اثربخشی آموزش رویکرد ارتقای بهبودی ذهن‌آگاه محور به شیوه گروهی بر واکنش‌پذیری شناختی نسبت به خلق غمگین و اضطراب مرتبط با درد در بیماران دارای درد مزمن

زﻣﯿﻨﻪ ﭘﮋوﻫﺶ ﺣﺎﺿﺮ، ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ اﺛﺮﺑﺨﺸﯽ آﻣﻮزش روﯾﮑﺮد ارﺗﻘﺎی ﺑﻬﺒﻮدی ذﻫﻦ آﮔﺎهﻣﺤﻮر ﺑﻪ ﺷﯿﻮه ﮔﺮوﻫﯽ ﺑﺮ ﮐﺎﻫﺶ واﮐﻨﺶﭘﺬﯾﺮی ﺷﻨﺎﺧﺘﯽ ﻧﺴﺒﺖ ﺑﻪ ﺧﻠﻖ ﻏﻤﮕﯿﻦ و اﺿﻄﺮاب ﻣﺮﺗﺒﻂ ﺑﺎ درد در ﺑﯿﻤﺎران ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ اﻧﺠﺎم ﮔﺮﻓﺖ.روش ﮐﺎر اﯾﻦ ﭘﮋوﻫﺶ ﺑﻪﺻﻮرت ﻧﯿﻤﻪآزﻣﺎﯾﺸﯽ ﺑﺎ ﭘﯿﺶآزﻣﻮن- ﭘﺲآزﻣﻮن ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل اﺟﺮا ﺷﺪ. ﺟﺎﻣﻌﻪ آﻣﺎری ﻣﻮرد ﻣﻄﺎﻟﻌﻪ، ﻫﻤﻪ ﺑﯿﻤﺎران ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﻣﺮاﮐﺰ درﻣﺎﻧﯽ (ﺑﯿﻤﺎرﺳﺘﺎنﻫﺎی دارای درﻣﺎﻧﮕﺎهﻫﺎی ﺗﺨﺼﺼﯽ ﻃﺐ ﻓﯿﺰﯾﮑﯽ و ارﺗﻮﭘﺪی) ﺷﻬﺮ اﻫﻮاز در ﺗﺎﺑﺴﺘﺎن 1397 ﺑﻮدﻧﺪ. 30 ﻓﺮد ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ از ﻃﺮﯾﻖ ﻓﺮاﺧﻮان و ﺑﻪ ﺷﯿﻮه داوﻃﻠﺒﺎﻧﻪ ﺑﺮ اﺳﺎس ﺗﺸﺨﯿﺺ ﭘﺰﺷﮏ ﻣﺘﺨﺼﺺ اﻧﺘﺨﺎب ﺷﺪﻧﺪ و ﺑﻪ دو ﮔﺮوه آزﻣﺎﯾﺶ (15ﻧﻔﺮ) و ﮐﻨﺘﺮل (15 ﻧﻔﺮ) ﺑﻪ ﺻﻮرت ﺗﺼﺎدﻓﯽ، ﮔﻤﺎرش ﺷﺪﻧﺪ. از ﻫﺮ دو ﮔﺮوه، ﭘﯿﺶآزﻣﻮن ﮔﺮﻓﺘﻪ ﺷﺪ. اﻋﻀﺎی ﮔﺮوه آزﻣﺎﯾﺶ ﺑﻪ ﻣﺪت 8 ﺟﻠﺴﻪ 120 دﻗﯿﻘﻪای ﺗﺤﺖ آﻣﻮزش ﮔﺮوﻫﯽ ﻣﺒﺘﻨﯽ ﺑﺮ روﯾﮑﺮد ارﺗﻘﺎی ﺑﻬﺒﻮدی ذﻫﻦ آﮔﺎهﻣﺤﻮر ﻗﺮار ﮔﺮﻓﺘﻨﺪ و اﻋﻀﺎی ﮔﺮوه ﮐﻨﺘﺮل، ﻫﯿﭻ ﻣﺪاﺧﻠﻪای درﯾﺎﻓﺖ ﻧﮑﺮدﻧﺪ. اﺑﺰارﻫﺎی ﭘﮋوﻫﺶ ﺷﺎﻣﻞ ﺷﺎﺧﺺ ﺗﺠﺪﯾﺪﻧﻈﺮ ﺷﺪه ﺣﺴﺎﺳﯿﺖ در ﺑﺮاﺑﺮ اﻓﺴﺮدﮔﯽ ﻟﯿﺪن- ﺗﺠﺪﯾﺪﻧﻈﺮ ﺷﺪه (leids_r) و ﻣﻘﯿﺎس ﻧﺸﺎﻧﮕﺎن اﺿﻄﺮاب ﻣﺮﺗﺒﻂ ﺑﺎ درد (pass) ﺑﻮد. ﺑﻪ ﻣﻨﻈﻮر ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ دادهﻫﺎ، از روشﻫﺎی آﻣﺎر ﺗﻮﺻﯿﻔﯽ و ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮه (ﺑﺎ ﻧﺮم اﻓﺰار 21 spss)اﺳﺘﻔﺎده ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ ﻧﺘﺎﯾﺞ ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮی ﺑﺎ ﺳﻄﺢ ﻣﻌﻨﺎداری (0/0001≥p) ﻧﺸﺎن داد ﮐﻪ ﺗﻔﺎوت ﻣﻌﻨﺎداری ﺑﯿﻦ دو ﮔﺮوه در ﻣﺮﺣﻠﻪ ﭘﺲآزﻣﻮن وﺟﻮد دارد ﮐﻪ ﻧﺸﺎندﻫﻨﺪه اﺛﺮﺑﺨﺸﯽ آﻣﻮزش ﮔﺮوﻫﯽ ﻣﺒﺘﻨﯽ ﺑﺮ ارﺗﻘﺎی ﺑﻬﺒﻮدی ذﻫﻦ آﮔﺎهﻣﺤﻮر ﺑﺮ واﮐﻨﺶﭘﺬﯾﺮی ﺷﻨﺎﺧﺘﯽ ﻧﺴﺒﺖ ﺑﻪ ﺧﻠﻖ ﻏﻤﮕﯿﻦ و اﺿﻄﺮاب ﻣﺮﺗﺒﻂ ﺑﺎ درد در ﺑﯿﻤﺎران ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ است ﻧﺘﯿﺠﻪﮔﯿﺮی از اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﯽﺗﻮان ﻧﺘﯿﺠﻪ ﮔﺮﻓﺖ ﮐﻪ آﻣﻮزش ﮔﺮوﻫﯽ ﻣﺒﺘﻨﯽ ﺑﺮ ارﺗﻘﺎی ﺑﻬﺒﻮدی ذﻫﻦ آﮔﺎهﻣﺤﻮر ﻣﯽﺗﻮاﻧﺪ روﯾﮑﺮدی ﻣﻨﺎﺳﺐ ﺑﺮای ﮐﺎﻫﺶ واﮐﻨﺶﭘﺬﯾﺮی ﺷﻨﺎﺧﺘﯽ ﻧﺴﺒﺖ ﺑﻪ ﺧﻠﻖ ﻏﻤﮕﯿﻦ و اﺿﻄﺮاب ﻣﺮﺗﺒﻂ ﺑﺎ درد در ﺑﯿﻤﺎران ﻣﺒﺘﻠﺎ ﺑﻪ درد ﻣﺰﻣﻦ ﺑﺎﺷﺪ.

The Effectiveness of Group Therapy based on Mindfulness Oriented Recovery Enhancement Approach on Cognitive Reactivity to Sad Mood and PainRelated Anxiety in chronic pain patients

AbstractBackground & Objectives:. This study aimed to determine the effectiveness of group therapy based on mindfulness oriented recovery enhancement approach on Cognitive Reactivity to Sad Mood and PainRelated Anxiety among Chronic Pain Patients.Materials & Methods: This study is quasiexperimental with control group. The statistical population included all the patients with chronic pain at Ahwaz who have been referred to Health Center (Hospitals with specialized clinics of physical medicine and orthopedics) in summer 2017. 30 chronic pain patients were selected through recall and in a voluntary method based on pain specialist diagnosis and randomly allocated into two experimental(n=15) and control (n=15) groups. Both groups were tested before. The experimental group for eight sessions of 120minute group therapy were based on mindfulness oriented recovery enhancement approach. Control group members did not receive any interventions. Data through questionnaires study were Index of Depression SensitivityRevised Version (LEIDSR) and Pain Anxiety Symptoms Scale (PASS). Research data to way multivariate analysis of variance were analyzed by SPSS 21 software.Results: The results of multivariate analysis of covariance with significance level (p > 0.0001) on the hypothesis show a significant difference between the two groups at posttest, that represents the effectiveness of mindfulness oriented recovery enhancement approach group therapy based on Cognitive Reactivity to Sad Mood and PainRelated Anxiety among Chronic Pain Patients.Conclusion: The conclusion of the study is based on group therapy, mindfulness oriented recovery enhancement approach is to reduce. Cognitive Reactivity to Sad Mood and PainRelated Anxiety among Chronic Pain Patients.