fa اثربخشی درمان مبتنی بر پذیرش و تعهّد (ACT) بر اجتناب تجربه‌ای و پذیرش بیماری در افراد مبتلا به مولتیپل-اسکلروزیس (MS) تخصصي Special پژوهشي Research <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مولتیپل</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">&shy;</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اسکلروزیس</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> (</span></span><span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">MS</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">) </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">زمرۀ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بیماری</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">&shy;</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">های</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">خاص،</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> یک </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اختلال</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">التهابی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مزمن و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">حادّ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">سیستم</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اعصاب</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مرکزی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">است</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">که</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">با</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تظاهرات</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">کلینیکی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">ناتوانی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">عصبی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">شدید</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">همراه است. </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">درمان </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مبتنی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بر</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پذیرش</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> و تعهّد یکی از درمان&shy;های موج سوم است که</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> در جمعیت پزشکی، به منظور</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">کمک</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">افراد</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مقابله</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">با</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">استرسِ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بیماری</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">&shy;</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">های</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">جسمانی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مورد</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">توجه</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">قرار</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">گرفته</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:12.0pt;">‌</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">است</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">. </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پژوهش حاضر با هدف ارزیابی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اثربخشی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">درمان</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مبتنی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بر</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پذیرش</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تعهّد</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> (</span></span><span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">ACT</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">) </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بر</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اجتناب</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تجربه&shy;ای</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پذیرش</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بیماری</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">افراد</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مبتلا به</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مولتیپل</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">&shy;</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اسکلروزیس</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> (</span></span><span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">MS</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">) انجام گرفت. </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">جامعۀ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">آماری</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مطالعۀ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">حاضر</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">شامل</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">کلیۀ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">افراد</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مبتلا به</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مولتیپل</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اسکلروزیس</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">استان</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">آذربایجان</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">شرقی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">سال</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> 95 </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بود.</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> 30 </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نفر</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">از</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بین</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مراجعه</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">&shy;</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">کنندگان</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">انجمن</span></span> <span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">MS</span></span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">روش</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نمونه</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">&shy;</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">گیری هدفمند</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> انتخاب </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">صورت</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">انتساب</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تصادفی</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">دو گروه</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">آزمایش</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> (15 </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نفر</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">) </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">گروه</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">کنترل</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> (15 </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نفر</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">) قرار گرفتند. گروه آزمایش بصورت هفتگی، 10 جلسه درمان </span></span><span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">ACT</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> دریافت- کردند. ابزار جمع</span></span><span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">‌</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">آوری اطّلاعات، </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پرسشنامۀ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پذیرش</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مولتیپل</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اسکلروزیس (</span></span><span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">MSAQ</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">)</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پذیرش</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">عمل</span></span> <span style="font-family:times new roman,serif;"><span style="font-size:12.0pt;">&ndash;</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نسخۀ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">دوم (</span></span><span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">AAQ-II</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">)</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> بود. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;در این پژوهش از </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تحلیل</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">واریانس</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> با اندازه&shy;گیری&shy;های مکرر </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">آمیخته</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> (</span></span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:12.0pt;">ANOVA</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">) </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">استفاده</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">&shy; </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">شد</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تجزیه</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تحلیل</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">داده</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">&shy;</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">های</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مزبور</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">وسیله</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">برنامۀ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">آماری</span></span> <span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">SPSS₂₁</span></span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">انجام</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">گرفت</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">. </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نتایج</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">حاصل</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">از</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تحلیل</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">واریانس</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نشان</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">داد</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">که</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نمرۀ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پذیرش</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بیماری</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">دو</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مرحلۀ</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پس</span></span><span dir="LTR"><span style="font-family:aparajita,sans-serif;"><span style="font-size:12.0pt;">&shy;</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">آزمون</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پیگیری</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> در گروه آزمایش </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">طور</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">معناداری</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">افزایش</span></span> <span style="font-family:b nazanin;"><span style="font-size:12.0pt;">داشته</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:12.0pt;">‌</span></span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">است</span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">. بنابراین </span></span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">شایسته به نظر می&shy;رسد که علاوه بر مشکلات جسمانی این جمعیت، به مسائل روانشناختی آنها نیز توجه شود و در کنار دارودرمانی، درمان&shy;های روانشناختی و از جمله رویکرد درمانی پذیرش و تعهّد، مدّ نظر قرار گیرد.&nbsp;&nbsp;&nbsp; </span></span> <p>Multiple Sclerosis (MS) is a severe and chronic inflammatory disorder of the central nervous system in which clinical manifestations and extreme neurological disabilities are presented. Acceptance and Commitment Therapy (ACT) is a third wave treatment option used in medical populations to help patients cope with the physical stress of diseases. The present study aimed to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance and eexperiential avoidance in patients suffering from multiple sclerosis (MS). The population of this study included all patients suffering from multiple sclerosis (MS) in East Azerbaijan province in 2016. Among them, 30 patients referred to the MS Society were selected through purposive sampling and then randomly assigned into two experimental (n=15) and control (n=15) groups. The experimental group received 10 sessions of ACT intervention. Multiple Sclerosis Acceptance Questionnaire (MSAQ) and the second version of the Acceptance and Action Questionnaire (AAQ-ii) were used as data collecting tools.&nbsp; Analysis of variance combined with mixed-design repeated measures (ANOVA) was used and data was analyzed using SPSS₂₁ software. The findings of the study revealed that the score of disease acceptance both in post-test and in follow-up increased significantly in the experimental group. Thus, it is important to pay attention to psychological and physical problems in this clinical population. Furthermore, it would be beneficial to offer, along with medication, psychological treatments including ACT to these patients.<br> <span dir="RTL"></span></p> درمان پذیرش و تعهد (ACT), پذیرش, اجتناب, مولتیپل اسکلروزیس (MS) Acceptance and Commitment Therapy (ACT), acceptation, Avoidance , Multiple Sclerosis (MS) 63 72 http://bjcp.ir/browse.php?a_code=A-10-2158-1&slc_lang=fa&sid=1 Razieh Pak راضیه پاک pak0312606@gmail.com 10031947532846004406 10031947532846004406 No Azarbaijan shahid madani university گروه روانشناسی، دانشگاه شهید مدنی آذربایجان Reza Abdi رضا عبدی r.abdi@azaruniv.ac.ir 10031947532846004407 10031947532846004407 Yes Azarbaijan shahid madani university گروه روانشناسی، دانشگاه شهید مدنی آذربایجان Gholamreza chalbianloo غلامرضا چلبیانلو Chalabianloo@azaruniv.ac.ir 10031947532846004408 10031947532846004408 No Azarbaijan shahid madani university گروه روانشناسی، دانشگاه شهید مدنی آذربایجان