مقایسه اثربخشی طرحواره درمانی با درمان ذهن آگاهی بر کنترل درد و عملکرد اجرایی در بیماران زن مبتلا به آرتریت روماتوئید

نویسندگان
آمنه فریدونی 1
محمد رجبی 2
علی اکبر صارمی 2
1 دانشجوی دکتری، گروه روانشناسی، واحد تربت جام، دانشگاه آزاد اسلامی، تربت جام، ایران
2 استادیار، گروه روانشناسی، واحد تربت جام، دانشگاه آزاد اسلامی، تربت جام، ایران
چکیده
مقدمه: باتوجه به افزایش روزافزون بیماران آرتریت روماتوئید و مشکلات روانشناختی آن‌ها، هدف پژوهش حاضر مقایسه اثربخشی طرحواره درمانی با درمان ذهن‌آگاهی بر کنترل درد و عملکرد اجرایی در بیماران مبتلا به آرتریت روماتوئید بود.

روش: روش پژوهش حاضر از نوع نیمه‌آزمایشی بود که به صورت پیش‌آزمون و پس‌آزمون، با گروه کنترل و پیگیری 2 ماهه انجام‌شد. جامعه آماری این پژوهش شامل کلیه بیماران 25 تا 55 ساله مبتلا به آرتریت روماتوئید مراجعه‌کننده به درمانگاه روماتولوژی بیمارستان رازی شهر رشت در سال 1401-1400 بود. با استفاده از روش نمونه‌گیری دردسترس و براساس نمره پرسشنامه‌های کنترل درد مک‌گیل (1985) و نقص عملکردهای اجرایی بارکلی (2010) در پیش‌آزمون، 45 نفر از افراد، نمونه آماری را تشکیل دادند که به طور تصادفی در 3 گروه 15 نفره (2 گروه آزمایش و یک گروه کنترل) گزینش‌شدند که برای گروه آزمایشی (A)، طرحواره درمانی و برای گروه دوم (گروه آزمایشی B)، درمان ذهن‌آگاهی را دریافت‌کردند و گروه کنترل (C) در لیست انتظار قرارگرفت.

یافته‎ها: نتایج نشان‌داد که هر دو روش طرحواره درمانی با درمان ذهن‌آگاهی بر کنترل درد و عملکرد اجرایی در بیماران مبتلا به آرتریت روماتوئید موثربودند، اما تفاوت معناداری با یکدیگر نداشتند.

نتیجه‎گیری: بنابراین، می‌توان گفت از هر دو روش طرحواره درمانی و درمان ذهن‌آگاهی می‌توان در جهت افزایش کنترل درد و بهبود عملکردهای اجرایی بیماران آرتریت روماتوئید بهره‌مندشد و هر دو رویکرد روش‌های مطلوبی جهت کاهش مشکلات روانشناختی بیماران خودایمنی همچون آرتریت روماتوئید می‌باشد.
کلیدواژه‌ها
طرحواره درمانی
درمان ذهن آگاهی
کنترل درد
عملکرد اجرایی
آرتریت روماتوئید

عنوان مقاله English

Comparing the Effectiveness of Schema Therapy with Mindfulness Therapy on Pain Control and Executive Function in Female Patients with Rheumatoid Arthritis

نویسندگان English

ameneh fereydoni 1
mohammad rajabi 2
aliakbar daremi 2
1 Department of Psychology, Torbat Jam Branch, Islamic Azad University, Torbat Jam, Iran
2 Department of Psychology, Torbat Jam Branch, Islamic Azad University, Torbat Jam, Iran
چکیده English

Introduction: Due to the increasing number of rheumatoid arthritis patients and their psychological problems, the purpose of this study was to compare the effectiveness of schema therapy with mindfulness therapy on pain control and executive function in female patients with rheumatoid arthritis.

Methods: The current research method was a semi-experimental type, which was conducted as a pre-test, and post-test, with a control group and a 2-month follow-up. The statistical population of this research included all patients aged 25 to 55 with rheumatoid arthritis who were referred to the rheumatology clinic of Razi Hospital in Rasht in 2001-1401. Among the statistical population, using the available sampling method and based on the scores of the McGill pain control questionnaires (1985) and Barclay's executive function deficits (2010) in the pre-test, 45 patients with rheumatoid arthritis who met the inclusion and exclusion criteria formed the statistical sample. These 45 individuals were randomly selected into 3 groups of 15 each (2 experimental groups and one control group) with schema therapy for the experimental group (A) and mindfulness therapy for the second group (experimental group B). Control (C) was placed on the waiting list.

Results: The results showed that both schema therapy and mindfulness treatment were effective for pain control and executive function in female patients with rheumatoid arthritis, but there were no significant differences between each other.

Conclusion: Therefore, it can be said that both schema therapy and mindfulness therapy can be used to increase pain control and improve the executive functions of rheumatoid arthritis patients. Both approaches are effective methods for reducing psychological problems in autoimmune patients such as rheumatoid arthritis.

کلیدواژه‌ها English

Schema therapy
mindfulness therapy
pain control
executive functioning
Rheumatoid Arthritis
1. Hensvold A, Klareskog L. Towards prevention of autoimmune diseases: the example of rheumatoid arthritis. European Journal of Immunology. 2021;51(8):1921-33.
2. Almutairi KB, Nossent JC, Preen DB, Keen HI, Inderjeeth CA. The prevalence of rheumatoid arthritis: a systematic review of population-based studies. The Journal of rheumatology. 2021;48(5):669-76.
3. Kaas J, Tóthová V. Quality of life of patients who suffer from rheumatic arthritis. Kontakt. 2017;19(3):e159-e64.
4. Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nature Reviews Rheumatology. 2020;16(11):645-60.
5. Russell F, McDougall J. Proteinase activated receptor (PAR) involvement in mediating arthritis pain and inflammation. Inflammation Research. 2009;58:119-26.
6. Weisbord SD, editor Patient‐centered dialysis care: depression, pain, and quality of life. Seminars in dialysis; 2016: Wiley Online Library.
7. Daroff RB, Aminoff MJ. Encyclopedia of the neurological sciences: Academic press; 2014.
8. Gatchel RJ, Neblett R, Kishino N, Ray CT. Fear-avoidance beliefs and chronic pain. Journal of Orthopaedic & Sports Physical Therapy. 2016;46(2):38-43.
9. Falasinnu T, Nguyen T, Jiang TE, Tamang S, Chaichian Y, Darnall BD, et al. The problem of pain in rheumatology: variations in case definitions derived from chronic pain phenotyping algorithms using electronic health records. The Journal of Rheumatology. 2024;51(3):297-304.
10. Myasoedova E, Davis III JM, Kronzer VL, Giblon RE, Atkinson EJ, LeBrasseur NK, Crowson CS, editors. The point of no return? Functional disability transitions in patients with and without rheumatoid arthritis: A population-based cohort study. Seminars in arthritis and rheumatism; 2022: Elsevier.
11. Turner KM, Wilcox G, Nordstokke DW, Dick B, Schroeder M, Noel M. Executive functioning in youth with and without chronic pain: A comparative analysis. The Clinical Journal of Pain. 2021;37(2):102-17.
12. Ter-Stepanian M, Grizenko N, Cornish K, Talwar V, Mbekou V, Schmitz N, Joober R. Attention and executive function in children diagnosed with attention deficit hyperactivity disorder and comorbid disorders. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2017;26(1):21.
13. Zelazo P, Qu L, Müller U. Hot and cool aspects of executive function: Relations in early development. Young children's cognitive development: Psychology Press; 2014. p. 71-93.
14. Dovis S, Maric M, Prins PJ, Van der Oord S. Does executive function capacity moderate the outcome of executive function training in children with ADHD? ADHD Attention Deficit and Hyperactivity Disorders. 2019;11(4):445-60.
15. Dalili Z, Bayazi MH. The effectiveness of mindfulness-based cognitive therapy on the illness perception and psychological symptoms in patients with rheumatoid arthritis. Complementary therapies in clinical practice. 2019;34:139-44.
16. Hanson R. Positive neuroplasticity: The neuroscience of mindfulness. Advances in contemplative psychotherapy: Routledge; 2017. p. 48-60.
17. Teasdale JD, Segal ZV, Williams JMG. Mindfulness training and problem formulation. 2003.
18. Roberts RL, Ledermann K, Garland EL. Mindfulness-oriented recovery enhancement improves negative emotion regulation among opioid-treated chronic pain patients by increasing interoceptive awareness. Journal of Psychosomatic Research. 2022;152:110677.
19. Jafarian N, Rezaie A, Izadi F. The Effectiveness of Mindfulness-Based Schema Therapy on Anxiety, Quality of life and Frustration Tolerance of Patients with Multiple Sclerosis. Clinical Psychology and Personality. 2024(Articles in Press).
20. Young JE, Klosko JS, Weishaar ME. Schema therapy: A practitioner's guide: guilford press; 2006.
21. Martin R, Young J. Schema therapy. Handbook of cognitive-behavioral therapies. 2010;317.
22. Tabibzadeh F, Soleimani E, Shiroodi SG. Effectiveness of emotional schema therapy on cancer related fatigue and self-care behaviors in patients with breast cancer. 2022.
23. Usichenko T, Röttenbacher I, Kohlmann T, Jülich A, Lange J, Mustea A, et al. Implementation of the quality management system improves postoperative pain treatment: a prospective pre-/post-interventional questionnaire study. British Journal of Anaesthesia. 2013;110(1):87-95.
24. Vejdan SA, Khosravi M, Naseh G. Post laparoscopic pain control using local anesthesia through laparoscopic port sites. Novelty in Biomedicine. 2014;2(3):102-6.
25. Pirrasoulzadeh M, Dehghanizadeh J. Assessing the Role of Physical Performance and Executive Functioning in Predicting the Quality of Life of Adults With Intellectual Disability in Northwest Iran. Scientific Journal of Rehabilitation Medicine. 2024;12(6):1136-49.
26. Aliakbari M, HassanzadehHanoui M, Alipour A, Bayat N. The efficacy of schema therapy on the inflammation severity in rheumatoid arthritis patients. Rheumatology Research. 2024;9(3):134-42.
27. Hosseini M, Ahadi H, Jomehri F, Kraskian-Mujembari A, Ahadi M. The effectiveness of emotional schemas group therapy on pain and depression in patients with rheumatoid arthritis. Psychological Models and Methods. 2019;10(35):135-19.
28. Pradhan B. Psychiatric aspects in chronic pain and utility of yoga and mindfulness-based cognitive behavioral therapy for pain (Y-MBCT pain) as a translational model. Urogenital Pain: A Clinicians Guide to Diagnosis and Interventional Treatments. 2017:207-35.
29. Castanho BCPC. Cognitive Functional Therapy: A New Approach on Chronic Pain in People with Musculoskeletal Conditions-A Scoping Review. PQDT-Global. 2021.
30. Yousefi S, Zanjani Z, Omidi A, Zamani B, Sayyah M. Comparison of mindfulness-based stress reduction therapy and cognitive-behavioral therapy of chronic fatigue, sleep quality, executive function and disease activity in patients with rheumatoid arthritis. Journal of Contemporary Psychotherapy. 2023;53(2):173-80.
31. Zhou B, Wang G, Hong Y, Xu S, Wang J, Yu H, et al. Mindfulness interventions for rheumatoid arthritis: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2020;39:101088.
32. Martínez E, Aira Z, Buesa I, Aizpurua I, Rada D, Azkue JJ. Embodied pain in fibromyalgia: Disturbed somatorepresentations and increased plasticity of the body schema. PLoS One. 2018;13(4):e0194534.
33. Latz DB. Themes for Christian education and formation in a British, postmodern, secular context. Christian Education Journal. 2018;15(3):378-89.