fa مقایسه اثربخشی شناخت‌درمانی مبتنی بر ذهن‌آگاهی با درمان مبتنی بر پذیرش و تعهد بر فاجعه‌پنداری درد و تاب‌آوری بیماران آسیب طناب نخاعی مديريت درد مزمن Chronic pain managment پژوهشي Original <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Calibri"><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">زمینه و هدف: </span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">هدف پژوهش حاضر مقایسه اثربخشی شناخت‌درمانی مبتنی بر ذهن‌آگاهی با درمان مبتنی بر پذیرش و تعهد بر فاجعه‌پنداری درد و تاب‌آوری بیماران آسیب طناب نخاعی بود.</span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Calibri"><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">مواد و روش‌ها: </span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">روش پژوهش، نیمه‌تجربی با طرح پیش‌آزمون- پس‌آزمون و پیگیری با گروه کنترل بود. جامعه آماری پژوهش را بیماران آسیب طناب نخاعی مراجعه‌کننده به‌مراکز مشاوره بهزیستی شهر تبریز در سال 1400 تشکیل دادند. 45 نفر با استفاده از روش نمونه‌گیری هدفمند انتخاب، و به‌صورت تصادفی در سه گروه قرار گرفتند. گروه‌های آزمایشی، درمان مختص گروه خود را در 8 جلسه 5/1 ساعته دریافت کردند. گروه</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">کنترل</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">درمانی را</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">دریافت</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">نکرد. ابزارهای اندازه‌گیری، پرسشنامه‌های</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">فاجعه‌پنداری درد سالیوان و همکاران و تاب‌آوری کانر و دیویدسون بودند. تجزیه</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">و</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">تحلیل</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">یافته‌ها</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">از</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">طریق</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">آزمون</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">تحلیل</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">واریانس</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">آمیخته</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">با</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">اندازه‌گیری</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">مکرر</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">و آزمون</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">تعقیبی بونفرونی انجام گرفت.</span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Calibri"><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">یافته‌ها: </span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">در پیش‌آزمون، میانگین و انحراف معیار شناخت‌درمانی مبتنی بر ذهن‌آگاهی برای </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">فاجعه‌پنداری درد </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">(63/4</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:Arial">&plusmn;</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">33/38) و برای </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">تاب‌آوری </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">(69/4</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:Arial">&plusmn;</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">80/42)، در </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">درمان</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"> مبتنی بر پذیرش و تعهد برای </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">فاجعه‌پنداری درد </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">(71/4</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:Arial">&plusmn;</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">53/37) و برای </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">تاب‌آوری </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">(57/4</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:Arial">&plusmn;</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">20/42)، و در گروه کنترل برای </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">فاجعه‌پنداری درد </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">(83/4</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:Arial">&plusmn;</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">93/37) و برای </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">تاب‌آوری </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">(60/4</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:Arial">&plusmn;</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">73/43) بود. هر دو درمان در مقایسه با گروه کنترل، </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">فاجعه‌پنداری درد </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">و </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">تاب‌آوری </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">بیماران را در پس&shy;آزمون به‌ترتیب کاهش و افزایش دادند (001/0</span></span></span><span b="" mitra="" style="font-family:">></span><span dir="LTR" new="" roman="" style="font-family:" times="">p</span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">). در مرحله پیگیری، اثر این دو درمان بر </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">فاجعه‌پنداری درد </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">و </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">تاب‌آوری </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">ماندگار بود (001/0</span></span></span><span b="" mitra="" style="font-family:">></span><span dir="LTR" new="" roman="" style="font-family:" times="">p</span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">). تأثیر این دو درمان بر </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">فاجعه‌پنداری درد </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">و </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">تاب‌آوری </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">در مراحل پس‌آزمون و پیگیری یکسان بود (05/0</span></span></span><span new="" roman="" style="font-family:" times=""><</span><span dir="LTR" new="" roman="" style="font-family:" times="">p</span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">).</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Calibri"><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">نتیجه‌گیری: </span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">شناخت‌درمانی مبتنی</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">بر ذهن‌آگاهی</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:">و درمان مبتنی بر پذیرش و تعهد سبب افزایش پذیرش بیماری در بیماران آسیب طناب نخاعی شدند، از این&rlm;رو می&rlm;توانند راهبرد درمانی مفیدی برای ارتقای وضعیت روانی این بیماران تلقی شوند.</span></span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:115%"><span style="font-family:Calibri"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Aims and background:</span></span></span></b> <span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">The aim of the present study was to compare the efficacy of MBCT with ACT on intensity of pain catastrophizing & </span></span></span><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">resilience</span></span></span><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> of patients with spinal cord injury.</span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:115%"><span style="font-family:Calibri"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Material and Methods:</span></span></b> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">The method of this study was semi-experimental with pre-test, post-test and follow up with the control group. The population of the study consisted of patients with spinal cord injury who referred to welfare counseling centers in <st1:city w:st="on"><st1:place w:st="on">Tabriz</st1:place></st1:city> in year <st1:metricconverter productid="2021. In" w:st="on">2021. In</st1:metricconverter> total, 45 people, They were selected by using simple random sampling and randomly divided into three groups. The experimental groups received their group-specific treatment in 8 sessions 1.5 hours. Measuring instruments were pain catastrophizing of sullivan et al and conner and davidson resilience questionnaires. Analysis of findings through repeated measures analysis of variance & Bonferroni post hoc test.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:115%"><span style="font-family:Calibri"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Results</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">:<b> </b>In the pretest, mean and standard deviation of MBCT for </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">pain catastrophizing </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">was (38/33&plusmn;4/63) & for resilience</span></span> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">was (42/80&plusmn;4/69); in ACT for for </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">pain catastrophizing </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">was (37/53&plusmn;4/71) & for resilience</span></span> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">was (42/20&plusmn;4/57); and in the control group for </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">pain catastrophizing </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">was (37/93&plusmn;4/83) & for resilience</span></span> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">was (43/73&plusmn;4/60).<b> </b>Both treatments compared to the control group, reduced </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">pain catastrophizing </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">and increased resilience of patients after the test (p<0.001). In the follow-up phase, the effect of these two treatments on </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">pain catastrophizing</span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> and resilience</span></span> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">was lasting (p<0.001). The effect of these two treatments on </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">pain catastrophizing</span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> and resilience</span></span> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">at posttest and follow-up was not different (p</span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">></span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">0.05).</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:115%"><span style="font-family:Calibri"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Conclusion</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">: MBCT and ACT increased the acceptance of the disease in patients with spinal cord injury; thus, they can be considered useful treatment strategies to improve the mental status of this patients.</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Mitra""></span></span></span></span></span></span><br> &nbsp; ذهن‌آگاهی, درمان مبتنی بر پذیرش و تعهد, فاجعه‌پنداری درد, تاب‌آوری, آسیب طناب نخاعی Mindfulness, Acceptance &, Commitment Therapy, Pain Catastrophizing, Resilience, Spinal Cord Injury 115 131 http://jap.iums.ac.ir/browse.php?a_code=A-10-626-4&slc_lang=fa&sid=1 nasrin Kashefimehr نسرین کاشفی مهر nasrin.khashefimehr@gmail.com 100319475328460018298 100319475328460018298 No Islamic Azad University, East Azarbaijan Science and Research Branch دانشگاه آزاد اسلامی واحد علوم و تحقیقات آذربایجان ‌شرقی Narges Shamesozan نرگس شمع سوزان narges.shamesozan@gmail.com 100319475328460018299 100319475328460018299 No Islamic Azad University, East Azarbaijan Science and Research Branch دانشگاه آزاد اسلامی واحد علوم و تحقیقات آذربایجان ‌شرقی hadi Smkhani akbarinejhad هادی اسمخانی اکبری نژاد hadiakbarinejhad@yahoo.com 100319475328460018300 100319475328460018300 Yes Nabi Akram University دانشگاه نبی اکرم (ص)