تعیین اثربخشی رویکردهای مبتنی بر معنویت و مذهب بر میزان نشانه‌های افسردگی یک مطالعۀ متاآنالیز

زمینه و هدف: افسردگی از بیماری های روانی بسیار شایع است. به منظور درمان و جلوگیری از عود مکرر این بیماری لازم است اطلاعاتی دربارۀ روش های درمان و میزان تاثیری که این درمان ها دارند، کسب کرد. دراین باره، فراتحلیل با یکپارچه کردن نتایج حاصل از انجام دادن تحقیقات مختلف، میزان آثار روش های درمان را مشخص می کند. پژوهش حاضر نیز بر آن بود تا با استفاده از الگوی پژوهشی فراتحلیل، میزان اثرگذاری رویکردهای مبتنی بر معنویت و مذهب را بر کاهش نشانه های افسردگی بررسی کند.روش بررسی: کلیدواژه های جست وجو شده شامل درمان، روان درمانی، مداخله، روان درمانگری، آموزش، مشاوره، معنویت، معنوی، مذهبی، افسرده و افسردگی بود. ملاک های ورود برای فراتحلیل عبارت بودند از: 1.پژوهش ها به صورت آزمایشی و شبه آزمایشی باشد؛ 2. حداقل یک گروه آزمایشی وجود داشته باشد؛ 3.ابزارهای اندازه گیری از پایایی و روایی کافی برخوردار باشد؛ 4. موضوع پژوهش رویکردهای مبتنی بر مذهب و معنویت در افسردگی باشد؛ 5. بررسی در قالب پژوهش گروهی صورت گرفته باشد (موردی نباشد)؛ 6.مداخلات حضوری باشد (اینترنتی، تلفنی یا... نباشد). بدین منظور، سیزده پژوهش که از لحاظ روش شناختی موردقبول بود، انتخاب شد و فراتحلیل بر روی آن ها انجام گرفت. ابزار پژوهش عبارت بود از: چک لیست تحلیل محتوا و نرم افزار cam2.یافته ها: یافته های پژوهش نشان داد اندازۀ اثر رویکردهای مبتنی بر مذهب و معنویت بر کاهش نشانه های افسردگی 0٫85 بود (0٫001>p) این اندازۀ اثر مطابق جدول کوهن در حد بالا ارزیابی شد.نتیجه گیری: با توجه به بافت فرهنگی و اجتماعی ایران، اندازۀ کارایی درمان های مبتنی بر معنویت و مذهب، در کاهش نشانه های افسردگی مشخص شد. بنابراین بهتر است درمانگران در درمان های خود بافت فرهنگی و مذهبی جامعه را نیز در نظر بگیرند.

Spirituality and religion approaches on depression symptoms A Metaanalysis

Background & Objective: Depression is the most common psychiatric disorder that has been increasing over the past fifty years and is considered the most common cause of hospitalization. Mainly, depressed people are self–assimilated and self–assertive, attention is paid to the positive effects of religion and spirituality is essential in the prevention and treatment of mental disorders. The present study aimed to investigate the effect of religious–spiritual approaches on decreasing depression syndromes in Iran using a meta–analysis model.Methods: This research was a review study. The statistical population consisted of theses and research published in scientific and research journals that have been conducted over the past twelve years (2004–2015) in the field of spirituality and religion–based depression approaches in Iran. In this research, 13 articles that had criteria for entry, and they had an adequate sample size and methodologically. Sources of research in the present study consisted of Master’s and Ph.D. thesis of Universities, scientific–research journals in the field of psychology, information resources of the Jihad University, and documents center of Iran. The search keywords included treatment, psychotherapy, intervention, psychotherapy, education, counseling, spirituality, spiritual, religious, depressed, and depression. Including criteria for the meta–analysis were experimental and quasi–experimental research; with at least one experimental group; measurement tools were sufficient reliability and validity; the topic of research had religion–based approaches and spirituality in depression; the study conducted in the form of group research; in–person intervention (without internet and telephone). A content analysis checklist was used to selected research papers with inclusion criteria and extracting the necessary information to perform their meta–analysis. The checklist included the following components: title of research on depression, full details of the executives, had study year, implementation of the study, hypotheses, data collection tools, statistical population, and sample size. A significance level of tests used in this research was performed based on Kuhn’s meta–analysis steps. The data was analyzed by CMA2 software.Results: The best estimate for the impact of spirituality and religion–based approaches on depression was 0.48, which was roughly high according to Cohen’s (1988) coefficient of interpretation (spirituality–based approaches and religion had a modest effect on depression).Conclusion: Discrepancies are effective interventions to reduce depression; it seems that a meta–analysis will help clarify the actual impact of interventions on depression symptoms and will determine the degree of effectiveness. Overall, the results of this study showed that spiritual and behavioral therapies could be effective in reducing the symptoms of depression, but a closer examination of the study revealed the basic difficulties in reporting and the quality of their performance. It seems that conducting accurate research based on the theoretical, scientific background, using authoritative sources related to the teachings, concepts of religion, Islamic culture treatment of depression is essential. It is necessary to study on validity and effectiveness of the procedure and to compare its efficacy with standard golden treatment. It can be said that multi–drug therapy needs to design to Iranian–culture that can increase the effectiveness of secular remedies on Iranian society. Based on these findings, therapists could select and execute treatment patterns appropriate to the problems encountered, and to achieve better and more reliable outcomes.