Middle Eastern Journal of Disability Studies

fa اثربخشی روش بازسازی شناختی بر کانون کنترل سلامت و خودمراقبتی در زنان مبتلا به فشارخون بالا Effects of Cognitive Restructuring on Health Control and Self-Care in Women With Hypertension روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article زمینه و هدف: لازمهٔ کمک به افراد مبتلا به فشارخون بالا برای حل مشکلات مربوط به این بیماری، شناخت عوامل مؤثر بر کانون کنترل سلامت و خودمراقبتی این افراد است که می‌توان با استفاده از رویکردهای مختلف به بهبود آن‌ها پرداخت؛ بنابراین هدف از انجام پژوهش حاضر، تعیین اثربخشی روش بازسازی شناختی بر کانون کنترل سلامت و خودمراقبتی در زنان مبتلا به فشارخون بالا بود. روش‌بررسی: روش پژوهش حاضر نیمه‌آزمایشی، از نوع پیش‌آزمون و پس‌آزمون و پیگیری با گروه گواه بود. جامعهٔ آماری پژوهش را تمامی زنان مبتلا به فشارخون بالا مراجعه‌کننده به کلینیک تخصصی قلب و عروق فرشچیان شهر همدان در سال ۱۳۹۸ تشکیل دادند. حجم نمونهٔ آماری ۳۰ نفر شامل دو گروه ۱۵نفری (گروه آزمایش و گروه گواه) بود که به‌صورت نمونه‌گیری دردسترس و داوطلبانه انتخاب شدند و به‌صورت تصادفی در دو گروه قرار گرفتند. آموزش گروهی در بازسازی شناختی طی دوازده جلسهٔ ۹۰دقیقه‌ای براساس بستۀ آموزشی لارسون و همکاران (۲۰۱۶) انجام شد. داده‌ها با استفاده از مقیاس چندوجهی منبع کانون کنترل سلامت (والستون و همکاران، ۱۹۷۶) و پرسشنامهٔ خلاصۀ فعالیت‌های خودمراقبتی دیابت (توبرت و همکاران، ۲۰۰۰) جمع‌آوری شد. در تجزیه‌و‌تحلیل داده‌ها از آزمون‌های آماری تحلیل واریانس با اندازه‌گیری مکرر و آزمون تعقیبی بونفرونی با کمک نرم‌افزار SPSS نسخهٔ ۲۲ استفاده شد. یافته‌ها: نتایج تحقیق نشان ‌داد که آموزش بازسازی شناختی بر کانون کنترل ‌سلامت (۰٫۰۰۱<p) و مؤلفه‌های آن شامل سلامت درونی، سلامت افراد مؤثر و سلامت مربوط به شانس (۰٫۰۰۱<p) و همچنین خودمراقبتی (۰٫۰۰۱<p) در زنان مبتلابه فشارخون بالا اثربخش‌ بود و تغییر ایجادشده در مرحلهٔ پیگیری همچنان پایدار بود (۰٫۰۵<p). نتیجه‌گیری: براساس یافته‌های این پژوهش می‌توان نتیجه گرفت، روش بازسازی شناختی بر کانون کنترل سلامت و خودمراقبتی در زنان مبتلا به فشارخون بالا مؤثر است. <div style="text-align: justify;">Background & Objectives: Cognitive Restructuring (CR) consists of a set of techniques that teach individuals to consider their assumptions about situations and the world and to make their ideas more realistic and wiser. Self–care is among the main aspects of a health–oriented lifestyle and health–promoting behaviors. Self–care is a self–developed activity for the normal protection of biopsychological health. Hypertension is a symptom characterized by an increase in systemic arterial pressure. Numerous studies have been conducted in this field. It is necessary to assist individuals with hypertension to solve problems related to their condition. It is essential to recognize the factors affecting the health control and self–care of this population to improve those using different approaches. The current study aimed to determine the effects of CR on health control and self–care in women with hypertension. Methods: This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population of the study included all women with hypertension referring to Farshchian Cardiovascular Clinic in Hamadan City, Iran, in 2019. The sample size equaled 30 individuals who were assigned into two groups of experimental and control (n=15/group). The study subjects were selected by convenience sampling method and participated voluntarily in the study. The inclusion criteria of the research were minimum education of diploma, providing informed consent forms for participation in the research, the lack of mental health disorders (based on medical records), and receiving no other psychological interventions. The exclusion criteria were the existence of mental health disorders requiring immediate treatments (e.g., psychotic symptoms) and substance dependence (based on medical records). Group CR training was performed in twelve 90–minute sessions based on Larson et al.'s training package (2016). The required data were collected using the Multidimensional Health Locus of Control Scale (MHLC) (Walston et al., 1976) and the Summary of Diabetes Self–Care Activities Measure (Toobert et al., 2000). The obtained data were analyzed using repeated–measures Analysis of Variance (ANOVA) and Bonferroni post hoc test in SPSS. Results: The collected results suggested that ANOVA data were significant for the within–subject factor (time) of self–care (p<0.001) and for between–subject (p<0.001) factors. Besides, respecting internal health, ANOVA data were significant for within–subject (time) (p<0.001) and between–subject (p<0.001) factors. In addition, ANOVA data were significant concerning health for within–subject (time) (p<0.001) and between–subject (p<0.001) factors. The health–related variable ANOVA results were significant for within–subject (time) (p<0.001) and between–subject (p<0.001) factors. The Bonferroni test data revealed that the test group’s self–care scores were higher in the posttest stage, compared to those of the pretest (p<0.05). Furthermore, the follow–up scores of self–care significantly differed from those of the pretest stage (p<0.05); however, there was no significant difference between the values of the posttest and follow–up in this respect (p>0.05). Additionally, the experimental group’s pretest scores of internal health were higher than those of the pretest (p<0.05); internal health scores presented a significant difference between the pretest and follow–up stages (p<0.05). However, there was no significant difference between the scores of the posttest and follow–up in this area (p>0.05). The test group’s posttest scores of health were higher than those of the pretest (p<0.005); the same values presented a significant difference between the follow–up and pretest stages (p<0.05). However, there was no significant difference between the two stages of the posttest and follow–up in this regard (p>0.05). The experimental group’s posttest scores of health were lower than those of the pretest (p<0.05); the same value suggested significant differences between follow–up and pretest stages in this aspect (p<0.05). Moreover, the health–related scores of the follow–up stage were significantly different from those of the pretest stage (p>0.05).    Conclusion: Based on the current research findings, CR was effective in health control and self–care in women with hypertension.</div> روش بازسازی شناختی, کانون کنترل سلامت, خودمراقبتی, زنان مبتلا به فشارخون بالا. Cognitive restructuring, Health control center, Self–Care, Women, Hypertension. 191 191 http://jdisabilstud.org/browse.php?a_code=A-10-2174-1&slc_lang=fa&sid=1 Maedeh Ashrafi مائده اشرفی dr.maedehashrafi@gmail.com 100319475328460052087 100319475328460052087 No Department of Psychology, Kish International Branch, Islamic Azad University گروه روان‌شناسی، واحد بین‌المللی کیش، دانشگاه آزاد اسلامی Farhad Jomehri فرهاد جمهری farhadjomehri@yahoo.com 100319475328460052088 100319475328460052088 Yes Department of Psychology, Allameh Tabatabai University گروه روان‌شناسی، دانشگاه علامه طباطبائی Mojgan Niknam مژگان نیکنام nikname@riau.ac.ir 100319475328460052089 100319475328460052089 No Department of Psychology, Roodehen Branch, Islamic Azad University گروه روان‌شناسی، واحد رودهن، دانشگاه آزاد اسلامی Amin Rafieipour امین رفیعی‌پور Rafiepoor@pnu.ac.ir 100319475328460052090 100319475328460052090 No Department of Psychology, Payame Noor University of Tehran گروه روان‌شناسی، دانشگاه پیام‌نور تهران