بررسی اثربخشی درمان مبتنی بر مرگ اندیشی بر کیفیت زندگی، امید به زندگی و افسردگی در زندانیان

هدف: پژوهش حاضر با هدف بررسی اثربخشی درمان مبتنی بر مرگ اندیشی بر کیفیت زندگی، امید به زندگی و افسردگی در زندانیان است.روش: روش پژوهش شبه-آزمایشی است که درآن از طرح پیش‎آزمون-پس‎آزمون با گروه کنترل استفاده شده است. جامعه آماری مورد مطالعه دراین پژوهش، مردان زندانی در واحد3 مشاوره زندان مرکزی شهر مشهد (825 نفر) بود. از میان آن‎ها 24 نفر که ملاک‎های ورود را دارا بودند، به صورت در دسترس به عنوان نمونه پژوهش انتخاب و به صورت تصادفی (12 نفر در گروه آزمایش و 12 نفر در گروه کنترل) گمارده شدند و در پایان مداخله، داده‎های 24 نفر مورد تجزیه و تحلیل قرار گرفت.جهت جمع آوری داده ها از پرسشنامه کیفیت زندگی (فرم کوتاه سازمان بهداشت جهانی ، 1998)، پرسشنامه افسردگی بک (1996) و مقیاس امید به زندگی اشنایدر (1991) به عنوان ابزار پژوهش استفاده گردید. هر دو گروه آزمایش و کنترل پرسشنامه های مذکور را به عنوان پیش آزمون تکمیل و سپس گروه آزمایش به مدت 15 جلسه تحت درمان الگوی مداخله‎ای ارائه شده قرار گرفت اما گروه کنترل درطول دوره پژوهش، الگوی مداخله ای را دریافت نکرد. سپس هر دو گروه پرسش نامه های پژوهش را به عنوان پس آزمون تکمیل و در نهایت، داده‎های پژوهش با استفاده از تحلیل کوواریانس تک متغیره و تحلیل واریانس چند متغیره و با استفاده از نرم افزار spss-21مورد تجزیه و تحلیل قرار گرفت. یافته‎ها: نشان داد که مرگ‎اندیشی منجر به بهبود کیفیت زندگی، افزایش امید به زندگی و کاهش میزان افسردگی در زندانیان می شود.

the effectiveness of death-thinking-based psychotherapy on prisoners’ quality of life, life expectancy, and depression

introduction: death-mindedness is defined as concerning about death. therefore, death-thinking individuals are aware of their own inevitable death and concerned about facing it. it can be said that death thinking is the way people deal with death and the way they understand it; both are related to the quality of life. according to terror management theory, when thoughts of death are consciously focused on, the person's lifestyle becomes more involved in meaning, personal values, and authentic relationships, and as a result, the quality of life increases. on the other hand, when thoughts of death are on the sidelines of individuals' mental life, they are more likely to be involved in dysfunctional relationships and psychological disorders. furthermore, thinking about death in the form of suicidal thoughts in depressed people means accepting the lack of control over death. in cases when people face with death in a dynamic and constructive way, their depression, anxiety, and hopelessness decrease and their life expectancy and life quality increase. moreover, hopelessness and depression can be considered as the reactions to the issue of death. due to the high psychological pressure felt as a result of anticipating imminent death, some prisoners show destructive and harmful behaviors such as using drugs and strong painkillers. as the consequences, depression, aggression, self-harm, and other behaviors that are harmful to them and also to other prisoners will also increase over time. considering the role of constructive death thinking on the quality of life, conducting a study on the effectiveness of death-mindedness-based intervention is important. death-thinking psychotherapy is assumed to be an intervention that may increase the prisoners' quality of life by facing them with a real, personal and realistic encounter with the phenomenon of death. the aim of this study was to explore the effectiveness of death-thinking treatment on the quality of life, life expectancy, and level of depression among prisoners.method: this research employed a quasi-experimental design with a control group using pre-test and post-test assessment. the statistical population consisted of all male prisoners (n = 825) residing at the counseling center no. 3 of the central prison of mashhad. out of these population, 24 prisoners who met the inclusion criteria were selected and randomly assigned in two groups: experimental and control group (12 participants in each group). all participants completed then the questionnaires in the pre-test stage including the world health organization quality of life brief version (whoqol-bref; 1998), schneider’s (1991) life expectancy questionnaire, and beck’s depression inventory (1996). the members of the experimental group received 15 sessions of the death thinking-based psychotherapy while the members of the control group did not receive any intervention. after the intervention period, the participants of both groups were asked again to complete the study questionnaires for the post-test stage. finally, the collected data were analyzed using analysis of covariance (ancova) and multivariate analysis of variance (mancova) in spss-21.results: the ancova analysis showed a significant difference between the quality of life of the members of the experimental and control groups. therefore, it can be concluded that the intervention based on death-thinking significantly improved the quality of life of prisoners of experimental group compared to the quality of life of the members of the control group (p<0.05). moreover, the results of the between-subject effects test for the comparison of the groups regarding life expectancy variable showed that the f value observed for these variables is significant, as it showed a significant difference between experimental and control groups in terms of life expectancy. accordingly, the intervention based on death-thinking improved prisoners’ life expectancy (p<0.05). moreover, the mancova analysis showed that there is a significant difference between the experimental group and control group regarding the level of depression. the intervention based on death-thinking significantly reduced the level of depression among prisoners of the experimental group (p>0.05).discussion and conclusion: this study was done to explore the effectiveness of the treatment based on death-thinking on the quality of life, life expectancy, and depression among prisoners. the results showed that the treatment based on death-thinking (independent variable) significantly improved the quality of life and life expectancy, and the level of depression (dependent variables). the evidence confirms the practical validity of the treatment based on death-thinking. on the other hand, the effectiveness of death-thinking on the improvement of the quality of life, life expectancy, and reducing the level of depression among prisoners was considerable. the clinical observations showed that these impacts were palpable in issues such as motivation and goal. the observations also showed that the prisoners who received the treatment based on death-thinking changed their internal and external goals. this finding is in line with the findings of jamil and gharibi (2018). many people can use the findings of this study, including those who seek better life quality, and the psychologists whose clients are in situations with imminent death such as those sentenced to death or awaiting imminent death in prisons, or patients with incurable diseases such as cancer and aids, etc.