Abstract
Background & objective: Aging is a progressive physiological change in an organism that leads to a decline of biological functions and of the organism's ability to adapt to stress. The World Health Organization has pointed out that a world-wide revolution is taking place in demography. Looking at the statistics and figures, the depth, intensity and importance of this issue become more apparent. There are about 600 million older people over 60 in the world, this figure will double by 2025 and will rise to 2 billion by 2050. One of the most debilitating and prevalent diseases in the elderly is blood pressure, which imposes enormous costs on the government. High blood pressure is one of the most common chronic diseases that afflicts a large population and is one of the most serious Psycho-physiological disorders which has attracted a lot of thoughts. In several studies, psychological factors such as depression and anxiety were introduced as risk factors for blood pressure. Depression is one of the most common psychiatry diagnoses that has created a major problem for mental health with its growing trend and prevalence. Among the effective therapies for depression and anxiety due to physical illnesses, stress management via cognitive-behavioral approach has been successfully applied to combine anxiety reduction methods such as muscle relaxation, cognitive rehabilitation, effective coping training, exerting training and anger management to treat emotional and physical problems such as anxiety and depression, insomnia, diabetes, high blood pressure, heart disease, arthritis, AIDS and cancer. Therefore, this study was conducted to evaluate the effectiveness of training cognitive-behavioral stress management techniques on anxiety, depression and blood pressure in elderly people.
Methods: The design of this study was quasi-experimental with pre-test and post-test and control group. The study population consisted of all the elderly people living in the nursing home of district 5 in Tehran, that were in the elderly group list in the year 1395. The sample consisted of 30 people from nursing home living in Mehrban Nursing Home, who were selected by simple random sampling method. In other words, after accessing the centers, due to the extensive aging centers of Tehran, one of the elderly centers of District 5 of Tehran (the Mehrban nursing Center) was selected, which was also the place of study. The following tools were used to collect data: Beck Depression Inventory (BDI-II) and Cattel's Anxiety Scale. The experimental group was trained in cognitive-behavioral stress management approach, and the control group received no intervention. The duration of the treatment sessions consisted of 10 sessions of 60 minutes, performed as a group once a week in the Mehrban nursing home. Single Variable-Covariance Analysis (ANCOVA) was used to test the research hypotheses.
Results: Based on the results of the Ancova test, after neutralizing the pre-test scores, stress management training has a meaningful effect on the anxiety (p<0.001, F(27,1)=16.099), and depression (p<0.001, F(27,1)=66.69) and blood pressure (p<0.001, F(27,1)=23.062).There is a meaningful difference in average moderated scores of anxiety, depression and blood pressure between stress management training groups via cognitive-behavioral approach and in the control group. In other words, these findings indicate a decrease in anxiety, depression and blood pressure in the experimental group compared with the control group. The extent of this effect was 45% for anxiety, 61% for depression and 50% for blood pressure.
Conclusion: A series of training courses presented in form of stress management in a cognitive-behavioral approach have significant positive effects on the reduction of anxiety and depression in the elderly and thereby protecting them from the numerous side-effects of anxiety and depression. Therefore, it can be used as a useful intervention to reduce the components of depression and anxiety and benefit from it in educational and health centers.
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