هم سنجی تأثیر آموزش مبتنی بر پذیرش و تعهد و آموزش بهبود مهارت‌های رویارویی زوجی بر بدریختی انگاری بدن و بهزیستی ذهنی زنان دچار سرطان پستان

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی، دانشگاه ارومیه، دانشکده ادبیات و علوم انسانی، ارومیه، ایران

2 استاد گروه روانشناسی، دانشگاه ارومیه، دانشکده ادبیات و علوم انسانی، ارومیه، ایران

3 دانشیار گروه روانشناسی، دانشگاه ارومیه، دانشکده ادبیات و علوم انسانی، ارومیه، ایران

4 دانشیار گروه داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، ایران

چکیده

سرطان پستان و جراحی آن می­تواند وضعیت­های روان‌شناختی متعارضی را به دنبال داشته باشد. هدف پژوهش هم سنجی اثربخشی آموزش مبتنی بر پذیرش و تعهد و آموزش بهبود مهارت‌های رویارویی زوجی بر بدریختی انگاری بدن و بهزیستی ذهنی زنان دچار سرطان پستان بود. این پژوهش یک طرح نیمه آزمایشی با پیش­آزمون، پس­آزمون و گروه گواه و پیگیری 3 ماهه بود. جامعه پژوهش بیماران زن دچار سرطان پستان مراجعه‌کننده به بیمارستان سیدالشهدا اصفهان در سال 1396 بود. از میان آن‌ها 45 نفر از داوطلبین به روش ­نمونه­گیری هدفمند پس از بررسی ملاک­های ورود انتخاب و به‌صورت تصادفی در گروه­های آزمایش و گواه گمارش شدند. مداخلات طی 9 نشست 90 دقیقه­ای اجرا شد، گروه گواه در لیست انتظار قرار گرفت. داده­ها با ابزارهای نگرانی از تصویر بدن لیتلتون و همکاران (2005) و بهزیستی ذهنی کی­یز و ماگیارمو (2003) گردآوری شد. برآیندهای تحلیل واریانس اندازه­های مکرر نشان داد که میان گروه­های آزمایش با گروه گواه در بدریختی انگاری بدن و بهزیستی ذهنی تفاوت معنی‌داری وجود دارد و آموزش مبتنی بر پذیرش و تعهد اثرات بیشتری را در سنجش با آموزش مهارت­های رویارویی زوجی بر بهزیستی ذهنی داشته است (05/0p<). بر پایه یافته­ها، آموزش مبتنی بر پذیرش و تعهد موجب فراگیری راهکارهای کارآمد در مدیریت هیجانات، احساسات منفی و عمل متعهدانه شده و آموزش مهارت­های رویارویی زوجی می­تواند منجر به بالا رفتن توانمندی در مدیریت فشار روانی برآمده از بیماری شود. مداخلاتی که در کنار کاهش علائم بدریختی انگاری بدن، می­توانند بهزیستی ذهنی زنان دچار سرطان پستان را ارتقا دهند.

کلیدواژه‌ها


عنوان مقاله [English]

Comparing the efficacy of acceptance and commitment training and groups training of couples coping skills enhancement on body dysmorphic and subjective well-being in women with breast cancer

نویسندگان [English]

  • Mehran Alipour 1
  • Firouzeh Sepehrian Azar 2
  • Esmaeil Soleimani 3
  • Fariborz Mokarian 4
1 Ph.D Student of psychology, Department of educational sciences, Faculty of Literature and Human Sciences, Urmia University, Urmia, Iran
2 Professor, Department of educational sciences, Faculty of Literature and Human Sciences, Urmia University, Urmia, Iran
3 Associate Professor, Department of educational sciences, Faculty of Literature and Human Sciences, Urmia University, Urmia, Iran
4 Associate Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Breast cancer and its surgery can lead to conflicting psychological conditions. The purpose of this study was to compare the efficacy of Acceptance and Commitment training and Groups Training of Couples Coping Skills Enhancement on body dysmorphic and Subjective Well-Being in women with breast cancer. This study was a semi-experimental study with pre-test, post-test and control groups with 3 months follow-up. The study population consisted of female patients with breast cancer who referred to Isfahan's Seyed Alshohada Hospital in 2017. Among them, 45 volunteers were selected through Purposive sampling after checking the inclusion criteria and randomly assigned to experimental and control groups. Experimental groups were treated for 90 minutes in 9 sessions while the control group did not reseive any treatment. The data were collected using Littleton et al Body Image Concern Inventory (2005) and Keez and Magharmo Subject Well-Being Scale (2003). The results of repeated measurements analysis showed that there was a significant difference in body dysmorphic and subjective Well-Being between experimental groups and control group. Moreover Acceptance and Commitment training was more effective than Training of Couples Coping Skills Enhancement on mental well-being (p<0.05). Findings indicate that Acceptance and Commitment training results in achievement of effective strategies for management of emotions, negative emotions, and committed action, and Training couple skills can lead to the improvement of the ability to manage disease-caused stress. The mentioned interventions not only could reduce body dysmorphic symptoms, but also could improve the Subjective Well-Being in women with breast cancer.

کلیدواژه‌ها [English]

  • acceptance and commitment
  • couples coping skills
  • body dysmorphic
  • subjective well-being
  • breast cancer

بساک نژاد، سودابه؛ غفاری، مجید. (1386). رابطه بین ترس از بدریختی بدن و اختلالات روان‌شناختی در دانشجویان، مجله علوم رفتاری، 1(2)، 188-179. [link]

توما، ناتان؛ مک­کی، دین. (1395). پرداختن به هیجان در درمان شناختی رفتاری. ترجمه: شهرام محمدخانی و همکاران. تهران: انتشارات ارجمند.

حبیب‌اللهی، اعظم و سلطانی زاده، محمد. (1394). اثربخشی درمان مبتنی بر پذیرش و تعهد، بر نارضایتی بدنی و ترس از ارزیابی منفی در دختران نوجوان مبتلا به اختلال بدشکلی بدن. مجله دانشگاه علوم پزشکی مازندران، 26 (134)، 299-287. [link]

صالحی، راحمه و دهشیری، غلامرضا. (1397). رشد پس آسیبی در بیماران مبتلا به سرطان: نقش ابعاد روانی، معنوی و ذهنی بهزیستی و امیدواری، فصلنامه پژوهش در سلامت روان‌شناختی،12(2)، 15-1. [link]

گلستانی بخت، طاهره. (1386). ارائه الگوی بهزیستی ذهنی و شادمانی در جمعیت شهر تهران. پایان­نامه دکتری روانشناسی عمومی، دانشگاه الزهرا، تهران.

نریمانی، محمد؛ علمداری، الهه و ابوالقاسمی، عباس. (1393). بررسی اثربخشی درمان مبتنی بر پذیرش و تعهد بر کیفیت زندگی زنان نابارور، مشاوره و روان‌درمانی خانواده، 4(3)، 405- 387.[link]

نریمانی، اکرم و حبی، محمدباقر. (1397). اثربخشی درمان متمرکز بر پذیرش و تعهد بر سازش یافتگی زوجیِ زنان، مشاوره و روان‌درمانی خانواده، 1،182- 166. [link]

نوروزی، اصغر؛ مرادی، علیرضا؛ زمانی، کریم و حسنی، جعفر. (1396). مقایسه اثربخشی معنادرمانی مبتنی بر اندیشه­های مولانا با درمان پذیرش و تعهد در بهزیستی روان شناختی سالمندان. فصلنامه پژوهش در سلامت روان‌شناختی، 11(3)، 61-41. [link]

Reference

Akbari, A., Razzaghi, Z., Homaee, F., Khayamzadeh, M., Movahedi, M., & Akbari, M. E. (2011). Parity and breastfeeding are preventive measures against breast cancer in Iranian women. Breast cancer, 18(1), 51-55. ‏[link]

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5). Arlington, VA: American Psychiatric Association.

Angelakis, I., Gooding, P. A., & Panagioti, M. (2016). Suicidality in body dysmorphic disorder (BDD): A systematic review with meta-analysis. Clinical psychology review, 49, 55-66. [link]‏

Azlan, H. A., Overton, P. G., Simpson, J., & Powell, P. A. (2017). Effect of partners’ disgust responses on psychological wellbeing in cancer patients. Journal of clinical psychology in medical settings, 24(3-4), 355-364.‏ [link]

Baucom, D. H., Porter, L. S., Kirby, J. S., Gremore, T. M., Wiesenthal, N., Aldridge, W., & Keefe, F. J. (2009). A couple‐based intervention for female breast cancer. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 18(3), 276-283. ‏[link]

Begovic-juhant, A., Chmielewski, A., Iwuagwu, S., & Chapman, A. (2012). Impact of Body Image on Depression and Quality of Life Among Women with Breast Cancer. Journal of Psychosocial Oncology, 30, 446–460. [link]

Blakey, S. M., Reuman, L., Buchholz, J. L., & Abramowitz, J. S. (2017). Experiential avoidance and dysfunctional beliefs in the prediction of body image disturbance in a nonclinical sample of women. Body image, 22, 72-77.‏ [link]

Bodenmann, G., & Shantinath, S. D. (2004). The Couples Coping Enhancement Training (CCET): A new approach to prevention of marital distress based upon stress and coping. Family Relations, 53, 477– 484. [link]

Bodenmann, G., Charvoz, L., Cina, A., & Widmer, K. (2001). Prevention of marital distress by enhancing the coping skills of couples: 1-year follow-up study. Swiss Journal of Psychology, 60, 3–10. [link]

Borstelmann, N. A., Rosenberg, S. M., Ruddy, K. J., Tamimi, R. M., Gelber, S., Schapira, L., & Partridge, A. H. (2015). Partner support and anxiety in young women with breast cancer. PsychoOncology, 24(12), 1679-1685. [link]

Browall, M., Gaston-Johansson, F., & Danielson, E. (2006). Postmenopausal women with breast cancer: their experiences of the chemotherapy treatment period. Cancer Nurs, 29, 34–42. [link]

Callaghan, G. M., Duenas, J. A., Nadeau, S. E., Darrow, S. M., Van der Merwe, J., & Misko, J. (2012). An empirical model of body image disturbance using behavioral principles found in Functional Analytic Psychotherapy and Acceptance and Commitment Therapy. International Journal of Behavioral Consultation and Therapy, 7(2-3), 16. ‏[link]

Casellas-Grau, A., Font, A., & Vives, J. (2014). Positive psychology interventions in breast cancer. A systematic review. Psycho-Oncology, 23, 9–19. [link]

Casellas-Grau, A., Vives, J., Font, A., & Ochoa, C. (2016).  Positive psychological functioning in breast cancer: An integrative review. The Breast, 27, 136-168. [link]

Christensen, H., Marck, D. (2017). The efficacy of mindfulness based stress reduction (MBSR) for decreasing anxiety and depression among breast cancer survivors. Sch Physician Assist Stud, 16, 613. [link]

Clarke, A., Friede, T., Putz, R., Ashdown, J., Martin, S., Blake, A., Adi, Y., Parkinson, J., Flynn, P., Platt, S., & Stewart-Brown1, S. (2011). Warwick-Edinburgh Mental Well-being Scale (WEMWBS): Validated for teenage school students in England and Scotland: A mixed methods assessment. Public Health, 11, 487. [link]  

Dahl, C., Reinertsen, K., Nesvold, I., Foss, A. S., & Dahl, A. (2010). A study of body image in long-term breast cancer survivors. Cancer, 116(15), 3549–3557. [link]

Didie, E. R., Loerke, E. H., Howes, S. E., & Phillips, K. A. (2012). Severity of interpersonal problems in individuals with body dysmorphic disorder. Journal of personality disorders, 26(3), 345-356.‏ [link]

Dokaneheei Fard, F., Mehrabian, B., Boroon, Z., Ghaderi, M., Yousefi, S., &  Shamseddini Lory, S. (2016). The effectiveness of acceptance and commitment therapy on reduction of obesity and body image. Bulletin de la Societe Royale des Sciences de Liege, 85, 1571–1577. [link]

Fortinash, K. M.,  & Worret, P. A. (2008). Psychiatric mental health nursing. 4th ed. St. Louis: Mosby.

Hagedoorn, M., Dagan, M., Puterman, E., Hoff, C., Meijerink, W. J., Delongis, A., &  Sanderman, R. (2011). Relationship satisfaction in couples confronted with colorectal cancer: the interplay of past and current spousal support. J Behav Med, 34(4), 288-297. [link]

Harris, R. (2009). ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy. Oakland,CA: New Harbinger.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice ofMindful Change, ed 2. New York: Guilford Press.

Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experimental approach to behavior change. New York: Guilford Press.

Heinrichs, N., Zimmermann, T., Huber, B., Herschbach, P., Russell, D. W, & Baucom, D. H. (2012). Cancer Distress Reduction with a Couple-Based Skills Training: A Randomized Controlled Trial. Annals of Behavioral Medicine, 43(2), 239–252. [link]

Hulbert-Williams, N. J., Storey, L., &mWilson, K. G. (2015). Psychological interventions for patients with cancer: psychological flexibility and the potential utility of Acceptance and Commitment Therapy. European Journal of Cancer Care, 24(1), 15- 27. [link]

Jamshidifar, Z., Mortezaei Shemirani , Sh., Ahramian, A., Ahmadi. A. Shamsedini Lory, S & Moradi-Joo, M. (2015). The effectiveness of positive psychotherapy on the psychological wellbeing of breast cancer patients. Ciência eNatura, Santa Maria, 37(1), 432−436. [link]

Jazayeri, S. B., Saadat, S., Ramezani, R., & Kaviani, A. (2015). Incidence of primary breast cancer in Iran: Ten-year national cancer registry data report. Cancer Epidemiology, 39(4), 519-527. [link]

Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30(7): 865- 878. [link]

Keesing, S., Rosenwax, L., & McNamara, B. (2016). A dyadic approach to understanding the impact of breast cancer on relationships between partners during early survivorship. BMC women's health, 16(1), 57.‏‏ [link]

Keyes, C. L. M. (1998). Social well-being. Social Psychology Quarterly, 61(2), 121-140. [link]

Keyes, C. L. M., Magyar-Moe, M., & Jeana, L. (2003). The measurment and utility ofadult subjective well-being .p.411-425 in positive psychological assessment: Handbook of models and measures ,edited by S.J.Lopez and .R. Snyder. Washington, DC: American Psychological Association.

Khanna, A., & Sharma, M. K. (2017). Selfie use: The implications for psychopathology expression of body dysmorphic disorder. Industrial psychiatry journal, 26(1), 106.‏ [link]

Li, Q., & Loke, A. Y. (2014). A systematic review of spousal couple‐based intervention studies for couples coping with cancer: direction for the development of interventions. PsychoOncology, 23(7), 731-739.‏ [link]

 Lisa, B., & David, K. (2017). Anxiety and depression in women with breast cancer. Cancer Forum, 41(1), 55-61. [link]

Littleton, H. L., Axsom, D., & Pury, C. L. S. (2005). Development of the body image concern inventory. Behavior Research and Therapy, 43, 229–241. [link]

Male, D. A., Fergus, K. D., & Cullen, K. (2016). Sexual identity after breast cancer. Current Opinion in Supportive and Palliative Care, 10(1), 66–74. [link]

McDonough, M. H., Sabiston, C. M., & Wrosch, C. (2014). Predicting changes in posttraumatic growth and subjective well-being among breast cancer survivors: the role of social support and stress. Psycho-Oncology, 23, 114–120. [link]

Pearson, A. N., Follette, V. M., & Hayes, S. C. (2012). A pilot study of acceptance and commitment therapy as a workshop intervention for body dissatisfaction and disordered eating attitudes. Cognitive and Behavioral Practice, 19(1), 181-197.‏ [link]

Rost, A. D., Wilson, K. G., Buchanan, E., Hildebrandt, M. J., & Mutch, D. (2012). Improving psychological adjustment among late-stage ovarian cancer patients: Examining the role of avoidance in treatment. Cognitive and Behavioural Practice, 19, 508-517. [link]

Stein, D. J., Kogan, C. S., Atmaca, M., Fineberg, N. A., Fontenelle, L. F., Grant, J. E., Matsunaga, H., Reddy, Y. C. J., Simpson, H. B., Thomsen, P. H., van den Heuvel, O. A., Veale, D., Woods, D. W & Reed, G. M. (2016). The classification of obsessive-compulsive and related disorders in the ICD-11. J Affect Disord, 190, 663–674. [link]

Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet-Tieulent, J., Jemal, A. (2015). Global cancer statistics, 2012. CA: a cancer journal for clinicians, 65(2), 87-108.[link]

Traa, M. J., De Vries, J., Bodenmann, G., & Den Oudsten, B. L. (2014). Dyadic coping and relationship functioning in couples coping with cancer: A systematic review. British Journal of Health Psychology, 20(1), 85-114. [link]

Ussher, J. M., Perz, J., & Gilbert, E. (2012). Changes to sexual well-being and intimacy after breast cancer. Cancer Nurs, 35, 456–465. [link]

Walker, S. S., & Schimmack, U. (2008).Validity of a happiness Implicit Association Test as a measure of subjective well-being. Journal of Research in Personality, 42, 490-497. [link]

 

References (in Persian)

 

Bassak Nejad, s., & Ghafari, M. (2007). Tha relationship between body dysmorphic concern and psychological problems among university students. Journal of behavior science, 1(2), 179-187. [link]

Golestani Bakht, T. (2007). Model of subjective well-being and happiness in Tehran. [PhD Thesis]. Tehran: University of Al-zahra.

Habibollahi, A., & Soltanizadeh, M. (2016). Efficacy of Acceptance and Commitment Therapy on Body Dissatisfaction and Fear of Negative Evaluation in Girl adolescents with Body Dysmorphic Disorder. J Mazandaran Univ Med Sci, 25(134), 278-290. [link]

Narimani, M., Alamdari, E., & Abolghasemi, A. (2015). The Study of The Efficiency of Acceptance and Commitment-Based Therapy on the Quality of Infertile Women’s Life, Family Counseling and Psychotherapy, 4(3), 387-405. [link]                                                        

Narimani,A & Hobbi,M. B. (2018). The effectiveness of acceptance and commitment therapy on marital adjustment in married women, Family Counseling and Psychotherapy, 1, 166-182. [link]

Noruzi, A., Moradi, A., Zamani, K., & Hassani, J. (2017). Comparison the effectiveness of Logotherapy Based on Rumi's Thought with acceptance and commitment therapy on the psychological well-being of elderly. Rph, 11(3), 41-61. [link]

Salehi, R., & Dehshiri, G. (2018). Post-traumatic growth in cancer patients: the role of psychological well-being, spiritual well-being, subjective well-being, and hope. Rph, 12(2), 1-15. [link]

Thoma, N., & Mckey, D. (2015). Working with Emotion in cognitive-behavioral therapy: Techniques for clinical practice. Tehran: Arjmand press