بررسی اثربخشی آموزش کاهش استرس مبتنی‌بر ذهن‌آگاهی (mbsr) بر درد و کیفیت زندگی بیماران مبتلا به تالاسمی ماژور

زمینه و هدف: با توجه به شیوع تالاسمی ماژور و نظر به اهمیت سازه‌های درد و کیفیت زندگی در این بیماران، کاهش درد و افزایش کیفیت زندگی می‌تواند در بهبود وضعیت روان‌شناختی این بیماران موثر باشد؛ بنابراین هدف این پژوهش بررسی اثربخشی آموزش کاهش استرس مبتنی‌بر ذهن‌آگاهی (mbsr) بر درد و کیفیت زندگی بیماران مبتلا به تالاسمی ماژور بود.روش‌بررسی: روش پژوهش، نیمه‌آزمایشی با طرح پیش‌آزمون-پس‌آزمون با گروه گواه بود. جامعهٔ آماری در این پژوهش تمامی بیماران مبتلا به تالاسمی ماژور مراجعه‌کننده به مراکز تخصصی و بیمارستان‌های سطح شهر بندرعباس در سال 1398 بودند. از بین آن‌ها تعداد 50 بیمار واجد شرایط داوطلب وارد مطالعه شدند و به‌صورت تصادفی در دو گروه آموزش کاهش استرس مبتنی‌بر ذهن‌آگاهی (mbsr) و گروه گواه قرار گرفتند. گروه آزمایش طی هشت جلسهٔ 90دقیقه‌ای به‌صورت هفتگی، آموزش کاهش استرس مبتنی‌بر ذهن‌آگاهی (mbsr) را براساس بستهٔ آموزشی کابات-‌زین و همکاران (1990) دریافت کرد. داده‌ها با استفاده از پرسشنامهٔ کیفیت زندگی (وار، 1994) و پرسشنامهٔ مختصر درد (کلیلند و همکاران، 1996) جمع‌آوری شد. تحلیل داده‌ها با روش تحلیل کوواریانس تک‌‌متغیره و نرم‌افزار spss نسخهٔ 22 صورت گرفت. سطح معناداری آزمون‌ها 0٫05 در نظر گرفته شد.یافته‌ها: تحلیل داده‌ها نشان داد که آموزش کاهش استرس مبتنی‌بر ذهن‌آگاهی (mbsr) بر کیفیت زندگی (0٫001>p) و مولفه‌های آن شامل عملکرد جسمی (0٫001>p)، محدودیت عملکرد جسمی (0٫001>p)، محدودیت نقش عاطفی (0٫001>p)، شادابی و نشاط (0٫001>p)، سلامت روان (0٫001>p)، عملکرد اجتماعی (0٫001>p)، درد بدنی (0٫001>p) و سلامت عمومی (0٫001>p) و همچنین شدت درد (0٫001>p) موثر است.نتیجه‌گیری: نتیجهٔ این پژوهش نشان داد که آموزش کاهش استرس مبتنی‌بر ذهن‌آگاهی (mbsr) بر کاهش شدت درد و افزایش کیفیت زندگی بیماران مبتلا به تالاسمی ماژور موثر است.

Effects of Mindfulness-Based Stress Reduction Training on Pain and Quality of Life in Patients With Thalassemia Major

Background & Objectives: Thalassemia is among the most prevalent chronic and inherited diseases. This condition is also one of the most common inherited diseases in Iran. Frequent visits of these patients to medical centers for blood transfusion change their lifestyle, and lead to frequent absences from school and work, decreased social activities, increased anxiety, the lack of self–confidence, and the fear of premature death. Additionally, this condition presents adverse effects on the mental health of other family members. Considering the prevalence of thalassemia major and the occurrence of numerous biopsychological problems in the affected individuals as well as their families, and the importance of pain structures and quality of life in these patients due to its chronic and debilitating nature, reducing pain and increasing quality of life can be effective in improving their mental status. Therefore, the present study aimed to evaluate the effects of Mindfulness–Based Stress Reduction (MBSR) training on pain and quality of life in patients with thalassemia major.Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of this study included all patients with thalassemia major who were referred to specialized centers and hospitals in Bandar Abbas City, Iran, in 2019. In total, 50 eligible patients were included in the study. Then, they were randomly divided into two groups of MBSR training and control. The required number of samples was calculated based on similar studies, considering the effect size of 0.40, confidence level of 0.95, test power of 0.80, and the sample dropout rate of 10% (n=25/group). The inclusion criteria of the study included the following: age of over 16 years, receiving the diagnosis of thalassemia major by an oncologist, having no psychiatric disorder (based on a clinical psychologist’s interview), and receiving no other psychiatric treatment. The exclusion criteria were the unwillingness of individuals to continue cooperation with the research project, and absence from more than two intervention sessions. The pretest and posttest data were collected using the Quality of Life Questionnaire (Ware, 1994) and the Brief Pain Questionnaire (Cleeland et al., 1996). The experimental group underwent MBSR training based on Kabat–Zinn et al.’s training package (1990) for eight 90–minute sessions per week. The obtained data were analyzed by one–way Analysis of Covariance (ANCOVA) in SPSS. The significance level of the tests was considered 0.05. Results: Data analysis suggested that MBSR training affected quality of life (p>0.001) and its components, including physical functioning (p>0.001), physical function limitation (p>0.001), emotional role limitation (p>0.001), vitality (p>0.001), mental health (p>0.001), social functioning (p>0.001), physical pain and general health (p>0.001), and pain intensity (p>0.001). The effect size of pain intensity and quality of life were 0.67 and 0.52, respectively. Furthermore, the effect of quality of life components, including physical functioning was equal to 0.55, physical function limitation equaled 0.76, emotional role limitation was measured as 0.71, vitality was equal to 0.64, mental health was calculated as 0.72, social functioning was measured as 0.76, physical pain was equal to 0.62, general health equaled 0.76, and pain intensity was equal to 0.67.Conclusion: Based on the current research findings, MBSR training is an efficient, practical, and effective method in improving the severity of pain and increasing the quality of life among patients with thalassemia major.