اثربخشی رفتاردرمانی دیالکتیک بر تنظیم هیجان و اضطراب سلامت بیماران مبتلا به آسم

باتوجه‌به شیوع هم‌زمان اختلالات روانی در بیماران مبتلا به آسم، درمان‌های روان‌شناختی می‌تواند سهم بسزایی در بهبود علائم روان‌شناختی این افراد داشته باشد؛ بنابراین، هدف پژوهش، بررسی اثربخشی رفتاردرمانی دیالکتیک بر تنظیم هیجان و اضطراب سلامت بیماران مبتلا به آسم شهر اصفهان بود. طرح پژوهش شبه‌آزمایشی با گروه آزمایش و کنترل بود و جامعۀ آماری شامل کلیۀ بیماران مراجعه‌کننده به بیمارستان خورشید با تشخیص بیماری آسم بودند. در این جامعه، 22 بیمار مبتلا به آسم با روش نمونه‌گیری دردَسترس انتخاب و به‌صورت تصادفی در دو گروه آزمایش و کنترل گمارده شدند. روش مداخلۀ رفتاردرمانی دیالکتیک برای گروه آزمایش در طی هشت جلسۀ درمانی انجام شد و گروه کنترل و آزمایش در مراحل پیش‌آزمون و پس‌آزمون با استفاده از پرسشنامۀ تنظیم هیجان و اضطراب سلامت ارزیابی شدند. داده‌های پژوهش با استفاده از روش تحلیل کوواریانس تحلیل شد. مطابق نتایج پژوهش در متغیر تنظیم هیجان در زیرمقیاس ارزیابی مجدد بین دو گروه آزمایش و کنترل تفاوت معنادار وجود داشت؛ اما در زیرمقیاس سرکوبی، تفاوت معناداری وجود نداشت. در متغیر اضطراب سلامت نیز تفاوت معناداری بین دو گروه آزمایش و کنترل وجود داشت. براساس یافته‌های پژوهش، می‌توان گفت که رفتاردرمانی دیالکتیک می‌تواند به بهبود تنظیم هیجان و اضطراب سلامت در بیماران مبتلا به آسم منجر شود؛ بنابراین، این مداخله به‌عنوان درمانی موثر در بهبود این نشانه‌ها کاربرد دارد و می‌توان با اجرای آن به بهبود وضعیت روانی مبتلایان به آسم کمک کرد.

effectiveness of dialectical behavior therapy on emotion regulation and health anxiety in asthma patients

the aim of this study was to investigate effectiveness of dialectical behavior therapy on emotion regulation and health anxiety in patients with asthma in isfahan. research design was quasi-experimental with experimental and control groups and statistical population included all patients who referred to khorshid hospital. in this community, 22 patients with asthma were selected by convenient sampling. they were randomly assigned into the experimental and the control groups. the intervention method of dialectical behavior therapy was performed for experimental group during eight treatment sessions. both groups were evaluated in pre-test and post-test phases using the emotion regulation and the health anxiety questionnaire. the data was analyzed using covariance analysis method. the results showed that there was a significant difference in emotion regulation variables in reappraisal subscale between experimental and control groups, but there was no significant difference in the suppression subscale. regarding health anxiety, there was also a significant difference between two groups. based on research findings, dialectical behavior therapy can lead to improvement of emotion regulation and health anxiety in patients with asthma. therefore, this intervention is used as an effective treatment in improving these symptoms.introductionasthma is a chronic respiratory disease (maierean et al., 2019). the overlap of psychiatric symptoms has a negative impact on quality of life of patients with asthma (normansell et al., 2018).emotion regulation is a psychological component that plays a significant role in psychological vulnerability of patients with asthma (hughes et al., 2011). negative emotional states and emotion regulation problems can lead to the exacerbation and increase of asthma symptoms (leupoldt et al., 2013).another component related to psychological vulnerability of asthmatics is the health anxiety (ten thoren petermann, 2000). health anxiety is common in people with asthma and has a significant impact on their disease management and symptom perception (burrows mason, 2004).considering that asthma is a disease consisting of several physical, psychological and social factors; it seems that psychological treatments along with drug treatments can be effective in reducing disease symptoms (baiardini et al., 2015). among treatment methods, dialectical behavior therapy seems to be effective in improving symptoms of asthma patients (linehan, 2020). this treatment is an integrative treatment method in which patient is taught to identify contradictions within or between himself and the environment and achieve an efficient result through their combination and integration (long witterholt, 2013). in recent years, dialectical behavior therapy has been used in a relatively diverse range of disorders (lin et al., 2019).finally, since patients with asthma show higher levels of negative emotions, anxiety, stress and excessive attention to symptoms, it is important to search for more novel and different psychological treatments for patients (gonzález-freire et al., 2020)). therefore, the present study was conducted with the aim of the effectiveness of dialectical behavior therapy on emotion regulation and health anxiety in patients with asthma. methodthe research design was quasi-experimental with a pre-test, post-test and two experimental and control groups. the statistical population of the present study was all patients with asthma who referred to khorshid hospital, isfahan. twenty-two people were selected through convenience sampling. they were randomly assigned to experimental and control groups. the research tools were the emotion regulation questionnaire (gross john, 2003) and the health anxiety questionnaire (salkovskis et al., 2002). individuals in experimental group underwent dialectical behavior therapy for eight sessions based on protocol of mckay et al. (2007/2011). finally, spss software was used to analyze covariance method. resultsmultivariate analysis of covariance (mancova) was used to investigate effectiveness of dialectical behavior therapy on emotion regulation. in order to investigate the difference between the groups in each of components of emotion regulation, a between-subjects test was used. results of the test are presented in table 1. table 1: test of inter-subject effects to compare emotional regulation components of experimental and control groups in post-testvariablelevelsum of squaresdfmean of squaresfpeffect sizesuppressionpre-test0/17910/1790/1700/6850/009 between subject0/27710/2770/2630/6140/014 error20/014191/053   reappraisalpre-test0/01110/0110/0120/9120/001 between subject6/52716/5277/2080/0150/275 error17/204190/905    as can be seen in table 1, pre-test variable is not significant for any of the components of emotion regulation variable (p>0.05). also, after removing pre-test effect, there was no significant difference between the control and the experimental groups in suppression variable, but in reappraisal component, the difference between control and experimental groups was