مقایسهٔ اثربخشی درمان مبتنی ‌بر پذیرش و تعهد و آموزش خود مدیریتی بر سرمایه‌های روان ‌شناختی زنان مبتلا به دیابت نوع دو با مقاومت روان‌ شناختی به انسولین

زمینه و هدف: دیابت به ‌عنوان یکی از اختلالات بسیار شایع مزمن، با خطر زیاد عوارض جسمانی و روانی همراه است. تحقیقات نشان می‌دهد، برخی درمان‌های روان‌شناختی در مدیریت این بیماری موثر است. پژوهش حاضر با هدف مقایسهٔ اثربخشی درمان مبتنی‌بر پذیرش‌ و ‌تعهد و آموزش خودمدیریتی بر سرمایه‌های روان‌شناختی زنان مبتلا به دیابت نوع دو با مقاومت روان‌شناختی به انسولین انجام شد. روش‌بررسی: روش پژوهش حاضر، نیمهآزمایشی از نوع پیش‌آزمون-پس‌آزمون و مرحلۀ پیگیری با گروه گواه بود. جامعۀ آماری پژوهش را تمامی زنان مبتلا به دیابت نوع دو، مراجعه‌کننده به انجمن دیابت استان گیلان در سال 1399 تشکیل دادند. در ادامه 48 بیمار واجد شرایط داوطلب وارد مطالعه شدند و به‌روش تصادفی در دو گروه آزمایش درمان پذیرش ‌و‌ تعهد و آموزش خودمدیریتی و یک گروه گواه (هر گروه شانزده نفر) قرار گرفتند. به‌منظور انجام مداخلات، درمان پذیرش‌ و‌ تعهد (هیز، 2004) و آموزش خودمدیریتی (شرورز، 2003) اجرا شد. ابزار استفاده‌شده در این پژوهش، مقیاس سرمایهٔ روان‌شناختی (لوتانز، 2007) بود. داده‌های پژوهش پیش و پس از مداخله و دو ماه بعد به‌منظور پیگیری با استفاده از آزمون تحلیل واریانس با اندازه‌‌گیری مکرر و آزمون بونفرونی در نرم‌افزار spss نسخهٔ 22 تحلیل شدند. یافته‌ها: نتایج مشخص کرد، میانگین نمرات سرمایهٔ روان‌شناختی و مولفه‌های هر دو گروه آزمایش درمقایسه با گروه گواه، همچنین گروه درمان پذیرش ‌و ‌تعهد درمقایسه با گروه آموزش خودمدیریتی بیشتر است (0٫001≥p). تغییرات میانگین سرمایهٔ روان‌شناختی و مولفه‌های آن در طول زمان، همین‌طور اثر گروه و اثر متقابل زمان و گروه معنادار بود (0٫001≥p). نتیجه‌گیری: این مطالعه نشان داد که هر دو درمان بر افزایش سرمایه‌های روان‌شناختی زنان مبتلا به دیابت نوع دو با مقاومت روان‌شناختی به انسولین اثربخش است؛ اما درمان پذیرش و تعهد از اثربخشی بیشتری برخوردار است.

comparing the effects of acceptance and commitment therapy and self-management training on psychological capitals in women with type 2 diabetes and psychological insulin resistance

background & objectives: diabetes, as one of the most widespread chronic diseases, is accompanied by high risks of biopsychological symptoms, reduced quality of life, early disability, and death besides imposing a high economic burden on the individual and society. research indicated that some psychotherapies effectively control and cope with this illness. however, few studies have addressed psychological insulin resistance (pir), i.e., more prevalent among women, and its nonuse can make the patient suffer from numerous complications. studies suggested that self–efficacy, resilience, and hopefulness associated with people with diabetes are severely reduced due to chronic disease. moreover, psychological assets, which include the components of self–efficacy, resilience, optimism, and hope, impact coping with stress, overcoming psychosocial and health–related adversity, and lifestyle modification in patients with diabetes. the present study aimed to compare the effects of the acceptance and commitment therapy (act) and self–management training (smt) on psychological capitals (pcs) in women with type 2 diabetes and psychological insulin resistance.methods: this was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. the statistical population consisted of all type 2 diabetes women referring to gilan diabetes society in 2020. 48 individuals were voluntarily selected by the convenience sampling method concerning the inclusion criteria. after obtaining their informed consent, they were randomly assigned into 3 groups and administered the pretest. luthans’ psychological capital scale was the instrument employed in this research. the questionnaire’s validity was verified by explanatory factor analysis. using cronbach’s alpha coefficient, the total reliability score of the pc item equaled 0.89. a study conducted in iran found that cronbach’s alpha coefficient for the overall score of the pc item was 0.89. moreover, the item–total correlations indicated excellent validity. besides, the researchers applied hayes and strosahl’s act package in eight 90–minute sessions to conduct the interventions. the smt for chronic illnesses intervention of schreurs et al. was also performed in six 90–minute sessions. after administering the posttest and follow–up stages, the research data were analyzed using repeated–measures analysis of variance (anova) and bonferroni post hoc test in the spss.results: the group–by–time interaction effect in the anova was significant for the overall score of the pc, hope, resilience, self–efficacy, and optimism (p<0.001). the control and experimental groups substantially differed in pretest, posttest, and follow–up steps. there was no difference in the overall score of the pc and its subscales in the pretest stage between the smt and control groups (p>0.05); therefore, the study groups were similar. in the posttest step, a significant difference was found between the control and smt groups. thus, the smt group outperformed the control group respecting improving pc and its subscales in the study subjects (p<0.001). there was no difference in the overall score of the pc and its subscales in the pretest stage between the act and smt groups (p>0.05); therefore, these groups were similar. a significant difference was found between the act and smt groups in the posttest. thus, the act group outperformed the smt group concerning improving pc and its subscales in the study participants (p<0.001). finally, all changes remained stable at the follow–up design in the experimental groups (p<0.001).conclusion: the obtained results revealed that the pc scores in both experimental groups were higher than the control group, and the act group outperformed the smt group. the changes observed in the experimental group were also stable in the follow–up phase to some extent. the collected results can solve the problems associated with patients with diabetes in hospital and private counseling centers.