مقایسهٔ اثربخشی آموزش ذهن‌آگاهی با آموزش اختصاصی‌سازی حافظهٔ سرگذشتی بر راهبردهای شناختی تنظیم هیجان بیماران همودیالیزی

زمینه و هدف: نارسایی مزمن کلیوی، تخریب رو به رشد و بازگشت ناپذیر عملکرد کلیوی است که عوارض جسمی و روانی بی شماری را در پی دارد. این پژوهش با هدف مقایسهٔ اثربخشی آموزش ذهن آگاهی با آموزش اختصاصی سازی حافظه بر راهبردهای شناختی تنظیم هیجان بیماران همودیالیزی انجام شد.روش بررسی: پژوهش حاضر از نوع شبه آزمایشی با طرح پیش آزمون پس آزمون و پیگیری بود. جامعهٔ آماری را بیماران همودیالیزی مراجعه کننده به مراکز همودیالیز شهر تهران در سال 1396 تشکیل دادند. تعداد 36 نفر به روش نمونه گیری هدفمند از جامعهٔ آماری انتخاب شده و به صورت تصادفی در سه گروه آموزش ذهن آگاهی (سگال، 2013) و آموزش اختصاصی سازی حافظه (مکس ول، 2016) و گروه کنترل قرار گرفتند. برای جمع آوری داده ها، پرسشنامهٔ راهبردهای شناختی تنظیم هیجان گارنفسکی (cerq) به کار رفت. داده ها با استفاده از نرم افزار spss نسخهٔ 22 و تحلیل واریانس با اندازه گیری مکرر، تجزیه وتحلیل شد. کد کارآزمایی بالینی irct20190202042582n1 بود.یافته ها: بررسی نتایج نشان داد که بین راهبردهای شناختی تنظیم هیجان مثبت و منفی گروه های آموزش ذهن آگاهی و آموزش اختصاصی سازی حافظهٔ سرگذشتی و کنترل، در مرحلهٔ پس آزمون بیماران همودیالیزی تفاوت وجود دارد (0٫001>p). همچنین بین راهبردهای شناختی تنظیم هیجان مثبت و منفی سه گروه مذکور، در مرحلهٔ پیگیری بیماران همودیالیزی تفاوت مشاهده می شود (0٫001>p).نتیجه گیری: براساس یافته های این مطالعه می توان از مداخله های ذهن آگاهی با آموزش اختصاصی سازی حافظه در افزایش استفاده از راهبردهای شناختی تنظیم هیجان بیماران تحت همودیالیز بهره برد.

Comparative of Mindfulness with Memory Specificity Training (MEST) on Cognitive Emotion Regulation Strategies in Hemodialysis Patients

Background & Objective: Chronic renal failure is a progressive and irreversible loss in kidney function, which results in numerous physical and psychological complications. The complications of hemodialysis treatment cause disruption in patients’ happiness and wellbeing and therefore leads to depression, anxiety, and sometimes suicide attempts. Cognitive emotion regulation strategies are an important part of hemodialysis patients’ lives. Disturbance in emotion and failure in its regulation can cause psychological trauma. The aim of this study was to investigate the effectiveness of mindfulness with memory specificity training (MEST) on cognitive emotion regulation strategies of hemodialysis patients.Methods: The present study was quasiexperimental with a pretestposttest and twomonths followup with the control group. The statistical population consisted of hemodialysis patients who referred to hemodialysis centers of Tehran city (capital city of Iran) in 2017. In total, 36 individuals were selected using the purposive sampling method from the statistical population and were randomly assigned into three groups: mindfulness therapy group (n=12), MEST group (n=12), and control group (n=12). In order to collect data, the cognitive emotion regulation questionnaire (CERQ) developed by Garnowski, for intervention mindfulness therapy (Segal, 2013), memory specify training (Maxwell, 2016) were used. After selecting the sample, mindful and memory specificity training were done for the groups, no training was provided for the control group. After training completion, a posttest was performed for the subjects in all three groups. The posttest included the previous questionnaire. Two months after the course completion, patients were asked to complete the same questionnaire again. This was done to track and evaluate the viability of interventions. The obtained data were analyzed using SPSS22 software and mixed analysis of variance.Results: There was a significant difference in cognitive emotion regulation strategies between the mindfulness therapy group and the MEST group in the posttest stages among hemodialysis patients (p<0.001). In addition, there was a significant difference in cognitive emotion regulation strategies between the mindfulness therapy group and the MEST group in the followup stages among hemodialysis patients (p<0.001).Conclusion: In the present study, mindfulness therapy and MEST, compared with the control group, were more effective for the positive and negative cognitive emotion regulation during the posttest, and the effect was more durable during interventions. Comparison of MEST to mindfulness therapy showed that MEST was more effective than mindfulness therapy for positive and negative cognitive emotion regulation. In order to explain this effectiveness, it can be argued that mindfulness therapy and its techniques target the fundamental beliefs and negative thoughts of selfefficacy in patients. It after making cognitive changes in patients and made aware of his own cognitive and emotional content, allow him to explore more appropriate alternatives and avid automated responses. Furthermore, in MEST and its techniques, by challenging the memory, irrational thoughts and beliefs about the chronic illness with depression, anxiety, and emotional disorders caused by incurable renal therapy, by reducing over general memory, increases the ability to solve social problems in individuals and prevent negative social interactions. It also leads to an increased sense of hope in patients by influencing future visualization capabilities. This therapy prevents rumination as well. It also reduces the psychological disorders in patients by experimenting with negative memories and the resultant negative emotions. Being exposed to distressing memories and emotions, even if they cause worries and unpleasantness for a short period of time, has longterm benefits for an individual’s mental health. According to the findings of this study, it can be deduced that MEST is more effective than mindfulness therapy and control group in improving cognitive emotion regulation and this therapy is more durable, this durability is due to easier treatment and faster training for patients as well as shorter duration of intervention sessions.