only be used for research purposes. For privacy reasons, the subjects ’ details were not recorded. In the end, all of them received informed consent.Authors rsquo; contributionsAmin Roustaei and Babolah Bakhshi Pour: Defined the concepts in choosing the subject and designing the study. All authors performed a search of the research literature and background. Maryam Koushki and Omid Shokoh Far: Collected and analyzed data. Writing and drafting: Saeid YazdiRavandi and Amin Roustaei. All authors discussed the results and participated in the preparation and editing of the article ’s final version.Funding No financial support has been received from any organization for this research.Acknowledgments We would like to thank all the staff and clients of Shokoofeh Clinic who helped us in this research.Conflict of interestThis study did not have any conflict of interest.