Middle Eastern Journal of Disability Studies

fa بررسی اثربخشی گروه‌درمانی دیالکتیکی بر بهبود نشانگان روان‌شناختی و کیفیت زندگی بیماران مبتلا به پرفشاری خون Determining the Effect of Dialectical Group Therapy on the Improvement of Psychological Symptoms and the Quality of Life of Hypertensive Patients روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article چکیده زمینه و هدف: فشارخون بالا می‌تواند نارسایی‌هایی در افراد ایجاد کند یا حتی با بیماری‌های قلبی‌عروقی همراه شود؛ درواقع این موضوع یکی از معضلات بهداشتی‌‌درمانی در کشورهای صنعتی و درحال توسعه است. پژوهش حاضر با هدف بررسی اثربخشی گروه‌درمانی دیالکتیکی بر بهبود نشانگان روان‌شناختی و کیفیت زندگی بیماران مبتلا به پرفشاری خون انجام شد. روش‌بررسی: پژوهش حاضر به‌شیوهٔ نیمه‌آزمایشی با طرح پیش‌آزمون و پس‌آزمون همراه با گروه گواه بود. از بین ۸۷ بیمار مبتلا به پرفشاری خون داوطلب واجد شرایط، سی نفر به‌شیوهٔ نمونه‌گیری هدفمند و براساس نمونه‌گیری تصادفی در دو گروه آزمایش و گواه (هر گروه پانزده‌ نفر) قرار گرفتند. ابزارهای استفاده‌شده پرسش‌نامهٔ افسردگی بک (بک و همکاران، ۱۹۶۰)، پرسش‌نامهٔ اضطراب بک (بک و استیر، ۱۹۹۰)، پرسش‌نامهٔ کیفیت زندگی سازمان بهداشت جهانی (سازمان بهداشت جهانی، ۱۹۹۶) و پروتکل رفتاردرمانی دیالکتیکی (لینهان، ۱۹۹۳) بود. برای تحلیل نتایج از آزمون تحلیل کوواریانس یک‌راهه استفاده شد. تجزیه‌وتحلیل داده‌ها در نرم‌افزار SPSS نسخهٔ ۲۲ انجام گرفت و سطح معناداری ۰٫۰۵ در نظر گرفته شد. یافته‌ها: نتایج حاکی‌از تفاوت معنادار بین دو گروه در مرحلهٔ پس‌آزمون در متغیرهای افسردگی، اضطراب، کیفیت زندگی و فشارخون بود )۰٫۰۰۱(p<. نتیجه‌گیری: براساس نتایج مطالعه، برای کاهش نشانگان روان‌شناختی (افسردگی و اضطراب) و افزایش کیفیت زندگی بیماران مبتلا به پرفشاری خون می‌توان از روش گروه‌درمانی دیالکتیکی سود جست. Abstract Background & Objectives: Dialectical behavior therapy is an evidence-based psychotherapy that was introduced as an attempt to treat personality disorders and interpersonal conflicts. There is evidence that dialectical behavior therapy can be useful in treating mood disorders, suicidal thoughts, as well as changing behavioral patterns such as self-harm and substance use. Blood pressure is one of the vital signs of a person's health. High blood pressure can lead to various health issues, and individuals may not live more than a few years. High blood pressure can cause malfunctions in people or even be associated with cardiovascular diseases. This issue is one of the health treatment problems in industrialized and developing countries. Problems such as anxiety and depression, and in the long term, these psychological problems become mental problems and reduce the person's quality of life. Therefore, it is very necessary to investigate treatments that can affect the psychological issues of people with high blood pressure, along with medical treatments. The present study was conducted to examine the effectiveness of dialectical group therapy on improving psychological symptoms and quality of life of patients with hypertension. Methods: The present study was a quasi-experimental study with a pretest and posttest design and a control group. The statistical population of the study consisted of all patients with hypertension referring to the Zahedan City Health Center, Iran. Out of 87 eligible volunteer hypertensive patients, 30 were randomly assigned to two experimental and control groups (15 people in each group) by purposive sampling. The instruments used were the Beck Depression Inventory (Beck et al., 1960), the Beck Anxiety Inventory (Beck and Steer, 1990), the World Health Organization Quality of Life Inventory (World Health Organization, 1996), and the Dialectical Behavior Therapy Protocol (Linehan, 1993). Experts confirmed the validity of the questionnaire, and the Cronbach alpha was used to examine the reliability, yielding values of 0.86, 0.92, and 0.77, respectively. The experimental group received dialectical behavior therapy for 90 minutes for 8 weeks (one session per week) according to the following content. The validity of the program content was examined using reliable sources of similar research and was approved by experts in the field of psychology for this research project. A 1-way analysis of covariance test was used to analyze the results. Data analysis was performed in SPSS version 22 software, and a significance level of 0.05 was considered. Results: Descriptive statistics showed that the scores of the subjects in the experimental group decreased compared to the control group in both depression and anxiety variables, and increased in the quality of life variable. However, no significant change was observed in the control group. The results of multivariate covariance analysis showed that dialectical behavior therapy has a significant effect on at least one of the variables of depression and anxiety in the experimental group (P≤0.001). The eta coefficient was 0.949. Dialectical behavior therapy has reduced depression and anxiety in people with high blood pressure; more precisely, dialectical behavior therapy has played a role in reducing depression by 96.2% and in reducing anxiety by 93.7%. (P≤0.001). The results of univariate covariance analysis showed that dialectical behavior therapy has a significant effect on the quality of life variable in the experimental group (P≤0.001). The eta coefficient was 0.914. The difference in the mean of posttests between the experimental and control groups in the quality of life variable is significant (P≤0.001). Therefore, it can be said that dialectical behavior therapy has increased the quality of life in people with high blood pressure. To be more precise, dialectical behavior therapy contributed 91.4% to improving quality of life. Conclusion: According to the results of the study, dialectical group therapy can be used to reduce psychological symptoms (depression and anxiety) and increase the quality of life of patients with hypertension. رفتاردرمانی دیالکتیکی, افسردگی, اضطراب, کیفیت زندگی Dialectical therapeutic behavior, Depression, Anxiety, Quality of life 50 50 http://jdisabilstud.org/browse.php?a_code=A-12-3411-1&slc_lang=fa&sid=1 Safora Asif Mehr صفورا آصف مهر saforaasefmher98@gmail.com 100319475328460066729 100319475328460066729 No PhD Student, Educational Psychology Department, Birjand Islamic Azad University, Birjand, Iran دانشجوی دکترا، گروه روان‌شناسی تربیتی، دانشگاه آزاد اسلامی بیرجند، بیرجند، ایران Abdul Majid Bahrainian عبدالمجید بحرینیان majidbahrainian@gmail.com 100319475328460066730 100319475328460066730 Yes Professor, Department of Psychology, Shahid Beheshti University of Tehran, Tehran, Iran استاد، گروه روان‌شناسی، دانشگاه شهید بهشتی تهران، تهران، ایران Fatima Shahabizadeh فاطمه شهابی زاده f_shabizadeh@yahoo.com 100319475328460066731 100319475328460066731 No Associate Professor, Department of Psychology, Birjand Islamic Azad University, Birjand, Iran دانشیار، گروه روان‌شناسی، دانشگاه آزاد اسلامی بیرجند، بیرجند، ایران