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Jamshid Hashemi; Majid Safarinia; Ahmad Alipour
Abstract
Objective: Postmenopausal women with irritable bowel syndrome have more severe symptoms of the condition than premenopausal women. It can also be said that, in addition to experiencing problems caused by menopause, such as hot flashes and a decrease in hormone levels, these women may experience more ...
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Objective: Postmenopausal women with irritable bowel syndrome have more severe symptoms of the condition than premenopausal women. It can also be said that, in addition to experiencing problems caused by menopause, such as hot flashes and a decrease in hormone levels, these women may experience more perceived stress than they did before menopause and when they did not have irritable bowel syndrome. Research has shown that women with irritable bowel syndrome experience higher levels of perceived stress, and stress in patients is one of the main reasons for the onset and continuation of the disease. Regarding the logical and scientific reasons for comparing these two treatments, it can be said that when one treatment can be identified as more effective than the other among the different and effective therapeutic approaches and interventions in terms of empirical studies, it can help psychologists and therapists who work in the field of reducing the problems of these patients to use the results of such research to determine which type of treatment is more effective. For this reason, this research has practical implications in this field for psychologists and therapists. The purpose of this study was to The compare the effectiveness of cognitive-behavioral therapy and hypnotherapy on perceived stress in postmenopausal women with irritable bowel syndrome. Method: This semi-experimental study was conducted with a pretest-posttest design with control group and follow-up 2 month. The statistical population of the research was all w postmenopausal women with irritable bowel syndrome of Tehran city in winter of year 2025. Then the number of 45 women patients diagnosed irritable bowel syndrome were randomly divided into two groups, including an cognitive-behavioral therapy group (15 women), hypnotherapy group (15 women) and a control group (15 women). Then the first experimental group underwent 8 sessions of 90 minute cognitive-behavioral therapy and the second experimental group underwent 8 sessions of 90 minute of hypnotherapy. To collect data perceived stress scale (PSC) of Cohen et al (1983). Menopause (permanent cessation of menstrual cycle), diagnosis of irritable bowel syndrome based on a specialist physician's diagnosis, and having at least a diploma degree were the criteria for inclusion in the study. Also, absence of more than 2 sessions in treatment sessions, simultaneous participation in other courses and therapeutic interventions concurrently with the study were the criteria for exclusion from the study. Explaining the objectives of the study to the participating women and providing intensive intervention sessions to the control group were the ethical principles observed in this study. Analysis of variance with repeated measures and Bonferroni post hoc test was used for data analysis. The data analysis software was SPSS version 28. Results: The mean and standard deviation of age in cognitive-behavioral therapy were 57.20 and 4.61; the mean and standard deviation in the hypnotherapy group were 61.07 and 5.34; and the mean and standard deviation of age in the control group were 60.80 and 5.02. The F statistic obtained from comparing the means of the 3 groups in the age variable was F = 2.96, which was not statistically significant (sig = 0.063), indicating that the 3 groups were similar in terms of age. The Chi-Square analysis statistic obtained from comparing the frequency and percentage of the 3 groups of postmenopausal women with irritable bowel syndrome in the education variable was Chi-Square = 4.68, which was not statistically significant (sig = 0.585), indicating that the three groups of women were similar in terms of education. Based on the results, cognitive-behavioral therapy and hypnotherapy had an effect on perceived stress and its dimensions in the post-test phase, and its therapeutic effects were persistent and stable after 2 months. The results also showed that the mean difference between the cognitive-behavioral therapy group and the control group was greater than the mean difference between hypnotherapy and the control group, which indicates that cognitive-behavioral therapy is more effective than hypnotherapy on perceived stress in postmenopausal women with irritable bowel syndrome. Conclusion: When people perceive a situation as an imminent threat (such as entering menopause and experiencing irritable bowel syndrome), stress becomes harmful. However, if they view it as a challenge, it becomes more manageable. By participating in cognitive-behavioral therapy sessions, these women learn to reduce their perceived stress by developing a calmer, more balanced approach to the stressors related to their illnesses and conditions and by changing the way they think about stress. But why cognitive-behavioral therapy has become more effective than hypnotherapy can be explained by the fact that, despite the efficiency and effectiveness of hypnotherapy, it is used less frequently for patients with irritable bowel syndrome. This may be due to a lack of interest on the part of doctors in using hypnotherapy to treat the problems of people with irritable bowel syndrome. It is also likely that this attitude is shared by the general public and some patients with irritable bowel syndrome. There were limitations in conducting the present study, the selection of a sample from Tehran requires caution in generalizing the findings. The limited data collection tool to a questionnaire and the lack of use of other measurement tools are other limitations and problems of this study. This is because there is a possibility that there is bias in the responses of postmenopausal women with irritable bowel syndrome, because the criterion for selecting the disease was the diagnosis of a specialist physician and the type of severity of the disease was not specified. Due to time constraints, this study was unable to conduct a longer-term follow-up phase to examine the continuity and durability of the effects of cognitive-behavioral therapy and hypnotherapy, and was limited to a two-month follow-up measurement phase. Based on the results of the present study, it can be said that cognitive-behavioral therapy and hypnotherapy can be used as a treatment method to on perceived stress in postmenopausal women with irritable bowel syndrome and priority of use in perceived stress women with postmenopausal women with irritable bowel syndrome is with cognitive-behavioral therapy.
