اثربخشی درمان مبتنی بر پذیرش و تعهد بر تصویر بدنی در زنان مبتلا به سرطان سینه پس از جراحی ماستکتومی

ﻣﻘﺪﻣﻪ: در ﺳﺎلﻫﺎی اﺧﯿﺮ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺎ ﺗﺄﮐﯿﺪ ﺑﺮ ﭘﺬﯾﺮش ﻣﺸﮑﻼت ﺑﻪ ﻋﻨﻮان ﺑﺨﺶ ﺟﺪاﯾﯽﻧﺎﭘﺬﯾﺮ زﻧﺪﮔﯽ اﻧﺴﺎن و اﻓﺰاﯾﺶ اﻧﻌﻄﺎفﭘﺬﯾﺮی روانﺷﻨﺎﺧﺘﯽ، ﮐﺎرﺑﺮد ﻓﺮاواﻧﯽ ﯾﺎﻓﺘﻪ اﺳﺖ. در اﯾﻦ راﺳﺘﺎ، ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺑﺮرﺳﯽ ﺗﺄﺛﯿﺮ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ ﺗﺼﻮﯾﺮ ﺑﺪﻧﯽ زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺳﯿﻨﻪ ﭘﺲ از ﺟﺮاﺣﯽ ﻣﺎﺳﺘﮑﺘﻮﻣﯽ اﻧﺠﺎم ﺷﺪ. روشﻫﺎ: ﭘﮋوﻫﺶ ﺣﺎﺿﺮ از ﻧﻮع ﻣﻄﺎﻟﻌﺎت ﻧﯿﻤﻪﺗﺠﺮﺑﯽ ﺑﺎ ﻃﺮح ﭘﯿﺶآزﻣﻮن و ﭘﺲآزﻣﻮن ﻫﻤﺮاه ﺑﺎ ﮔﺮوه آزﻣﺎﯾﺶ و ﮔﻮاه ﺑﻮد. ﻧﻤﻮﻧﻪ ﻣﻮرد ﻣﻄﺎﻟﻌﻪ 26 ﺑﯿﻤﺎر ﺑﻮدﻧﺪ ﮐﻪ ﺑﻪ ﺷﯿﻮه ﻧﻤﻮﻧﻪﮔﯿﺮی ﻫﺪﻓﻤﻨﺪ از «ﻣﺮﮐﺰ ﺧﯿﺮﯾﻪ آﻻ» ﺷﻬﺮ اﺻﻔﻬﺎن در ﺳﺎل 1395-96 اﻧﺘﺨﺎب ﺷﺪﻧﺪ و ﺑﻪ ﺻﻮرت ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه 13 ﻧﻔﺮی ﺟﺎی ﮔﺮﻓﺘﻨﺪ. ﮔﺮوه آزﻣﺎﯾﺶ، درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ را ﺑﻪ ﻣﺪت ﻫﺸﺖ ﺟﻠﺴﻪ ﯾﮏ ﺳﺎﻋﺘﻪ ﺑﻪ ﺻﻮرت ﻫﻔﺘﮕﯽ درﯾﺎﻓﺖ ﻧﻤﻮد. ﭘﺮﺳﺸﻨﺎﻣﻪ ﭼﻨﺪ ﺑﻌﺪی ﻧﮕﺮش ﻓﺮد در ﻣﻮرد ﺗﺼﻮﯾﺮ ﺑﺪﻧﯽ ﺧﻮد (1990) ﺗﻮﺳﻂ ﻫﺮ دو ﮔﺮوه آزﻣﺎﯾﺶ و ﮔﻮاه در ﻣﺮاﺣﻞ ﭘﯿﺶآزﻣﻮن و ﭘﺲآزﻣﻮن ﺗﮑﻤﯿﻞ ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮماﻓﺰار spss ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﻧﺸﺎن دادﻧﺪ ﮐﻪ ﺑﯿﻦ ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮات ﺗﺼﻮﯾﺮ ﺑﺪﻧﯽ و زﯾﺮﻣﻘﯿﺎسﻫﺎی آن در دو ﮔﺮوه آزﻣﺎﯾﺶ و ﮔﻮاه در ﻣﺮﺣﻠﻪ ﭘﺲآزﻣﻮن ﺗﻔﺎوت ﻣﻌﻨﺎداری وﺟﻮد دارد و درﻣﺎن ﺑﺮ ﺑﻬﺒﻮد ﺗﺼﻮﯾﺮ ﺑﺪﻧﯽ ﺑﯿﻤﺎران در ﮔﺮوه آزﻣﺎﯾﺶ ﺗﺄﺛﯿﺮ ﻣﻌﻨﺎداری داﺷﺘﻪ اﺳﺖ (p<0/05). ﻧﺘﯿﺠﻪﮔﯿﺮی: ﺑﻪ ﻧﻈﺮ ﻣﯽرﺳﺪ ﮐﻪ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﻣﯽﺗﻮاﻧﺪ در زﻣﯿﻨﻪ ﺑﻬﺒﻮد ﻣﺸﮑﻼت روانﺷﻨﺎﺧﺘﯽ زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺳﯿﻨﻪ ﭘﺲ از ﺟﺮاﺣﯽ ﻣﺎﺳﺘﮑﺘﻮﻣﯽ ﻣﻔﯿﺪ واﻗﻊ ﺷﻮد.

Effectiveness of Acceptance and Commitment Therapy on Body Image in Women with Breast Cancer after Mastectomy Surgery

Background: In recent years, Acceptance and Commitment Therapy (ACT) has been widely used, with an emphasis on accepting problems as an integral part of human life and increasing psychological flexibility. In this regard, the current study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on the body image of women with breast cancer after mastectomy surgery.Methods: This study was a quasiexperimental study with pretest and posttest design with the experimental and control groups. The study population consisted of 26 patients who were selected by purposeful sampling from Alla Charity Center in Isfahan in 2015 and were randomly assigned to two groups of 13 cases. The experimental group received ACT in 8 onehour weekly sessions. The Multidimensional Personality Attitude Questionnaire (1990) was completed by both experimental and control groups in the pretest and posttest stages. The obtained results were analyzed in SPSS software.Findings: The results of covariance analysis revealed that there was a significant difference between the mean scores of body image and its dimensions in the experimental and control groups. Moreover, it was found that ACT was effective in the improvement of body image in patients of the experimental group (P<0.05).Conclusion: As evidenced by the obtained results, the ACT can be of great help in the alleviation of psychological problems in women with breast cancer.