fa تعیین اثربخشی روان‌درمانی مبتنی بر پذیرش و تعهد (‌Act‌) بر کاهش پریشانی ‌دانش‌آموزان مبتلابه تالاسمی روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article <strong><span dir="RTL">چکیده</span></strong><br> <strong>زمینه و هدف</strong>: تالاسمی از شایع‌ترین اختلالات تک ژنی می&shy;باشد، گرفتاری و عوارض ناشی از آن که تمام سیستمهای بدن را درگیر می&shy;کند و در کمتر بیماری دیگری دیده شده و مانند هر بیماری مزمن دیگری سلامت روانی شخص را تحت تأثیر قرار میدهد. هدف از این پژوهش بررسی اثربخشی روان‌درمانی مبتنی بر پذیرش و تعهد بر کاهش پریشانی در دانش‌آموزان مبتلابه تالاسمی بود. <span dir="LTR"></span><br> <strong>روش بررسی</strong>: پژوهش حاضر از انواع طرح های نیمه آزمایشی به صورت دو گروهی، با پیش‌آزمون - پس‌آزمون و پیگیری با گروه گواه بود. جامعه آماری&nbsp; 209 نفر از افراد مبتلابه تالاسمی شهر زابل که در مرکز بیماران خاص شهر زابل تحت درمان قرار داشتند بودند، نمونه پژوهش شامل 30 نفر بود که با درنظرگرفتن حداقل نمونه در طرح های آزمایشی و به روش داوطلب واجد شرایط انتخاب شدند وبه طور تصادفی در&nbsp; دو گروه 15 نفری آزمایش و گواه&nbsp; تقسیم شدند. آموزش‌ روان درمانی مبتنی بر پذیرش و تعهد به ‌مدت 10 جلسه 90 دقیقه‌ای‌ روی گروه ‌آزمایش‌ اجرا ‌شد‌ و‌ پس از ‌اتمام ‌جلسات ‌پس‌آزمون و یکماه بعد دوره پیگیری اجرا ‌شد و از پرسشنامه پریشانی روانشناختی کسلر(2003) ‌برای‌ جمع‌آوری‌ اطلاعات ‌استفاده ‌شد. تجزیه و تحلیل داده‌ها با تحلیل آزمون اندازه&shy;گیری مکرر و با استفاده از نرم افزار <span dir="LTR">Spss-23</span>در سطح معناداری 05/0 انجام شد.<br> <strong>یافته&shy;ها: </strong>نتایج نشان داده است که آموزش مبتنی بر پذیرش و تعهد موجب کاهش پریشانی در دانش‌آموزان مبتلابه تالاسمی شد (001/0 <span dir="LTR">P&le;</span>). علاوه بر این با توجه به اثر زمان (پیش آزمون، پس آزمون و دورۀ پیگیری) بین سه دورۀ زمانی در تحمل پریشانی تفاوت معناداری وجود داشت(001/0&ge;<span dir="LTR">P</span>). علاوه بر این اثر متقابل بین زمان اندازه&shy;گیری و گروه نیز بر میانگین نمرات تحمل پریشانی دانش آموزان تالاسمی معنادار بود(001/0&ge;<span dir="LTR">P</span>). اندازۀ اثرنشان داد که 67/0&nbsp; از تغییرات نمرۀ پریشانی &nbsp;به واسطه آموزش پذیرش و تعهد تبیین شد.&nbsp;<br> <strong>نتیجه گیری:</strong> بر اساس یافته های این پژوهش آموزش روان‌درمانی مبتنی بر پذیرش و تعهد بر کاهش تحمل پریشانی در دانش‌آموزان مبتلابه تالاسمی در مرحله پس آزمون و پیگیری مؤثر بوده است .<br> <strong>کلید واژه&shy;ها: </strong>پذیرش و تعهد ، پریشانی و تالاسمی.<br> &nbsp; <strong>Abstract</strong><br> <strong>Background & Objective: </strong>Chronic diseases, including thalassemia, occur in all age groups, &lrm;socioeconomic &lrm;classes, and cultures. Thalassemia is a chronic and life-threatening disorder that &lrm;limits the quality &lrm;of life of patients and affects them clinically, their children and families are &lrm;exposed to a variety &lrm;of emotional and behavioral problems, stress and psychological problems can &lrm;reduce the strength &lrm;of the immune system and disrupt the central and organic nervous system. It &lrm;is so important to &lrm;pay more attention to these psychological states because the reduction of &lrm;mortality of thalassemia &lrm;and the increase of life expectancy of these patients, the reduction of &lrm;stress and anxiety are &lrm;among the most effective factors in health care. Acceptance and &lrm;commitment therapy, which is &lrm;formed from the development of cognitive therapy, is the third &lrm;type of this therapy and aims to &lrm;provide mental flexibility and improve physical and &lrm;psychological problems. The present study &lrm;tries to examine the effectiveness of acceptance and &lrm;commitment therapy on reducing distress in students with thalassemia. &lrm;&lrm;<br> <strong>Methods:</strong> This study is a quasi-experimental study with two groups of pre-test and post-test, and &lrm;&lrm;follow-up with the control group. The statistical population includes 209 patients with &lrm;&lrm;thalassemia who were treated at the Center for Special Diseases in Zabol. The participants were &lrm;&lrm;selected based on inclusion criteria such as medical diagnosis, Patient tests available in the file &lrm;&lrm;and the student studying and residing in this city. Those, who had mental retardation and other &lrm;&lrm;mental and behavioral disorders, were excluded from the study. 30 qualified people, participated &lrm;&lrm;voluntarily in the study, were randomly divided into experimental group and control group (15 &lrm;&lrm;participants each). The experimental group was trained by acceptance and commitment therapy &lrm;&lrm;&lrm;(ACT) during ten 90-minute sessions and after the completion of the course, the post-test was &lrm;&lrm;performed and one month later the follow-up sessions were held. The Kessler Psychological Distress Scale (K-10) were used &lrm;&lrm;to collect data. Data were analyzed by ANOVA test with repeated measures using Spss-23 &lrm;&lrm;software.&lrm;<br> <strong>Findings:</strong> In comparison with post-test, the mean of distress has &lrm;&lrm;increased in the experimental group increased, and this change was more stable in the post-test &lrm;&lrm;than in the follow-up while their scores in the control group faced fewer changes than those in &lrm;&lrm;the control group; therefore, ANOVA test with repeated measures was used to determine &lrm;&lrm;differences in inferential statistics. To perform the ANOVA test with repeated measures, its &lrm;&lrm;aspects were first examined. Kolmogorov-Smirnov test was used to inspect the normality of the &lrm;&lrm;data and the results showed that the score distribution of distress was &lrm;&lrm;normal in pre-test and post-test. Levene&#39;s test was used to determine the homogeneity of &lrm;&lrm;variances. The results confirmed the homogeneity of variances of distress. Also, the results of Box&#39;s M test showed the covariances were homogeneous. Therefore, &lrm;&lrm;the ANOVA test with repeated measures could be performed. First, Mauchly&#39;s sphericity was &lrm;&lrm;examined and then the level of Greenhouse&ndash;Geisser estimate of epsilon was evaluated. Analysis &lrm;&lrm;of variance (ANOVA) was used to examine the repeated measures (2&times; 3 design) to examine the &lrm;&lrm;significant differences between the means of the two groups. Mauchly&#39;s sphericity test was &lrm;&lrm;significant (P = 0.001). Also, the results of Greenhouse-Geisser Estimate Epsilon showed that the &lrm;&lrm;Epsilon level is less than 0.75; therefore, Feldt-Huynh correction was used. Considering the &lrm;&lrm;effect of time between the three periods (i.e. pre-test, post-test, and 3-month follow-up period), &lrm;&lrm;there was a significant difference in distress (P&ge;0.05). Also, the &lrm;&lrm;findings showed that acceptance and commitment therapy (ACT) training has been effective in &lrm;&lrm;reducing distress in students with thalassemia in two stages of post-&lrm;&lrm;test and follow-up.&lrm;<br> <strong>Conclusion:</strong> The findings showed that acceptance and commitment therapy (ACT) training has &lrm;&lrm;been effective in reducing distress in students with thalassemia in two &lrm;&lrm;stages of post-test and follow-up. It also indicated that the Ministry of Education should provide &lrm;&lrm;some workshops on this therapy for the counselors and psychologists in the schools and the &lrm;&lrm;families of students with this disease to reduce disorders such as distress. &lrm; پذیرش و تعهد , پریشانی , تالاسمی Keywords: Acceptance and Commitment, distress, Thalassemia ‎ 0 0 http://jdisabilstud.org/browse.php?a_code=A-10-1857-2&slc_lang=fa&sid=1 Mahmoud shirazi محمود شیرازی mshirazi@edpsy.usb.ac.ir 100319475328460039566 100319475328460039566 Yes mostafa okati مصطفی اوکاتی mostafa.okati@gmail.com 100319475328460039567 100319475328460039567 No Gholamreza Sanagouye Moharar غلامرضا ثناگوی محرر Reza.sanagoo@gmail.com 100319475328460039568 100319475328460039568 No