Middle Eastern Journal of Disability Studies

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Gohari Nasab A, Seyrafi M R, Kraskian A, Kalhornia Golkar M. Comparing the Effects of Acceptance and Commitment Therapy and Motivation-Based Intervention on Health Anxiety and Treatment Adherence in Patients Undergoing Open-Heart Surgery. MEJDS 2021; 11 :157-157
URL: http://jdisabilstud.org/article-1-1937-en.html

Background & Objectives: Cardiovascular disease is the most common cause of death induced by non–communicable diseases. Cardiovascular disease is linked to other conditions, leading to multiple problems in occupational performance, sleep function, cancer, obesity, and lifestyle. Meanwhile, negative psychological factors, such as depression, anxiety, and hostility, play an essential role in the development and progression of cardiovascular disease. Acceptance and Commitment Therapy (ACT) promotes wellbeing, reduces anxiety, and increases psychological resilience. Another theory that has recently attracted the attention of health researchers to change and manage behavior is the theory of protection motivation. This theory is used to understand and predict health behaviors that protect the individual from harmful events. The present study aimed to compare the effects of ACT and an intervention based on motivational components on health anxiety and treatment adherence in patients who underwent open-heart surgery.
Methods: This was an experimental study with a multi–group pretest–posttest design. The statistical population consisted of all patients with cardiovascular disease in Tehran City, Iran, in 2018. Forty–Five of them were selected by purposive sampling and were divided into two experimental (ACT and intervention based on protective motivation components) and control groups. The study's inclusion criteria were no use of psychotropic drugs, narcotics, and psychological therapies during the study; being over 40 years old and having no acute or chronic mental disorders. The exclusion criteria included not attending more than 2 experimental sessions, unwillingness to continue attending the experimental sessions, severe psychiatric disorder requiring immediate treatment, and using psychotropic drugs or substances. The necessary data were collected using Health Anxiety Inventory (Salkovskis et al., 2002) and Adherence to Treatment Inventory (Seyed Fatemi et al., 2017). ACT was performed in 8 ninety–minute weekly sessions for two months based on Hayes's training package (2005). The intervention based on protective motivation components was performed in 8 ninety–minute weekly sessions for two months based on Norman et al.'s (2005) training package. In addition to using descriptive statistics, including mean and standard deviation, the data were analyzed based on Multivariate Analysis of Covariance (MANCOVA) in SPSS. The Bonferroni post hoc test was also used to compare pairs in groups. The significance level of the tests was considered 0.05.  
Results: The obtained results suggested that by eliminating the effects of pretest, there was a significant difference between the ACT group and group of intervention based on protective motivation components, and the control group in health anxiety (p<0.001) and treatment adherence (p<0.001). There was a significant difference between each of the two experimental groups and the control group respecting health anxiety (p<0.001) and treatment adherence (p<0.001). Furthermore, there was a significant difference between the effectiveness of ACT and intervention based on protective motivation components for health anxiety (p=0.035) and treatment adherence (p=0.014).
Conclusion: According to the present research findings, ACT significantly reduced health anxiety and increased treatment adherence in patients who underwent open-heart surgery, compared to the intervention based on protection motivation components.