تدوین مدل کیفیت زندگی بر اساس باورهای فراشناختی با میانجی‏گری استرس ادراک شده سالمندان

این پژوهش با هدف ارائه یک مدل از باورهای فراشناختی و استرس ادراک‏شده برای کمک به فهم بهتر کیفیت زندگی سالمندان انجام شد. بدین منظور از بین سالمندان بالای 60 سال ساکن در شهر تهران در سال 1397، تعداد 377 نفر به شیوه‏ نمونه‏گیری در دسترس انتخاب شدند و با استفاده از پرسشنامه کیفیت زندگی سازمان بهداشت جهانیفرم کوتاه، پرسشنامه باورهای فراشناختی30 ساخته ولز و کارترایت هاتون و پرسشنامه استرس ادراک شده14 ساخته کوهن، کامارک و مرملستین مورد ارزیابی قرار گرفتند. داده‏های به دست آمده با استفاده از روش تحلیل مسیر با نرم‏افزارهای spss نسخه 20 و amos نسخه 20 مورد ارزیابی آماری قرار گرفت. یافته‏ها نشان داد بین متغیر استرس ادراک‏شده و کیفیت زندگی سالمندان رابطه منفی و معنادار وجود دارد. بین باورهای فراشناختی (شامل باورهای منفی در مورد کنترل ناپذیری، باورهای مثبت درباره نگرانی، اطمینان شناختی، نیاز به کنترل افکار) با کیفیت زندگی سالمندان رابطه منفی و معنادار وجود دارد. یافته‏ها همچنین نقش واسطه‏گری استرس ادراک‏شده در رابطه بین باورهای فراشناختی و کیفیت زندگی سالمندان را مورد تایید قرار داد. با توجه به یافته‏های به دست آمده آموزش راهبردهای فراشناختی به عنوان یک مکانیسم تاثیرگذار بر اصلاح باورهای فراشناختی عمل کرده و راه مناسب برای ارتقای کیفیت زندگی سالمندان محسوب شود و افزودن آن در مداخلات مربوطه پیشنهاد می‌شود.

The Development of a Quality of Life Model Based on Metacognitive Beliefs with the Mediation role of Perceived Stress in the Elderly

This study aimed to provide a model of metacognitive beliefs and perceived stress to help better understand the quality of life of the elderly. To this end, a sample of 377 subjects was selected by the available sampling method among the elderly over 60 years of age living in Tehran in 2018 and was evaluated using WHO Quality of LifeBREF, Metacognition Questionnaire30 by Wells & CartwrightHatton and perceived stress scale14 by Cohen, Kamarck & Mermelstein. The data were evaluated using path analysis by statistical software SPSS20 and AMOS20. Results showed that there is a significant negative correlation between perceived stress and quality of life in the elderly. There is a negative and significant relationship between metacognitive beliefs (including negative beliefs about irresponsibility, positive beliefs about worries, cognitive confidence, need for control of thoughts) and quality of life in the elderly. The findings also confirmed the role of perceived stress mediated in the relationship between metacognitive beliefs and the quality of life of the elderly. Based on the findings, training of metacognitive strategies as an effective mechanism for modification of metacognitive beliefs is an appropriate way to improve the quality of life of elderly people and it is suggested to add it to relevant interventions. Ballard S. M., Jenkins C., Savut N. Y., McKinnon W. H., Carroll K. E., & Escott Stump S. (2011). Innovative and complementary approaches to aging in place. Journal of Family & Consumer Sciences, 103(2), 2434. Carlson, E., Speca, M., Patel, K., & Goodey, E. (2003). MindfulnessBased stress reduction in relation to quality of life: mood symptoms of stress, and immune parameters in breast and prostate cancer outpatient. American Psychosomatic Society Psychosomatic Medicine, 65, 571581. CartwrightHatton, S., & Wells, A. (1997). Beliefs about worry and intrusions: The metacognitions questionnaire and its correlates. Journal of Anxiety Disorders, 11, 279–296. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385396. Craven, R. F., Hirnle, C. J., & Sharon, J. (2012). Fundamentals of Nursing: Human Health and Function. Philadelphia: Lippincott Co. Davey, C. L., & Wells, A. (2006). Worry and its psychological disorder, theory, assessment and treatment. New York: John Willy and sons. Ellis, D. M., & Hudson, J. L. (2010). The Metacognitive Model of Generalized Anxiety Disorder in Children and Adolescents. Clinical Child and Family Psychology Review, 13(2), 151163. KabatZinn, J. (2005). Coming to our senses: Healing ourselves and our world though mindfulness. New York: Hyperion. Kang, Y. S., Choi, S. Y., & Ryu, E. (2009). The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. Nurse Education Today, 29(5), 538543. Keyes, B., Michalec, B., Kobau, R., & Zahran, H. (2005). Social Support and HealthRelated Quality of Life among Older AdultsMissouri 2000. Morbidity and mortality weekly report, 54(17), 4337. Lippincott. (2012). Professional Guide to Diseases (Professional Guide Series). LWW Press. Lobban, F., Haddock, G., Kinderman, P., & Wells, A. (2002). The role of metacognitive beliefs in auditory hallucinations. Personality and Individual Differences, 32(8), 13511363. Mennin, D. S., McLaughlin, K. A., & Flanagan, T. J. (2009). Emotion regulation deficits in generalized anxiety disorder, social anxiety disorder, and their cooccurrence. Journal of anxiety disorders, 23(7), 866871. Palmer, E. C, David, A. S, & Fleming, S. M. (2014). Effects of age on metacognitive efficiency. Consciousness and Cognition, 28, 15160. Papageoryiou, C., & Wells, A. (Eds.). (2004). Depressive nomination: Nature, therapy and treatment. Chichester, UK: Wiley. Puchalski, C. H. M. (2015). Spirituality in Geriatric Palliative Care. Clinics in Geriatric Medicine, 31(2), 252245. Roelofs, J., Onckels, L., & Muris, P. (2013). Attachment Quality and Psychopathological Symptoms in Clinically Referred Adolescents: The Mediating Role of Early Maladaptive Schema. Journal of Child and Family Studies, 22(3), 377385. Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOLBREF quality of life assessment: Psychometric properties and results of the international field trial. A Report from the WHOQOL Group. Quality of Life Research, 13(2), 299310.  Spada, M. M., Mohiyeddini, C., Wells, A. (2008). Measuring metacognitions associated with emotional distress: Factor structure and predictive validity of the Metacognitions Questionnaire 30. Personality and Individual Differences, 45(3), 238242. Spasojevic, J., Alloy, L. B., Abramson, L. Y., Maccoon, D., & Robinson, M. S. (2004). Reactive rumination: outcomes, mechanisms, and developmental antecedents. Chichester, UK: Wiley. Varkal, M. D., Yalvac, D., Tufan, F., Turan, S., Cengiz, M., & Emul, M. (2013). Metacognitive differences between elderly and adult outpatients with generalized anxiety disorder. European Geriatric Medicine, 4(3), 150153. Wells, A., & Carter, K. (2001). Further tests of a cognitive model of generalized anxiety disorder: Metacognitions and worry in GAD, panic disorder, social phobia, depression, and nonpatients. Behavior Therapy, 32(1), 85102. Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove, UK: Erlbaum. Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The SREF model. Behaviour Research and Therapy, 34(11), 881888. Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. John Wiley & Sons. LTD. Wells, A. (2007). Cognition about cognition: Metacognitive therapy and change in generalized anxiety disorder and social phobia. Cognitive and Behavioral Practice, 14(1), 1825. Wells A. (2010). Metacognitive Therapy for anxiety and depression. Guilford Press. Wells, A. (1995). Metacognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23(3), 301320. Wells, A. (2009). Metacognitive therapy for anxiety and depression. New York: Guilford press. Wells, A., & CartwrightHatton, S. (2004). A short form of the metacognitions questionnaire: properties of the MCQ30. Behaviour Research and Therapy, 42(4), 385396. World Health Organization (WHO). (2011). 10facts on ageing and the life course. [Cited2011 Jun. 20]. Available from: URL:http://www.who.int/topics/ageing/en/htm. World Health Organization. (1997). WHOQOL, measuring quality of life. WHO publication.