روان‌شناسی بالینی: نوآوری‌ها در پژوهش و عمل

روان‌شناسی بالینی: نوآوری‌ها در پژوهش و عمل

اثربخشی درمان رفتاری-شناختی بر استرس ادراک‌شده و عملکرد انطباقی بیماران مبتلا به فشار خون بالا

نوع مقاله : مقاله پژوهشی

نویسندگان
عزیز سیفی آوارسین 1
علیرضا پیرخائفی 2
مریم کلهرنیا گلکار 3
1 گروه روانشناسی سلامت، واحد امارات، دانشگاه آزاد اسلامی، دبی، امارات متحده عربی
2 گروه روانشناسی بالینی، واحد گرمسار، دانشگاه آزاد اسلامی، گرمسار، ایران
3 گروه روان‌شناسی، واحد کرج، دانشگاه آزاد اسلامی، کرج، ایران
10.22075/jcp.2024.35094.2964
چکیده
مقدمه: فشارخون بالا به عنوان یک بیماری شایع مزمن، علاوه بر بعد جسمی بر عملکرد روانی بیماران نیز می‌تواند تأثیرگذار باشد. از این‌رو، در پژوهش حاضر، اثربخشی درمان رفتاری-شناختی بر استرس ادراک‌شده و مهارت‌های انطباقی بیماران مبتلا به فشار خون بالا بررسی شد.
مواد و روش‌ها: این پژوهش از نوع نیمه آزمایشی و با طرح پیش‌آزمون، پس‌آزمون و پیگیری سه ماهه بود. نمونۀ آماری شامل 36 نفر از بیماران مبتلا به فشارخون بالا مراجعه کننده به مراکز درمانی شهر تهران در سال 1402 بود که با روش نمونه‌گیری هدفمند برگزیده شده و به صورت تصادفی در دو گروه 18 نفری آزمایش و کنترل جایگزین شدند. ابزار پژوهش، شامل مقیاس‌های استرس ادراک‌شده (PSS) و عملکرد انطباقی (APS) بود.
یافته‌ها: نتایج تحلیل واریانس با اندازه‌گیری مکرر نشان داد که درمان شناختی-رفتاری بعد از آخرین جلسۀ درمان توانست موجب کاهش استرس ادراک‌شده (53/16=F) و افزایش عملکرد انطباقی (15/27=F) در بیماران مبتلا به فشارخون بالا شود. همچنین اثر درمان شناختی-رفتاری پس از سه ماه بعد از آخرین جلسۀ درمان نیز در بیماران ماندگار بود (0/001>P).
نتیجه‌گیری: نتایج حاکی از تأثیر مثبت درمان گروهی شناختی-رفتاری در کاهش فشار روانی و افزایش عملکردهای انطباقی بیماران مبتلا به فشارخون بود. بنابراین پیشنهاد می‌شود در کنار درمان روتین پزشکی، از این روان‌درمانی جهت ارتقای سلامت روان این بیماران استفاده شود.
کلیدواژه‌ها
درمان شناختی-رفتاری
استرس ادراک‌شده
عملکرد انطباقی
فشارخون
موضوعات

عنوان مقاله English

The Effectiveness of Cognitive-Behavioral Therapy on Perceived Stress and Adaptive Performance in Patients with Hypertension

نویسندگان English

Aziz Seyfi Avarsin 1
Alireza Pirkhaefi 2
Maryam Kalhornia-Golkar 3
1 Department of Health Psychology, UAE Branch, Islamic Azad University, Dubai. United Arab Emirates
2 Department of Clinical Psychology, Garmsar Branch, Islamic Azad University, Garmsar, Iran
3 Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
چکیده English

Introduction: Hypertension, as a common chronic illness, can affect not only the physical well-being of patients but also their psychological functioning. Therefore, this study aimed to investigate the effectiveness of cognitive-behavioral therapy (CBT) on perceived stress and adaptive performance in patients with hypertension.
Methods: This semi-experimental study employed a pretest-posttest design with a three-month follow-up. The statistical sample included 36 patients with hypertension who visited medical centers in Tehran in 2023. They were selected through purposive sampling and were randomly assigned to two groups of 18, one experimental and one control group. The research instruments included the Perceived Stress Scale (PSS) and the Adaptive Performance Scale (APS).
Results: The results of repeated measures ANOVA showed that CBT, after the last therapy session, was able to reduce perceived stress (F = 16.53) and increase adaptive performance (F = 27.15) in patients with hypertension. Also, the effect of CBT was also lasting in patients three months after the last therapy session (P < 0.001).
Conclusion: The findings indicate the positive impact of CBT in reducing psychological stress and enhancing adaptive performance in patients with hypertension. Therefore, it is recommended to use this psychotherapy alongside routine medical treatment to improve the mental health of these patients.

کلیدواژه‌ها English

Cognitive-Behavioral Therapy
Perceived Stress
Adaptive Performance
Hypertension

  1. منابع

    1. Crepaldi M, Giannì J, Brugnera A, Greco A, Compare A, Rusconi ML, et al. Predictors of psychological well-being and quality of life in patients with hypertension: a longitudinal study. Healthcare. 2024;12(6):621.
    2. Mancia G, Cappuccio F, Burnier M, Coca A, Persu A, Borghi C, et al. Perspectives on improving blood pressure control to reduce the clinical and economic burden of hypertension. Journal of Internal Medicine. 2023;294(3):251-68.
    3. Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of hypertension in China: results from the China hypertension survey, 2012–2015. Circulation. 2018;137(22):2344-56.
    4. Cai L, Liu Y and He L. Investigating genetic causal relationships between blood pressure and anxiety, depressive symptoms, neuroticism and subjective well-being. General Psychiatry. 2022;35(5):1-6.
    5. Li D, Lv J, Liu F, Liu P, Yang X, Feng Y, et al. Hypertension burden and control in mainland China: analysis of nationwide data 2003–2012. International Journal of Cardiology. 2015;184:637-44.
    6. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the european society of cardiology (ESC) and the European society of hypertension (ESH). European Heart Journal. 2018;39(33):3021-104.
    7. Mahdavi M, Parsaeian M, Mohajer B, Modirian M, Ahmadi N, Yoosefi M, et al. Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines. BMC Public Health. 2020;20:1-9.
    8. Sabetfar N, Meschi F and Hosseinzade Taghvaei M. The effectiveness of mindfulness-based group therapy on perceived stress, emotional cognitive regulation, and self-care behaviors in patients with hypertension. Internal Medicine Today. 2021;27(2):246-63.
    9. Trevisol DJ, Moreira LB, Kerkhoff A, Fuchs SC and Fuchs FD. Health-related quality of life and hypertension: a systematic review and meta-analysis of observational studies. Journal of Hypertension. 2011;29(2):179-88.
    10. Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the european society of cardiology and the european society of hypertension.Manual of Hypertension of the European Society of Hypertension, Third Edition: CRC Press; 2019. p. 543-627.
    11. Ventura HO, Lavie CJ. Impact of comorbidities in hypertension. Current opinion in cardiology. 2016;31(4):374-5.
    12. Li D, Rong C and Kang Q. Association between perceived stress and hypertension in Chinese adults: a population-based survey. Journal of Human Hypertension. 2023;37(4):321-6.
    13. Lu X, Juon H-S, He X, Dallal CM, Wang MQ and Lee S. The association between perceived stress and hypertension among Asian Americans: does social support and social network make a difference? Journal of Community Health. 2019;44:451-62.
    14. Park S-E, So W-Y, Kang Y-S and Yang J-H. Relationship between perceived stress, obesity, and hypertension in Korean adults and older adults. Healthcare. 2023;11(16):2271.
    15. Suls J, Bunde J. Anger, anxiety, and depression as risk factors for cardiovascular disease: the problems and implications of overlapping affective dispositions. Psychological Bulletin. 2005;131(2):260.
    16. Cohen S, Janicki-Deverts D and Miller GE. Psychological stress and disease. Jama. 2007;298(14):1685-7.
    17. Black J, Sweeney L, Yuan Y, Singh H, Norton C and Czuber‐Dochan W. Systematic review: the role of psychological stress in inflammatory bowel disease. Alimentary Pharmacology Therapeutics. 2022;56(8):1235-49.
    18. Stasielowicz L. Adaptive performance in refugees after trauma: How relevant are post-traumatic stress and post-traumatic growth? International Journal of Workplace Health Management. 2022;15(6):711-27.
    19. Park S and Park S. Employee adaptive performance and its antecedents: Review and synthesis. Human Resource Development Review. 2019;18(3):294-324.
    20. Shoss MK, Witt LA and Vera D. When does adaptive performance lead to higher task performance? Journal of Organizational Behavior. 2012;33(7):910-24.
    21. Tuovinen S, Aalto‐Viljakainen T, Eriksson J, Kajantie E, Lahti J, Pesonen AK, et al. Maternal hypertensive disorders during pregnancy: adaptive functioning and psychiatric and psychological problems of the older offspring. BJOG: An International Journal of Obstetrics Gynaecology. 2014;121(12):1482-91.
    22. Mann SJ. Drug therapy for resistant hypertension: simplifying the approach. The Journal of Clinical Hypertension. 2011;13(2):120-30.
    23. Wright R, Roberson K, Onsomu EO, Johnson Y, Dearman C, Carr LTB, et al. Examining the relationship between mindfulness, perceived stress, and blood pressure in African-American college students. Journal of Best Practices in Health Professions Diversity: Research, Education Policy. 2018;11(1):13.
    24. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European society of cardiology (ESC) and the European society of hypertension (ESH). European Heart Journal. 2018;39(33):3021-104.
    25. Kretchy IA, Owusu-Daaku FT and Danquah SA. Mental health in hypertension: assessing symptoms of anxiety, depression and stress on anti-hypertensive medication adherence. International Journal of Mental Health Systems. 2014;8:1-6.
    26. Creswell C, Hentges F, Parkinson M, Sheffield P, Willetts L, Cooper P. Feasibility of guided cognitive behaviour therapy (CBT) self‐help for childhood anxiety disorders in primary care. Mental Health in Family Medicine. 2010;7(1):49.
    27. Wenzel A. Basic strategies of cognitive behavioral therapy. Psychiatric Clinics. 2017;40(4):597-609.
    28. Jiang M, Zhao Q, Li J, Wang F, He T, Cheng X, et al. A Generic review of integrating artificial intelligence in cognitive behavioral therapy. Preprint. 2024;24(7):1-48.
    29. McMain S, Newman MG, Segal ZV and DeRubeis RJ. Cognitive behavioral therapy: current status and future research directions. Psychotherapy Research. 2015;25(3):321-9.
    30. Rawlings GH, Novakova B, Armstrong I and Thompson AR. A systematic review of psychological interventions in adults with pulmonary hypertension: Is the evidence‐base disproportionate to the problem? The Clinical Respiratory Journal. 2023;17(9):966-72.
    31. Xue F, Yao W and Lewin RJ. A randomised trial of a 5 week, manual based, self-management programme for hypertension delivered in a cardiac patient club in Shanghai. Cardiovascular Disorders. 2008;8:1-11.
    32. Liu L, Li M, Song S, Shi A, Cheng S, Dang X, et al. Effects of long-term psychological intervention on blood pressure and health-related quality of life in patients with hypertension among the Chinese working population. Hypertension Research. 2017;40(12):999-1007.
    33. Nolan RP, Feldman R, Dawes M, Kaczorowski J, Lynn H, Barr SI, et al. Randomized controlled trial of e-counseling for hypertension: REACH. Circulation: Cardiovascular Quality Outcomes. 2018;11(7):e004420.
    34. Abgrall-Barbry G and Consoli SM. Psychological approaches in hypertension management. Presse Medicale. 2006;35(6):1088-94.
    35. Cohen S, Kamarck T abd Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behavior. 1983:385-96.
    36. Zarei S and Fooladvand K. The moderating effect of self-differentiation in the relationship between perceived stress and marital adjustment in married nurses. Iranian Journal of Psychiatric Nursing. 2019;7(2):48-55 [in Persian].
    37. Charbonnier‐Voirin A and Roussel P. Adaptive performance: A new scale to measure individual performance in organizations. Canadian Journal of Administrative Sciences. 2012;29(3):280-93.
    38. Hemmati F and Mahdad A. Relationship between ethical leadership and adaptive performance: the mediating role of intrinsic motivation. Ethics in Science and Technology. 2019;13(4):38-44 [in Persian].
    39. Free ML. Cognitive therapy in groups: Guidelines and resources for practice: John Wiley & Sons; 2007.
    40. Adavi A, Fathi R and Medmeli Y. The effectiveness of cognitive-behavioral stress management group intervention on perceived stress in women with hypertension in Masjid Sulaiman in 2013. The 4th Cognitive Behavioral Psychotherapy Conference; 2015; Tehran: Milad Hospital.
    41. Sabetfar N, Meschi F and Hosseinzade Taghvaei M. The effectiveness of mindfulness-based group therapy on perceived stress, emotional cognitive regulation, and self-care behaviors in patients with hypertension. Internal Medicine Today. 2021;27(2):246-63.
    42. Heidaran F, Sajjadian I and Fathi M. Effectiveness of hypnotherapy on the perceived stress and blood pressure in patients with primary hypertension. Medical Journal of Mashhad University Of Medical Sciences. 2017;60(5):669-80 [in Persian].
    43. Salimpour M, Dehghan M, Ahmadi A, Azzizadeh Forouzi M, Roy C, Zakeri MA, et al. Effectiveness of cognitive‐behavioral therapy on perceived stress among patients undergoing percutaneous coronary intervention: A randomized controlled trial. Perspectives in Psychiatric Care. 2022;58(4):2962-9.

    44. Agoha BC, Ogiri SO, Akindele ZA and Ogiri SO. Effectiveness of behavioural therapy on the blood pressure of adults with hypertension: A systematic review in non-african populations. Nigerian Postgraduate Medical Journal. 2020;27(2):76-82

  • تاریخ دریافت 31 مرداد 1403
  • تاریخ بازنگری 07 آذر 1403
  • تاریخ پذیرش 01 بهمن 1403
  • تاریخ اولین انتشار 01 بهمن 1403
  • تاریخ انتشار 01 دی 1403