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۳۱

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سرطان سینه شایع ترین سرطان و دومین علت اصلی مرگ در زنان با بسیاری از عوارض جسمی و روانی است. هدف پژوهش حاضر مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و برنامه کاهش استرس مبتنی بر ذهن آگاهی بر نگرش کژکار، اضطراب سلامت، بهزیستی روانشناختی و تصویر بدنی در زنان مبتلا به سرطان سینه ماستکتومی شده شهر شیراز که در سال 1401 به بیمارستان امیر مراجعه کردند می باشد. آزمودنی شامل یک نمونه 45 نفری که به صورت تصادفی در دو گروه آزمایش و یک گروه کنترل (سه گروه 15نفری) داده ها در دو مرحله پیش آزمون، پس آزمون با گروه کنترل و پیگیری ثبت شد. ابزارهای پژوهش شامل پرسشنامه نگرش کژکار وایزمن و بک، بهزیستی روانشناختی ریف، اضطراب سلامت سالکوسکیس و وارویک و تصویر بدنی کش، میکولاو براون، بود. داده های پژوهش با استفاده از روش کوواریانس چند متغیره و آزمون های تعقیبی شفه و بنفرونی جهت آزمون فرضیه ها استفاده شد و داده ها با استفاده از نرم افزار (spss-18) تجزیه و تحلیل شدند. نتایج نشان می دهد که هر دو روش درمانی بر این متغیرها از نظر آماری اثر معنی داری اعمال کرده اند (P<0.05). یافته ها نشان می دهد میانگین نمره کل اضطراب سلامت، بهزیستی، تصویر بدنی و نگرش کژکاری در گروه کنترل در هر سه مرحله پیش آزمون، پس آزمون و دوره پیگیری، تفاوت چشم گیری نشان نمی دهد اما در گروه آزمایش ACT و MBSR تفاوت های چشم گیری مشاهده می شود. نتایج این تحقیق نشان داد که درمان مبتنی بر پذیرش و تعهد، اثربخشی بیشتری نسبت به برنامه کاهش استرس مبتنی بر ذهن آگاهی دارد، زیرا اصول زیربنایی درمان مبتنی بر پذیرش و تعهد در راستای افزایش انعطاف پذیری روانشناختی می باشد.

Comparing the Effectiveness of Acceptance and Commitment Therapy and Mindfulness-Based Stress Reduction Program on Negative Feedback, Health Anxiety, Psychological Well-Being, and Body Image in Women Undergoing Mastectomy

Introduction Breast cancer is the most common cancer and the second leading cause of death in women with many physical and psychological complications. The increasing growth of cancer in the last few decades and its harmful effects on all dimensions of the patient's life (physical, emotional, spiritual, social, and economic) have caused attention of specialists to be more focused on this disease. Among the different types of cancer that women suffer from, breast cancer is the most common type of cancer in the world. The purpose of this study is to compare the effectiveness of treatment based on acceptance and commitment and the stress reduction program based on mindfulness on the attitude of work, health anxiety, psychological well-being, and body image in women with breast cancer who underwent a mastectomy in Shiraz city who visited Amir Hospital in 2022.    Method The subjects included a sample of 45 people who were randomly divided into two experimental groups and a control group (three groups of 15 people) who had the criteria for entering the research, age, education, and mastectomy surgery, and the data were collected in two stages: pre-test, post-test with the control group and follow-up. And it was recorded that the research data were used using the multivariate covariance method and post hoc tests of Sheffe and Benferoni to test the hypotheses and the data were analyzed using spss (18) software. The research tools included Weissman &, Beck's inefficient Attitudes Questionnaire (1978) attitude questionnaire, Rief's psychological well-being (1989), Salkoskis and Warwick's (2000) health anxiety questionnaire, and Kesh's body image, Mykola Braun (1990).   Results The results of this research showed that the therapy based on acceptance and commitment is more effective than the stress reduction program based on mindfulness because the underlying principles of the therapy based on acceptance and commitment are aimed at increasing psychological flexibility. The pairwise comparison made regarding the well-being variable in Table (4-6) shows that both treatments (ACT and MBSR) have a statistically significant effect on this variable (P<0.05). The results showed that the treatment of acceptance and commitment was more effective. Regarding the effectiveness of the treatment based on acceptance and commitment in comparison with the stress reduction program based on mindfulness in the attitude of work, health anxiety, psychological well-being, and body image in women with cancer. The mastectomy breast of Shiraz can be because the underlying principles of treatment are based on acceptance and commitment to increasing psychological flexibility.   Discussion Acceptance and Commitment Therapy focuses on reducing experiential avoidance and cognitive entanglement with dysfunctional rules until it reconnects with meaningful values. Mediation analysis of the believability of negative thoughts has been identified as a partially mediating factor in the ability to predict awareness attention, experiential avoidance, and cognitive fusion in psychological distress. With stronger negative thoughts, believability was positively associated with higher levels of psychological distress.

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