Middle Eastern Journal of Disability Studies

fa اثربخشی درمان مبتنی بر پذیرش و تعهد بر اضطراب، افسردگی و شاخص‌های چربی خون بیماران دیابتی نوع دو The Effectiveness of Acceptance and Commitment Therapy on Anxiety, Depression, and Lipid Profile of Patients with Type 2 Diabetes روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article زمینه و هدف: دیابت بیماری‌ای شایع، بدخیم و پیش‌رونده‌ است. افراد مبتلا در طی درمان و متعاقب آن اختلالات جسمی و عاطفی متعددی را تجربه می‌کنند؛ لذا هدف از پژوهش حاضر تعیین اثربخشی درمان مبتنی بر پذیرش و تعهد بر اضطراب، افسردگی و شاخص‌های چربی خون بیماران دیابتی نوع دو بود. روش بررسی: این مطالعه پژوهشی نیمه‌آزمایشی از نوع پیش‌آزمون پس‌آزمون با گروه گواه بود. جامعهٔ پژوهش، تمامی افراد مبتلا به دیابت نوع دو مراجعه‌کننده به کلینیک دیابت شهر بیرجند در بهار سال ۱۳۹۸ بودند که ۴۰ نفر داوطلب واجد شرایط انتخاب و به صورت گمارش تصادفی به دو گروه بیست نفری آزمایش و گواه تقسیم شدند. مداخلهٔ پذیرش و تعهد طی هشت جلسهٔ نود دقیقه‌ای انجام شد. اطلاعات از طریق تکمیل خرده‌مقیاس‌های اضطراب و افسردگی لاویبوند و لاویبوند (۱۹۹۵) و اندازه‌گیری شاخص‌های چربی خون قبل از مداخله و بعد از آن جمع‌آوری گردید. داده‌ها با استفاده نرم‌افزار SSPS نسخهٔ ۲۲ و آزمون تحلیل کوواریانس تک‌متغیری و چندمتغیری در سطح معناداری ۰٫۰۵= α تجزیه‌وتحلیل شد. یافته‌ها: پس از مداخله، نمرات افسردگی، اضطراب و شاخص‌های چربی در گروه آزمایش در مقایسهٔ با گروه گواه به‌طور معناداری کاهش یافت (۰٫۰۰۱>p). نتیجه‌گیری: بر اساس یافته‌های این پژوهش درمان مبتنی بر پذیرش و تعهد بر کاهش اضطراب، افسردگی و شاخص‌های چربی بیماران دیابتی نوع دو مؤثر می‌باشد. پیشنهاد می‌گردد درمان مذکور به‌عنوان درمان مکملی در سایر بیماری‌های روان‌تنی استفاده شود. Background & Objective: Diabetes is one of the most common chronic metabolic diseases characterized by abnormalities in carbohydrate, protein, and fat metabolism. The most common symptoms are glucose intolerance or hyperglycemia, which causes short– and long–term complications of diabetes. Diabetes is a metabolic disorder characterized by insulin deficiency and secretion. Diabetes consists of two types, type 2 and type 1. In type 2 diabetes or non–insulin dependent diabetes, the produced insulin by the pancreas does not work well. Diabetes occurs when the pancreas does not release enough insulin or the secreted insulin does not work properly. Reports indicate an increase in the prevalence of type 2 diabetes in developing countries by 4%. The disease alone caused 4.9 million deaths worldwide in 2014, and it is estimated that by the year 2030, Iran will become one of the most populous countries in the world in terms of diabetes. In the etiology of type 2 diabetes, the role of environmental factors is prominent. Studies have shown that complications are common in these patients, especially long–term complications such as cardiac, ophthalmic, and renal, as well as psychological problems in personal, family, and social relationships. Treating all these problems has a high cost, both directly and indirectly, for the patients and the government. Among the most important complications are psychological disorders (anxiety and depression) that negatively affect the patient's ability to perform and maintain recommended medical care. On the one hand, the psychological problems of chronic diseases, including diabetes, which are often overlooked, highlight the need for more attention to appropriate treatment. One of the treatments is Acceptance and Commitment Therapy (ACT). This therapy belongs to the third wave of cognitive–behavioral therapies that enhances one's psychological well–being rather than changing cognitions. Therefore, the present study aimed to determine the effectiveness of ACT on anxiety, depression, and blood lipid profile of patients with type 2 diabetes. Methods: This study was a quasi–experimental study with a pretest–posttest design and a control group. The study population consisted of all type 2 diabetic patients referred to Birjand Diabetes Clinic in the spring of 2010. A total of 40 patients were selected and randomly assigned into two groups of 20 experimental and control groups. The ACT intervention was performed in eight 90–minute sessions. Data were collected by completing the Anxiety and Depression Scale (Levibond and Lovebond, 1995) and measuring blood lipid indexes before and after the intervention. Ethical considerations included accepting volunteer members in the group counseling sessions, willingly completing the questionnaires by the samples, proper scheduling of meetings, and keeping the information and names of individuals in the study confidential. It is worth noting that this study was approved by the Ethics Committee of Birjand University of Medical Sciences under code Ir.Mums.REC.1398.189. Data analysis was performed by calculating mean and standard deviation in the descriptive part and univariate and multivariate analysis of covariance in the inferential part in SPSS version 22. The significance level was considered at α=0.05. Results: After the intervention, depression and anxiety scores and lipid indices were significantly decreased in the experimental group compared to the control group (p<0.001). The Eta coefficients for the depression variable (0.220), the anxiety variable (0.0301), total cholesterol (0.257), triglyceride (0.397), LDL–cholesterol (0.184), and HDL–cholesterol (0.171) indicated the efficacy of ACT in reducing anxiety, depression and lipid profile in type 2 diabetic patients. Conclusion: The results showed that after the intervention, the anxiety, depression, and lipid profile in type 2 diabetic patients were significantly reduced in the experimental group compared to the control group. So, it is recommended that this treatment be used as a complementary treatment for other psychosomatic diseases. درمان مبتنی بر پذیرش و تعهد, اضطراب, افسردگی, شاخص‌های چربی خون, دیابت نوع دو Acceptance and commitment therapy, Anxiety, Depression, Lipids, Type 2 diabetes 125 125 http://jdisabilstud.org/browse.php?a_code=A-10-1811-1&slc_lang=fa&sid=1 Elahe Khosravani الهه خسروانی e.khosravaani@gmail.com 100319475328460061959 100319475328460061959 No Islamic Azad University, Zahedan Branch دانشکدهٔ روان‌شناسی و علوم تربیتی، دانشگاه آزاد اسلامی، واحد زاهدان Gholam Reza Sanagouye Moharer غلامرضا ثناگوی محرر e.khosravaani@gmail.com 100319475328460061960 100319475328460061960 Yes Islamic Azad University, Zahedan Branch گروه روان‌شناسی، دانشگاه آزاد اسلامی، واحد زاهدان Mahmood Shirazi محمود شیرازی e.khosravaani@gmail.com 100319475328460061961 100319475328460061961 No University of Sistan and Baluchestan گروه روان‌شناسی، دانشگاه سیستان و بلوچستان Mrayam Rezaei مریم رضایی e.khosravaani@gmail.com 100319475328460061962 100319475328460061962 No Birjand University of Medical Sciences دانشگاه علوم پزشکی، بیرجند