نوع مقاله : علمی- پژوهشی

نویسندگان

• زهرا دهقانی ¹
• زهرا مردانی ²
• حسن رضوانیان ³

¹ کارشناسی ارشد، گروه روان‌شناسی، دانشگاه پیام نور، تهران، ایران.

² استادیار، گروه روانشناسی، دانشگاه پیام نور، تهران، ایران.

³ ستاد دانشکده پزشکی، گروه غدد و متابولیسم، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

چکیده

مقدمه: دیابت نوع 2 گونه‌ای اختلال سوخت‌و‌سازی مزمن است که عامل بسیاری از مرگ‌و‌میرهای حال حاضر جهان بشمار ‍‌می‌رود. هدف مطالعه‌ حاضر بررسی اثربخشی درمان متمرکز بر شفقت بر بهبود تبعیت از درمان و چربی خون (کلسترول، تری‌گلیسیرید، LDL وHDL) در بیماران مبتلا به دیابت نوع 2 بود.
روش: این مطالعه نیمه‌آزمایشی با گروه گواه و طرح پیش‌آزمون، پس‌آزمون و پیگیری سه‌ماهه بود. جامعه آماری پژوهش شامل بیماران مبتلا به دیابت نوع 2 مراجعه کننده به مرکز تحقیقات غدد و متابولیسم اصفهان در پاییز سال 1400 بودند که 46 نفر آنان به روش نمونه‌گیری هدفمند انتخاب شده و به طور تصادفی در  دو گروه گواه (23 نفر در هر گروه) قرار  گرفتند. اعضای گروه آزمایش تحت هشت جلسه درمان متمرکز بر شفقت (دو جلسه 90 دقیقه‌ای در هفته) و گروه گواه در انتظار مداخله آموزشی قرار گرفتند. پرسشنامه‌ تبعیت از درمان مدانلو (1392) و نیز ارزیابی چربی خون توسط پزشک متخصص برای هر دو گروه در مراحل پیش‌آزمون، پس‌آزمون و پیگیری سه ماهه انجام شد. داده‌ها با استفاده از تحلیل واریانس مختلط بین- درون آزمودنی‌ها (تحلیل واریانس با اندازه‌گیری مکرر) در نسخه‌ 24 نرم‌افزارSPSS مورد تجزیه و تحلیل قرار گرفت.
یافته‌ها: یافته‌ها حاکی از بهبود تبعیت از درمان (132/36=F و001/0=P) و متعادل شدن سطوح چربی خون (تری‌گلیسرید، کلسترول، LDL و(HDL گروه آزمایش در مقایسه با گروه گواه و همچنین پایداری نتایج در مرحله پیگیری (306/70=F و001/0=P) بود.
نتیجه‌گیری: درمان متمرکز بر شفقت با بهره‌گیری از فنونی مانند صندلی خالی و نوشتن نامه‌های شفقت‌آمیز دارای کارایی بالینی مناسبی برای بهبود تبعیت از درمان و متعادل کردن چربی خون در بیماران مبتلا به دیابت نوع 2 به شمار می‌رود.

کلیدواژه‌ها

• تبعیت از درمان
• چربی خون
• درمان متمرکز بر شفقت
• دیابت نوع 2

موضوعات

• مداخلات روانشناختی در سلامت و بیماریها

عنوان مقاله [English]

The Effectiveness of Compassion Focused Therapy on Improving Treatment Adherence & Blood Lipids (Cholesterol, Triglycerides, LDL & HDL) in Patients with type 2 Diabetes

نویسندگان [English]

• Zahra Dehghani ¹
• Zahra Mardani ²
• Hasan Rezvanian ³

¹ M.A, Department of Psychology, Payame Noor University, Tehran, Iran.

² Assistant Professor, Department of Psychology, Payame Noor University, Tehran, Iran.

³ Professor of Faculty of Medicine, Department of Endocrinology and Metabolism, Isfahan University of Medical Sciences, Isfahan, Iran

چکیده [English]

Objective: Chronic diseases, including diabetes mellitus, have become increasingly prevalent, posing significant physical, psychological, and economic challenges. Type 2 diabetes, accounting for approximately 90% of diabetes cases, is characterized by insulin resistance and impaired insulin production. In Iran, over 1.5 million individuals are affected by diabetes, a condition associated with a doubled risk of mood disorders. To comprehensively address this complex issue, a biopsychosocial model has been adopted to explain the disease and its contributing factors. Adherence to diabetes treatment (The degree to which a patient follows a prescribed healthcare plan, including taking medications as directed, attending follow-up appointments, and making lifestyle changes) is crucial, yet it varies widely among patients, ranging from 23% to 93%.    Non-adherence is associated with increased health risks and hospitalizations. Furthermore, diabetic patients often experience elevated cholesterol levels, emphasizing the importance of effective management. Psychological interventions, such as Compassion-Focused Therapy (CFT is a therapeutic approach that combines elements of mindfulness, cognitive-behavioral therapy, and evolutionary psychology to foster compassion, helps individuals develop a more balanced and compassionate relationship with themselves and others by addressing underlying fears and insecurities) have demonstrated potential in improving treatment adherence and overall well-being in diabetic patients. Self-compassion, encompassing self-kindness, shared humanity, and mindfulness, is central to CFT and can enhance resilience and self-care. Research has consistently shown that CFT positively impacts treatment adherence, quality of life, and stress reduction. Method:  This research was semi-experimental using pretest, posttest and quarterly follow-up with control group. The statistical population consisted of patients with type 2 diabetes referred to Isfahan Endocrine and Metabolism Research Center in the autumn of 2021 that 46 of them were selected via purposive sampling and randomly allocated to experimental and control group (23 people in each group). The members of the experimental group underwent eight sessions of compassion-focused therapy (two 90-minute sessions per week) and the control group was waiting for intervention. Modanloo Adherence to Treatment Questionnaire (2013) and evaluation of blood lipids by specialist  doctor was done in pre-test, post-test and three-month follow-up stages in both experimental and control groups.  Data were analysed by using Mixed Model ANOVA with SPSS software version 24. Results: The findings indicated an improvement in adherence to treatment (F=36.132, P=0.001) and the balancing of blood lipids (triglycerides, cholesterol, LDL and HDL) in the experimental group compared to the control group, as well as the stability of the results in the follow-up phase (F=70.306, P=0.001). Conclusion: These results align with both domestic and international research, supporting the role of self-compassion in improving self-care and treatment adherence. By cultivating mindfulness and self-compassion, CFT empowers patients to reduce negative emotions, increase motivation to follow medical advice, and develop effective coping mechanisms. Self-compassion plays a crucial role in enhancing treatment adherence among individuals with diabetes. When individuals cultivate kindness and understanding towards themselves, they are more likely to engage in healthy behaviors and make choices that support their long-term well-being. By practicing self-compassion, individuals with diabetes can reduce feelings of self-blame and guilt associated with treatment failures, which can be a significant barrier to adherence. Furthermore, self-compassion can help individuals develop a more positive outlook on life, which can increase motivation and empower them to take an active role in managing their condition. Despite limitations such as the COVID-19 pandemic and reliance on self-report measures, this study highlights the value of CFT as a complementary approach to diabetes care. By addressing the psychological dimensions of the disease, CFT enhances treatment adherence, Healthcare providers are encouraged to incorporate CFT into their treatment plans to optimize the physical and psychological well-being of diabetic patients. Continued research is warranted to further explore the long-term effects of CFT and its applicability to diverse populations.

کلیدواژه‌ها [English]

• Blood Lipids
• Compassion Focused Therapy
• Tretment Adherence
• Type 2 Diabetes