مقایسه اثربخشی گروه‌درمانی شناختی-رفتاری مبتنی بر شفقت‌ورزی و ذهن‌آگاهی با و بدون مداخله فیزیوتراپی بر بهزیستی روان‌شناختی و کارکردهای اجرایی سالمندان مبتلا به درد مزمن ناشی از آرتروز

نویسندگان
نسرین بزرگپور نیازی 1
فاطمه شهابی زاده 1
محبوبه فرامرزی 2
1 گروه روانشناسی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران
2 روانشناسی، مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، پزوهشکده سلامت، دانشکاه علوم پزشکی بابل، بابل، ایران.
چکیده
این پژوهش با هدف بررسی اثربخشی درمان شناختی-رفتاری مبتنی بر شفقت‌ورزی و توجه‌آگاهی همراه با فیزیوتراپی بر بهزیستی روان‌شناختی و کارکردهای اجرایی سالمندان مبتلا به درد مزمن ناشی از آرتروز زانو انجام شد. طرح پژوهش از نوع نیمه‌آزمایشی با پیش‌آزمون، پس‌آزمون و پیگیری همراه با گروه کنترل بود. جامعه آماری شامل کلیه سالمندان 60 سال به بالا مبتلا به درد مزمن ناشی از آرتروز بود که به مراکز سلامت مراجعه کرده بودند. نمونه‌گیری به‌صورت هدفمند انجام شد و 45 نفر به‌صورت تصادفی در سه گروه (دو گروه آزمایش و یک گروه کنترل) گمارده شدند. گروه‌های آزمایش مداخلات درمان شناختی–رفتاری مبتنی بر شفقت‌ورزی و توجه‌آگاهی را با یا بدون فیزیوتراپی دریافت کردند. داده‌ها با استفاده از پرسشنامه بهزیستی روان‌شناختی ریف و آزمون عملکرد اجرایی استروپ جمع‌آوری و با تحلیل کوواریانس چندمتغیره و آزمون‌های تعقیبی تحلیل شد.یافته ها نشان داد مداخلات به‌ویژه درمان ترکیبی با فیزیوتراپی، در بهبود معنادار مؤلفه‌های بهزیستی روان‌شناختی (پذیرش خود، روابط مثبت با دیگران، خودمختاری) و کارکردهای اجرایی مؤثر بوده است و این اثرات تا مرحله پیگیری نیز پایدار مانده‌اند. همچنین در مؤلفه‌هایی نظیر رشد فردی، تسلط بر محیط و زندگی هدفمند نیز بهبودهایی مشاهده شد، هرچند تفاوت بین دو گروه آزمایشی در این موارد معنادار نبود. نتایج تحلیل اثر اندازه نیز نشان داد که مداخلات از اثرگذاری بالا و قابل‌توجهی برخوردار بوده‌اند. در مجموع، مداخلات مبتنی بر ترکیب روان‌درمانی و فیزیوتراپی می‌تواند رویکردی اثربخش برای ارتقای سلامت روان و عملکرد شناختی سالمندان مبتلا به درد مزمن باشد.
کلیدواژه‌ها
گروه‌درمانی شناختی-رفتاری
شفقت‌ورزی
توجه‌آگاهانه
بهزیستی روان‌شناختی
کارکردهای اجرایی

عنوان مقاله English

A Comparative Study on the Effectiveness of Compassion-Focused and Mindfulness-Based Cognitive Behavioral Group Therapy with and Without Physiotherapy on Psychological Well-Being and Executive Functions in Elderly Individuals with Chronic Pain Due to Osteoarthritis

نویسندگان English

nasrin bozorgpoor niazi 1
Fatemeh shahabizadeh 1
mahboobeh faramarzi 2
1 Department of Psychology, Bi.C., Islamic Azad University, Birjand, Iran
2 Department of Psychology, Research Center for Social Factors Affecting Health, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
چکیده English

This study aimed to investigate the effectiveness of compassion-focused and mindfulness-based cognitive-behavioral therapy (CBT), combined with physiotherapy, on psychological well-being and executive functions among elderly individuals suffering from chronic pain due to knee osteoarthritis. The research followed a quasi-experimental design with pretest, posttest, and follow-up assessments, along with a control group. The statistical population included elderly individuals over 60 years old diagnosed with chronic osteoarthritic pain, selected through purposive sampling. A total of 45 participants were randomly assigned to two intervention groups and one control group. The intervention groups received compassion-focused and mindfulness-based CBT, either with or without physiotherapy. Data were collected using Ryff’s Psychological Well-Being Scale and the Stroop Executive Function Test and analyzed using multivariate covariance analysis and Bonferroni post hoc tests. Findings indicated that the interventions, particularly the combined CBT with physiotherapy, significantly improved components of psychological well-being (self-acceptance, positive relations with others, autonomy) and executive functions. These effects remained stable at follow-up. Although improvements were observed in personal growth, environmental mastery, and purpose in life, no significant differences were found between the two intervention groups in these dimensions. Effect size analysis suggested a large clinical impact. Overall, the results support the integration of psychotherapy and physiotherapy as an effective approach to promoting mental health and cognitive functioning in elderly patients with chronic pain.

کلیدواژه‌ها English

Cognitive Behavioral Group Therapy
Compassion-Focused Therapy
Mindfulness
Psychological well-being
Executive Functions
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