Middle Eastern Journal of Disability Studies

fa بررسی اثربخشی شناخت‌درمانی مبتنی‌بر ذهن‌‌آگاهی بر حس انسجام، دشواری در تنظیم هیجان و کیفیت خواب زنان مبتلا به آسم The Effectiveness of Mindfulness Based Cognitive Therapy on Sense of Coherence, Difficulties in Emotion Regulation, and Sleep Quality in Women with Asthma توانبخشی Rehabilitation مقاله پژوهشی اصیل Original Research Article زمینه و هدف: آسم به‌عنوان بیماری مزمن تنفسی، بر هیجانات و کیفیت زندگی بیماران تأثیرگذار است. این پژوهش باهدف بررسی اثربخشی شناخت‌درمانی مبتنی‌بر ذهن‌آگاهی بر حس انسجام، دشواری در تنظیم هیجان و کیفیت خواب زنان مبتلا به آسم انجام شد. روش‌بررسی: روش پژوهش نیمه‌آزمایشی با طرح پیش‌آزمون و پس‌آزمون همراه با گروه گواه و دورۀ پیگیری سه‌ماهه بود. جامعۀ آماری را تمامی زنان مبتلا به آسم مراجعه‌کننده به کلینیک تخصصی بیماری‌های آلرژی امام علی(ع) شهر کرج در سال ۱۴۰۳ تشکیل دادند. از بین آن‌ها سی‌ بیمار داوطلب، با استفاده از روش نمونه‌گیری هدفمند و با رعایت ملاک‌های ورود، انتخاب و به‌صورت تصادفی در گروه‌های آزمایش و گواه گمارده شدند. گروه آزمایش به‌مدت هشت‌جلسۀ نوددقیقه‌ای برنامۀ شناخت‌درمانی مبتنی‌بر ذهن‌آگاهی را دریافت کرد؛ درحالی‌که گروه گواه در فهرست انتظار ماند. ابزارهای پژوهش، مقیاس حس انسجام (آنتونوفسکی، ۱۹۹۳)، مقیاس دشواری در تنظیم هیجان (گراتز و رومر، ۲۰۰۴) و پرسش‌نامۀ کیفیت خواب (بویس و همکاران، ۱۹۸۹) بود. برای تحلیل داده‌ها از تحلیل واریانس با اندازه‌گیری مکرر و آزمون تعقیبی بونفرونی در سطح معناداری ۰٫۰۵ به‌کمک نرم‌افزار SPSS نسخۀ ۲۵ استفاده شد. یافته‌ها: نتایج نشان داد، اثر گروه، اثر زمان و اثر متقابل زمان و گروه بر حس انسجام، دشواری در تنظیم هیجان و کیفیت خواب معنادار بود (p < ۰٫۰۰۱). همچنین، تفاوت میانگین نمره‌های متغیرهای یادشده، بین مراحل پیش‌آزمون و پس‌آزمون و نیز بین مراحل پیش‌آزمون و پیگیری معنادار بود (p < ۰٫۰۰۱)؛ اما بین مراحل پس‌آزمون و پیگیری تفاوت معناداری مشاهده نشد (p > ۰٫۰۵). نتیجه‌گیری: براساس یافته‌های پژوهش، شناخت‌درمانی مبتنی‌بر ذهن‌آگاهی بر بهبود حس انسجام، دشواری در تنظیم هیجان و کیفیت خواب زنان مبتلا به آسم اثربخشی دارد و این اثرگذاری در طول پیگیری سه‌ماهه ماندگار است. Background & Objectives: Asthma is one of the most common chronic inflammatory diseases of the respiratory system, characterized by reversible airway obstruction, bronchial hyperresponsiveness, and symptoms such as dyspnea, wheezing, and chest tightness. As a chronic condition, asthma has extensive consequences for various dimensions of patients' lives, including psychological, emotional, and social functioning, often leading to a decreased sense of control, increased feelings of helplessness, and diminished mental health. Previous studies have shown that patients with asthma experience higher levels of anxiety, depression, and rumination compared to healthy individuals, which weakens their coping resources. One important construct in explaining this process is the sense of coherence, which represents a global life orientation regarding the extent to which individuals perceive the world as comprehensible, manageable, and meaningful. Furthermore, difficulties in emotion regulation and poor sleep quality are prevalent psychological challenges in this population, significantly affecting disease management and quality of life. The present study aimed to investigate the effectiveness of mindfulness–based cognitive therapy (MBCT) on the sense of coherence, difficulties in emotion regulation, and sleep quality in women with asthma. Methods: This study employed a quasi–experimental pretest–posttest design with a three–month follow–up. The statistical population included all women with asthma who were referred to the Allergy Specialty Clinic of Imam Ali Hospital in Karaj, Iran, in 2024. Among them, 30 participants were selected via purposive sampling according to the inclusion criteria and were randomly assigned to two groups (one experimental group and one control group), with 15 participants in each group. The inclusion criteria were as follows: a confirmed diagnosis of asthma by a pulmonologist; age between 20 and 45 years; the ability to read and write; provision of written informed consent to participate in the study; no use of psychiatric medications; and no concurrent receipt of other psychological treatments, based on self–report. The exclusion criteria included absence from more than two intervention sessions, concurrent participation in other group–based treatments, the need for hospitalization, unwillingness to continue participation, and the need for individual psychotherapy during the intervention period. It should be noted that, in this study, the use of asthma–related medications was kept constant throughout the study period, and participants continued taking their prescribed medications according to their treating physician’s instructions. This procedure was implemented to control the potential effects of medication changes and to ensure that the observed changes in the psychological variables were, to the greatest extent possible, attributable to the mindfulness–based cognitive therapy (MBCT) intervention rather than to changes in asthma pharmacotherapy. The experimental group received eight 90–minute weekly sessions of mindfulness–based cognitive therapy based on the protocol developed by Segal et al. (2002). The control group received no intervention. Data were collected using the Sense of Coherence Scale (Antonovsky, 1993), the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004), and the Pittsburgh Sleep Quality Index (PSQI; Buysse et al., 1989). Data were analyzed using SPSS software, version 25. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to summarize the data. In the inferential statistics section, repeated–measures analysis of variance, the Bonferroni post hoc test, and the chi–square test were used to examine differences between the two groups in terms of demographic variables. The significance level for all statistical tests was set at 0.05. Results: The results showed that the main effects of group and time, as well as the group×time interaction, were significant for the sense of coherence, difficulties in emotion regulation, and sleep quality (p < 0.001). Furthermore, the mean scores of these variables differed significantly between the pretest and posttest, as well as between the pretest and follow–up assessments (p < 0.001). However, no significant differences were observed between the posttest and follow–up assessments (p > 0.05), indicating that the effects of the intervention were maintained during the 3–month follow–up period. Conclusion: Based on the results of the present study, mindfulness–based cognitive therapy improved sense of coherence, reduced difficulties in emotion regulation, and enhanced sleep quality in women with asthma. Therefore, this intervention may be considered to improve these outcomes when designing psychological interventions for patients with asthma. شناخت‌درمانی مبتنی‌بر ذهن‌آگاهی, حس انسجام, دشواری در تنظیم هیجان, کیفیت خواب, آسم Mindfulness–based cognitive therapy, Sense of coherence, Difficulties in emotion regulation, Sleep quality, Asthma 27 0 http://jdisabilstud.org/browse.php?a_code=A-11-4166-1&slc_lang=fa&sid=1 Fakhro Sadat Kazemi فخرالسادات کاظمی fakrosadatkazemi@gmail.com 100319475328460069611 100319475328460069611 No Department of Health and Clinical Psychology, Ka.C., Islamic Azad University, Karaj, Iran گروه روان‌شناسی سلامت و بالینی، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران Sheida Sodagar شیدا سوداگر sh.sodagar@iau.ac.ir 100319475328460069612 100319475328460069612 Yes Department of Health and Clinical Psychology, Ka.C., Islamic Azad University, Karaj, Iran گروه روان‌شناسی سلامت و بالینی، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران Biuok Tajeri بیوک تاجری biuk.tajeri@kiau.ac.ir 100319475328460069613 100319475328460069613 No Department of Health and Clinical Psychology, Ka.C., Islamic Azad University, Karaj, Iran گروه روان‌شناسی سلامت و بالینی، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران Alireza Shokrgozar علیرضا شکرگزار Shokrgozardr@gmail.com 100319475328460069614 100319475328460069614 No Department of Health and Clinical Psychology, Ka.C., Islamic Azad University, Karaj, Iran گروه روان‌شناسی سلامت و بالینی، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران Marzieh Tavakol مرضیه توکل marziyeh.tavakol@yahoo.com 100319475328460069615 100319475328460069615 No Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran مرکز تحقیقات بیماری‌های غیرواگیر، دانشگاه علوم پزشکی البرز، کرج، ایران