Abstract: (1841 Views)
Abstract
Background & Objective: Chronic diseases, including thalassemia, occur in all age groups, socioeconomic classes, and cultures. Thalassemia is a chronic and life-threatening disorder that limits the quality of life of patients and affects them clinically, their children and families are exposed to a variety of emotional and behavioral problems, stress and psychological problems can reduce the strength of the immune system and disrupt the central and organic nervous system. It is so important to pay more attention to these psychological states because the reduction of mortality of thalassemia and the increase of life expectancy of these patients, the reduction of stress and anxiety are among the most effective factors in health care. Acceptance and commitment therapy, which is formed from the development of cognitive therapy, is the third type of this therapy and aims to provide mental flexibility and improve physical and psychological problems. The present study tries to examine the effectiveness of acceptance and commitment therapy on reducing distress in students with thalassemia.
Methods: This study is a quasi-experimental study with two groups of pre-test and post-test, and follow-up with the control group. The statistical population includes 209 patients with thalassemia who were treated at the Center for Special Diseases in Zabol. The participants were selected based on inclusion criteria such as medical diagnosis, Patient tests available in the file and the student studying and residing in this city. Those, who had mental retardation and other mental and behavioral disorders, were excluded from the study. 30 qualified people, participated voluntarily in the study, were randomly divided into experimental group and control group (15 participants each). The experimental group was trained by acceptance and commitment therapy (ACT) during ten 90-minute sessions and after the completion of the course, the post-test was performed and one month later the follow-up sessions were held. The Kessler Psychological Distress Scale (K-10) were used to collect data. Data were analyzed by ANOVA test with repeated measures using Spss-23 software.
Findings: In comparison with post-test, the mean of distress has increased in the experimental group increased, and this change was more stable in the post-test than in the follow-up while their scores in the control group faced fewer changes than those in the control group; therefore, ANOVA test with repeated measures was used to determine differences in inferential statistics. To perform the ANOVA test with repeated measures, its aspects were first examined. Kolmogorov-Smirnov test was used to inspect the normality of the data and the results showed that the score distribution of distress was normal in pre-test and post-test. Levene's test was used to determine the homogeneity of variances. The results confirmed the homogeneity of variances of distress. Also, the results of Box's M test showed the covariances were homogeneous. Therefore, the ANOVA test with repeated measures could be performed. First, Mauchly's sphericity was examined and then the level of Greenhouse–Geisser estimate of epsilon was evaluated. Analysis of variance (ANOVA) was used to examine the repeated measures (2× 3 design) to examine the significant differences between the means of the two groups. Mauchly's sphericity test was significant (P = 0.001). Also, the results of Greenhouse-Geisser Estimate Epsilon showed that the Epsilon level is less than 0.75; therefore, Feldt-Huynh correction was used. Considering the effect of time between the three periods (i.e. pre-test, post-test, and 3-month follow-up period), there was a significant difference in distress (P≥0.05). Also, the findings showed that acceptance and commitment therapy (ACT) training has been effective in reducing distress in students with thalassemia in two stages of post-test and follow-up.
Conclusion: The findings showed that acceptance and commitment therapy (ACT) training has been effective in reducing distress in students with thalassemia in two stages of post-test and follow-up. It also indicated that the Ministry of Education should provide some workshops on this therapy for the counselors and psychologists in the schools and the families of students with this disease to reduce disorders such as distress.