نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه روانشناسی بالینی، دانشکده روانشناسی و علوم تربیتی دانشگاه آزاد اسلامی واحد اصفهان(خوراسگان)، اصفهان، ایران

2 ،داگروه روانشناسی بالینی، دانشکده روانشناسی و علوم تربیتی، دانشگاه آزاد اسلامی واحد اصفهان(خوراسگات)، اصفهان، ایران

چکیده

این پژوهش با هدف بررسی اثربخشی شناخت درمانی مبتنی بر ذهن آگاهی بر خستگی، اضطراب و افسردگی کارکنان دارای سندرم خستگی مزمن دانشگاه آزاد اصفهان (خوراسگان) به مرحله اجرا در آمد. روش پژوهش نیمه آزمایشی از نوع پیش آزمون-پس آزمون با گروه کنترل بود. جامعه آماری را کلیه کارکنان دانشگاه آزاد اصفهان(خوراسگان) در سال 1394 شامل می‌شد. بدین منظور 200 نفر از کارکنان براساس جدول کوهن و همکاران، که دارای معیارهای ورود به پژوهش بودند به شیوه تصادفی ساده، انتخاب شدند و به پرسشنامه های علائم دوپال (جیسون و همکاران) و کیفیت زندگی (وار و شربن) پاسخ دادند، سپس 28 نفر که تشخیص سندرم خستگی مزمن را دریافت نمودند به طور تصادفی در گروه آزمایشی و گروه کنترل جایگزین شدند (هر گروه 14 نفر). آزمودنی ها قبل و بعد از مداخله و 1 ماه بعد، در مرحله پیگیری به ابزارهای پژوهش شامل پرسشنامه‌های خستگی(چالدر)، اضطراب و افسردگی بیمارستانی (زیگموند و اسنیث) پاسخ دادند. آزمودنی‌های گروه آزمایش به مدت 8 جلسه 90 دقیقه‌ای تحت شناخت درمانی مبتنی بر ذهن آگاهی قرار گرفتند اما بر گروه کنترل هیچ مداخله ای صورت نگرفت. برای تجزیه و تحلیل داده‌ها از تحلیل کوواریانس چند متغیره استفاده گردید. یافته‌ها حاکی از کاهش میانگین خستگی، اضطراب وافسردگی در گروه آزمایشی نسبت به گروه کنترل، در مراحل پس آزمون و پیگیری بود(05/0p≤). بنابر یافته‌های پژوهش، می‌توان برای کاهش خستگی، اضطراب و افسردگی در کارکنان مبتلا به سندرم خستگی مزمن، از شناخت درمانی مبتنی بر ذهن آگاهی سود جست.

کلیدواژه‌ها

عنوان مقاله [English]

Effectiveness of Mindfulness Based Cognitive Therapy on Fatigue, Anxiety and Depression among Staff with Chronic Fatigue Syndrome

نویسندگان [English]

  • sara taheri 1
  • ilnaz sajjadian 2

1 MA in clinical psychology, Department of psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

2 Department of psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

چکیده [English]

Introduction
Chronic fatigue syndrome is a complex disabling disorder and the symptoms of the disease are common. It can be named as weakness, muscle aches, memory weakness and mental disorientation, insomnia, chest pain, confusion, night sweats, weight loss and psychiatric problems such as depression and early suffering, anxiety, and so on. People with this syndrome, often show the occurrence of a unique fatigue that differs from other symptoms of fatigue. Most patients with diagnostic criteria for chronic fatigue syndrome, also receive some diagnostic criteria for psychiatry, in particular, anxiety and depression disorders.
 
Method
The purpose of this research was to determine the effectiveness of mindfulness-based cognitive therapy on fatigue, anxiety, depression of staff of Islamic Azad university, Isfahan (Khorasgan) branch, suffering from chronic fatigue syndrome. Research method was quasi-experimental with a pre- and post-test design with a control group. For this purpose, 200 staff, according to Cohen et al. (2000), who had entry criteria for research, were selected by a randomized sampling method and responded to chronic fatigue syndrome (Jason, 2010), and quality of life questionnaire (Ware and Hays,1998). Twenty-eight persons who received diagnosis of fatigue syndrome were selected and assigned randomly to experimental and control groups (each group 14 persons). The subjects in the two groups, before and after intervention, and one month later, answered to research instruments, including fatigue scale (Chalder, 1993), hospital anxiety and depression scale (Zigmond and Snaith, 1983). Mindfulness based cognitive therapy was applied to experimental group, in 8 sessions with each session of 90 minutes, but no intervention was carried out in control group.
 
Results
For data analysis, multiple analysis of covariance was used. Findings indicated a reduction in means of fatigue, anxiety and depression in experimental group, in comparison to control group (p ≤ 0.05). Findings indicated that mindfulness-based cognitive therapy has been effective on fatigue, anxiety and depression of staff with chronic fatigue syndrome.
 
Conclusions
Based on the findings of this research, reduction of fatigue, anxiety, and depression in staff suffering from chronic fatigue syndrome, mindfulness-based cognitive therapy can be a useful as intervention.

کلیدواژه‌ها [English]

  • Fatigue
  • Anxiety
  • Depression
  • Chronic fatigue syndrome
  • Mindfulness based cognitive therapy
Aghaei, A., Jalali, D., Hassanzadeh, R., & Aslan, Z. (2011). Prediction of role ambiguity, role conflict, job burnout, and quadruple dimensions of stress overflow in counselors in Isfahan. Counsellors Based on Their Demographic Characteristics, 6 (20), 7-19. [Persian]
Ahmadi, A., Mohammadi Sartang, M., Nooraliee, P., Veisi, M., & Rasouli, J. (2013). Prevalence of anxiety and its relationship with consumption of snacks in high school students in Shiraz. Journal of Shahrekord University of Medical Sciences, 15 (1), 83-90. [Persian]
Barnhofer, T., Crane, C., Hargus, E., Amarasinghe, M., Winder, R., & Williams, M. )2009(. Mindfulness-based cognitive therapy as a treatment for chronic depression: A preliminary study. Behavior Research and Therapy, 47 (5), 366-373.
Bassak Nejad, S., Aghajani Afjadi, A., & Zargar, Y. (2012). The effectiveness of cognitive group therapy based on mindfulness on sleep quality and life quality in female university students. Journal of Psychological Achievements, 18 (2), 181-198.[Persian]
Bayrami, M., Movahedi, Y., & Alizadeh Goradel, J. (2015). The effectiveness of cognition-based mindfulness therapy on the reduction of social anxiety and dysfunctional attitude in adolescents. Journal of Social Cognition, 20 (12), 1-18. [Persian]
Behzadiazad, E., Askary, P.(2018). Effectiveness of Cognitive-Behavioral Therapy on Reduction of Chronic Fatigue and Feelings of Entrapment Among Female Married Employees. Journal of Women and Culture, 9 (36), 75-132. [Persian]
Belankirom, P. (2005). Storeis and analogies in cognitive behaviar theropy. Behavior and Cognitive Psycotheropy, 33 (1), 45-59.
Bond, F. W., Flaxman, P. E., van Veldhoven, M. J., & Biron, M. (2010). The impact of psychological flexibility and acceptance and commitment therapy (ACT) on health and productivity at work. Contemporary Occupational Health Psychology, Global Perspectives on Research and Practice, 1 (1), 296- 313.
Carruthers, B. M., Jain, A. K., De Meirleir, K. L., Peterson, D. L., Klimas, N. G., et al. (2003). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols, Journal of CFS, 11 (1), 7-115.
Chalder, T., Berelowitz, G., & Hirsch, S. (1993). Development of a Fatigue Scale. Journal of Psychosomatic Research. 37 (2), 147-153.
Cohen, L., Monion, L., & Morrison, K. (2000). Research methods in education. Brithitish Journal of Education Studies, 48 (4), 446-446.
Crane, R. (2009). Mindfulness, Based cognitive therapy. New York, Routlege Press page, 18-19.
Dobkin, P. L. (2007). Mindfulness based stress reduction: what processes are at work? Complementary Therapies in Clinical Practice, 14 (1), 8-16.
Farhadi, M., Yarmohamadi Vasel, M., Zoghi Paidar, M. R., & Chegini, A. A. (2017). The efficacy of hypnotherapy based on ego strengthening on treatment of major depression in female‐headed households, Journal of Psychological Achievement, 24 (1), 63-78. [Persian]
Ghamari, H., Dastani, S., & Ghadimi, S. (2014). Effectiveness of the cognitive behavior therapy on reducing depression and obsessive rumination in women with chronic fatigue. Journal of Counseling Research, 13 (50), 101-118. [Persian]
Ghasemi Motlagh, M., Maneshi, Gh. R., Askari, K., & Talebi, H. (2013). The Effectiveness of Mindfulness Based Cognitive Therapy on the Level of Use of Negative Self-Conscious Thoughts in Depressed Patients. Educational Research Center of Islamic Azad University, Bojnourd Branch, 35, 134-121. [Persian]
Graham, L. (2014). NHS Staff Mindfulness (MBCT) Project 2011 to 2014 Large Reductions in Staff Sickness Rates One Year Following MBCT.
Haddadi, M., Zakerian, A., & Mahmoodi, M. (2014). Investigation of Chronic Fatigue Syndrome Questionnaire Validity and Reliability CFS (DSQ Revised). Journal of School of Public Health and Institute of Public Health Research, 12 (1), 75-84. [Persian]
Hanasabzadeh, M., Yazdandoost, R., Asgharnejad-Farid, A., & Gharaee, B. (2011). Mindfulness based cognitive therapy (MBCT) on suicidal depressed patients: A qualitative study. Journal of Behavioral Sciences, 1(1),35-45. [Persian]
Heins, M.J., Knoop, H., Burk, W.J., & Bleijenberg, G. (2013). The process of cognitive behaviour therapy for chronic fatigue syndrome: Which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue? Journal of Psychosomatic Research ,75 (3), 235–241
Institute of Medicine. (2015a). Beyond myalgic encephalomyelitis/chronic fatigue syndrome: Redefining an illness, Washington, DC: The National Academies, Page 2.
Jason, L., Evans, M., & Porter, N., (2010). The development of a revised Canadian myalgic encephalomyelitis hronic fatigue syndrome case definition. Am Journal of Biochem Biotechnol, 6 (2), 120-135.
Jason, L. A., Porter, N., Hunnell, J., Rademaker, A., & Richman, J. A. (2011). CFS prevalence and risk factors over time. Journal of Health Psychology, 16 (3), 445-456.
Kaplan, H. I., & Sadock, B. J. (2015). Synopsis of psychiatry: Behavioral sciences, clinical psychiatry 11th edition. Published by LWW.
Kaviani, H., Javaheri, F., & Bahari, H. (2005). Effectiveness of cognitive therapy based on Anxiety Knowledge (MBCT) is a reduction in your thoughts, negative attitudes, ineffective attitudes and depression. Follow up: 60 days. Journal of Cognitive Science, 1 (7), 49-59. [Persian]
Kaviani, H., Javaheri, F., & Darayeri, H. (2007). Effectiveness of cognitive therapy based on reducing their thoughts, negative, ineffective attitude, depression and anxiety: 60 day follow up. Journal of Cognitive Science, 7 (1), 49-59. [Persian]
Kozak, A. (2008). Mindfulness in the management of chronic pain: Conceptual and clinical considerations. Techniques in Regional Anesthesia and Pain Management, 12 (7), 115-118.
Mahdad, A., Rahimi, R., & Atashpour, S. H. (2011). Comparison of occupational stress and occupational accidents frequency among off Shore and OnShore Oil Industry Employees. Journal of New Discoveries in Psycologie, 6 (19), 53-63. [Persian]
Moghtaderani, K., Kafi, M., Afshar, H., Ariapouran, S., Daghaghzadeh, H., & Pourkazem, T. (2013). Effectiveness of mindfulness-based cognitivegroup therapy on somatic symptoms inwomen withirritable bowel syndrome. Journal of Reserch Behavioral Science, 10 (7), 698-708. [Persian]
Montazeri, A., Vahdaninia, M., Ebrahimi, M., & Jarvandi, S. (2003). The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health and Quality of Life Outcomes, 1, 14. http://doi.org/10.1186/1477-7525-1-14. [Persian]
Narimani, M., Aria Pouran, S., Abolghasemi, A., Ahadi, B. (2011). Comparison of the effectiveness of mindfulness education and exercise setting training on mental health in chemical war veterans, Journal of Clinical Psychology, 2 (4), 61-71. [Persian]
Nasri, S. (2004). Epidemiological study of chronic fatigue syndrome and its relation to psychiatric difficulties in nurses, Journal of Educational Sciences and Psychology, 9 (4), 25-33. [Persian]
Nasri, S., Najarian, B., Mehrabizadeh Harmandand, M., & Shokrushkan, H. (2002). Comparison of the effectiveness of two psychological methods in reducing symptoms of chronic fatigue syndrome in female nurses in Tehran. Journal of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, 2 (1), 53-88. [Persian]
Neff, K. (2010). Self-Compassion and ACT. Weill-Cornell Medical College, American Institute for Cognitive Therapy, University of Texas at Austin.
Rimes, K. A., & Wingrove, J. (2013). Mindfulness-Based Cognitive Therapy for People with Chronic Fatigue Syndrome Still Experiencing Excessive Fatigue after Cognitive Behaviour Therapy: A Pilot Randomized Study, Clinical Psychology Psychotherapy, 20 (2), 107–117.
Risal, A., Manandhar, K., Linde, M., Koju, R., Steiner, T. J., & Holen, A. (2017). Reliability and validity of a Nepali-language version of the Hospital Anxiety and Depression Scale (HADS). Kathmandu University Medical Journal, 13 (2), 115-124
Rostami, R., Moghaddas Tabriz, Y., Dervish Porkakkhi, A., & Montazeri, A. (2012). Effect of exercise training on the quality of life of drug dependent patients under methadone maintenance therapy, Journal of Psychological Research Applicable, 3 (1), 1-11. [Persian]
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse, Guilford Publication.
Sharpe, M. (1996a). Cognitive-behavior therapy forfunctional somatic complaints, the example of chronic fatigue syndrome. Psychosomatics, 38 (4), 350-359.
Sohrabi, F., Jaafarifard, S., Zarei, & Eskandari, H. (2013). The effectiveness of mindfulness-based cognitive therapy on panic disorder "case study”. Journal of Clinical Psychology, 3 (4), 31-40. [Persian]
Surawy, C., Hackmann, A., Hawton, K., & Sharpe, M. (1995). Chronic fatigue syndrome: A cognitive approach. Behavior Research and Therapy, 33 (5), 535–544.
Teasdale, J. D., Williams, J. M., Segal, Z. V., & Soulsby, J. (2000). Mindfulness – based cognitive therapy reduces over general autobiographical memory in for merely depressed patients. Journal of Abnormal Psychology, 109 (1), 150-155.
Tyler, P. (1976). Institute of Psychiatry Maudsley Monograph 23, The role of bodily feeling in anxiety. Oxford: Oxford University Press.
Valentine, S., Godkin, L., & Varca, Ph. L. (2010). Role conflict, mindfulness, and organizational ethics in an education-based health care institution. Journal of Business Ethics, 94 (3), 455–469.
Ware, J. E., & Sherburne, C. D. (1992). The MOS 36-item Short-Form Health Survey (SF-36): Onceptual framework and item selection. Medical Care, 30, 473–483.
Williams, K. A., Kolar, M. M., Reger, B. E., & Pearson, C. (2001). Evaluation of a wellness-based mindfulness stress Reduction intervention: A controlled trial. Journal of US National Library of MedicineNational Institutes of Health, 15 (6), 422-432.
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, Mindfulness Based Cognitive Therapy for Chronic Fatigue Syndrome, 117 Copyright. Journal of Acta Psychiatrica Scandinavica, 67 (6), 361–370.