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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. ‎
     
Type of Study: Original Research Article | Subject: Psychology

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