مقایسه تأثیر روان‌درمانی پویشی- حمایتی و شناختی- رفتاری بر روی افسردگی و تبعیت از درمان در بیماران همودیالیزی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری تخصصی روان‌شناسی سلامت، واحد تربت‌جام، دانشگاه آزاد اسلامی، تربت‌جام، ایران.

2 استادیار گروه روانشناسی سلامت، واحد کاشمر، دانشگاه آزاد اسلامی، کاشمر، ایران.

3 دانشیار گروه طب چینی و مکمل ، دانشکده طب ایرانی و مکمل، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: مطالعه حاضر با هدف مقایسه تأثیر روان‌درمانی پویشی– حمایتی و شناختی– رفتاری بر افسردگی و تبعیت از درمان بیماران همودیالیزی انجام گرفت.
روش کار: پژوهش حاضر  از نوع شبه‌آزمایشی با طرح پیش‌آزمون، پس‌آزمون در دو گروه آزمایش، یک گروه کنترل بود. شرکت‌کنندگان شامل 45 نفر از بیماران همودیالیزی،که 15 نفر در گروه روان‌درمانی پویشی– حمایتی، 15 نفر روان‌درمانی شناختی– رفتاری و 15 نفر دیگر در گروه کنترل بصورت تصادفی قرار گرفتند. درمان در طی 15 جلسه  به صورت فردی برای کلیه بیماران (بجز گروه کنترل) اجرا گردید. ابزارهای اندازه‌گیری شامل دو پرسشنامه افسردگی بک (II) و تبعیت از درمان بیماران مزمن کلیوی (ESRD-AQ) بود. تجزیه و تحلیل آماری داده‌ها نیز با استفاده از نرم افزار SPSS-23 صورت پذیرفت.
نتایج: یافته‌ها در بررسی شاخص‌های چند متغیری و سطح معناداری 001/0 در درمان پویشی - حمایتی اندازه اثر کوتاه‌مدت (پیش‌آزمون- پس‌آزمون)  90/0 و بلندمدت (پیش‌آزمون- پیگیری 4 ماهه) 80/0، در درمان شناختی – رفتاری با همین سطح معناداری، اثر کوتاه‌مدت 61/0 و اثر بلندمدت 39/0 را نشان داد و در نهایت با آزمون بن‌فرونی و با استفاده از پروفایل مقایسه میانگین‌ها اثر کوتاه‌مدت و بلندمدت در درمان پویشی- حمایتی بیشتر ازدرمان شناختی- رفتاری بود.
 نتیجه گیری: درمان پویشی– حمایتی در بهبود علائم افسردگی این بیماران نسبت به درمان شناختی- درمانی مؤثرتر می‌باشد اما در خصوص تبعیت از درمان بین این دو نوع روان‌درمانی تفاوت معناداری یافت نشد.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of the effect of supportive – expressive and cognitive-behavioral psychotherapy on depression and adherence to hemodialysis patients

نویسندگان [English]

  • Mozhgan badiee Aval 1
  • Ali Akbar Samari 2
  • Shapour Badiee Aval 3
1 PhD Student of Health Psychology, Torbat Jam Branch, Islamic Azad University, Torbat Jam, Iran.
2 Assistant Professor, Department of Health Psychology, Kashmar Branch, Islamic Azad University, Kashmar, Iran.
3 Associate Professor, Department of Chinese and Complementary Medicine, Faculty of Iranian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Abstract
Introduction: The aim of this study was to compare the efficacy of supportive- expressive and cognitive - behavioral psychotherapy on depression and adherence to hemodialysis patients.
Materials and Methods: The study had a quasi-experimental design with pretest and post-test.A total of 45 patients undergoing hemodialysis were selected through purposive sampling and randomly allocated to the three study groups. 15 patients were treated by supportive – expressive psychotherapy, 15 patients by cognitive - behavioral psychotherapy and 15 patients were in the control group. The measurement tool was Beck Depression Inventory II and End stage renal disease adherence questionnaire (ESRD-AQ). The data were analyzed through spss-23.
Results: Results in the study of multivariate indicators and significance level of 0.001 in the group of supportive-expressive psychotherapy showed the size of short-term (pre-test-post-test) effect was 0.90 and long-term (pre-test-follow-up for 4 months) was 0.80 and in cognitive-behavioral therapy With the same significance level, the short-term effect was 0.61 and the long-term effect was 0.39, and finally, with the Benfroni test and using the average comparison profile, the short-term and long-term effect in supportive- expressive psychotherapy was higher than cognitive-behavioral therapy.
Conclusion: Supportive-expressive psychotherapy is more effective in improving the depressive symptoms of these patients than cognitive- behavioral psychotherapy, but no significant difference was found between these two types of psychotherapy for adherence.
 

کلیدواژه‌ها [English]

  • Depression
  • Hemodialysis
  • adherence
  • psychotherapy

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 62، شماره 6
بهمن-اسفند98- شماره6-دوره 62
بهمن و اسفند 1398
صفحه 1853-1865

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