fa تاثیر فراشناخت درمانی بر افسردگی و رشد پس از سانحه بیماران تحت همودیالیز تخصصي Special پژوهشي Research <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="AR-SA" mitra="" style="font-family:">مقدمه:</span></b><span b="" lang="AR-SA" mitra="" style="font-family:"> دیالیز فرایندی تنش</span>&shy;<span b="" lang="AR-SA" mitra="" style="font-family:">زا و استرس</span>&shy;<span b="" lang="AR-SA" mitra="" style="font-family:">آور است و سبب بروز افسردگی در</span>&shy;<span b="" lang="AR-SA" mitra="" style="font-family:"> بیش از نیمی از بیماران تحت دیالیز می‌شود</span>.<span b="" mitra="" style="font-family:"> مطالعه حاضر با هدف تعیین تاثیر فراشناخت درمانی بر افسردگی و رشد پس از سانحه بیماران تحت همودیالیز انجام گرفته است.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="AR-SA" mitra="" style="font-family:">روش&shy; کار:</span></b><span b="" lang="AR-SA" mitra="" style="font-family:"> پژوهش حاضر از نوع کار</span>&shy;<span b="" lang="AR-SA" mitra="" style="font-family:">آزمایی بالینی</span> <span b="" lang="AR-SA" mitra="" style="font-family:">با پیش</span> <span b="" lang="AR-SA" mitra="" style="font-family:">آزمون و پس</span> <span b="" lang="AR-SA" mitra="" style="font-family:">آزمون و دوره پیگیری سه ماهه بود.</span> <span b="" lang="AR-SA" mitra="" style="font-family:">در این مطالعه تعداد 36</span> <span b="" lang="AR-SA" mitra="" style="font-family:">بیمار تحت همودیالیز مراجعه کننده به بیمارستان امام علی (ع)</span> <span b="" lang="AR-SA" mitra="" style="font-family:">و شهید رجایی شهر کرج سال 1399،</span> <span b="" lang="AR-SA" mitra="" style="font-family:">به صورت نمونه گیری در دسترس و تصادفی گمارده شدند. برای گروه </span><span b="" lang="FA" mitra="" style="font-family:">مداخله</span> <span b="" lang="AR-SA" mitra="" style="font-family:">(18 نفر) درمان</span> <span b="" lang="AR-SA" mitra="" style="font-family:">فراشناختی 8</span> <span b="" lang="AR-SA" mitra="" style="font-family:">جلسه 60 دقیقه ای، بصورت انفرادی و چهره به چهره در بخش دیالیز بیمارستان‌های مورد مطالعه برگزار گردید. برای جمع آوری</span> <span b="" lang="AR-SA" mitra="" style="font-family:">داده ها در این مطالعه از سیاهه افسردگی بک و سیاهه رشد پس از سانحه استفاده شد. سپس داده ها با استفاده از روش آنالیز کوواریانس در نرم افزار </span>. spss<span b="" lang="AR-SA" mitra="" style="font-family:">با نسخه 23 و سطح معنی داری کمتر از ۰۵/۰ تجزیه و تحلیل شدند. </span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="AR-SA" mitra="" style="font-family:">یافته&shy; ها:</span></b><span b="" lang="AR-SA" mitra="" style="font-family:"> نتایج</span> <span b="" lang="AR-SA" mitra="" style="font-family:">تحلیل</span> <span b="" lang="AR-SA" mitra="" style="font-family:">کوواریانس</span> <span b="" lang="AR-SA" mitra="" style="font-family:">تک متغیری</span> <span b="" lang="AR-SA" mitra="" style="font-family:">نشان</span> <span b="" lang="AR-SA" mitra="" style="font-family:">داد</span> <span b="" lang="AR-SA" mitra="" style="font-family:">که</span> <span b="" lang="AR-SA" mitra="" style="font-family:">تفاوت‌های</span> <span b="" lang="AR-SA" mitra="" style="font-family:">معنی داری بین</span> <span b="" lang="AR-SA" mitra="" style="font-family:">گروه</span> <span b="" lang="AR-SA" mitra="" style="font-family:">مداخله</span> <span b="" lang="AR-SA" mitra="" style="font-family:">و</span> <span b="" lang="AR-SA" mitra="" style="font-family:">کنترل</span> <span b="" lang="AR-SA" mitra="" style="font-family:">در</span> <span b="" lang="AR-SA" mitra="" style="font-family:">مراحل</span> <span b="" lang="AR-SA" mitra="" style="font-family:">پس آزمون</span> <span b="" lang="AR-SA" mitra="" style="font-family:">و</span> <span b="" lang="AR-SA" mitra="" style="font-family:">پیگیری</span> <span b="" lang="AR-SA" mitra="" style="font-family:">وجود</span> <span b="" lang="AR-SA" mitra="" style="font-family:">دارد (001/0</span>.(P &le; <span b="" lang="FA" mitra="" style="font-family:">در</span><span b="" lang="AR-SA" mitra="" style="font-family:">گروه مداخله از</span> <span b="" lang="AR-SA" mitra="" style="font-family:">لحاظ</span> <span b="" lang="AR-SA" mitra="" style="font-family:">کاهش</span> <span b="" lang="AR-SA" mitra="" style="font-family:">علایم</span> <span b="" lang="AR-SA" mitra="" style="font-family:">افسردگی (17/342</span>F = <span b="" lang="FA" mitra="" style="font-family:">)</span> <span b="" lang="FA" mitra="" style="font-family:">و رشد پس از سانحه</span><span b="" lang="AR-SA" mitra="" style="font-family:"> (44/267</span>F= <span b="" lang="FA" mitra="" style="font-family:">) </span><span b="" lang="AR-SA" mitra="" style="font-family:">در</span> <span b="" lang="AR-SA" mitra="" style="font-family:">مرحله‌ی</span> <span b="" lang="AR-SA" mitra="" style="font-family:">پس آزمون،</span> <span b="" lang="AR-SA" mitra="" style="font-family:">تفاوت‌های</span> <span b="" lang="AR-SA" mitra="" style="font-family:">معنی دار آماری مشاهده شد که</span> <span b="" lang="AR-SA" mitra="" style="font-family:">این</span> <span b="" lang="AR-SA" mitra="" style="font-family:">تفاوت‌ها</span> <span b="" lang="AR-SA" mitra="" style="font-family:">در</span> <span b="" lang="AR-SA" mitra="" style="font-family:">گروه کنترل</span> <span b="" lang="AR-SA" mitra="" style="font-family:">مشاهده</span> <span b="" lang="AR-SA" mitra="" style="font-family:">نشد</span>.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="AR-SA" mitra="" style="font-family:">نتیجه&shy; گیری:</span></b><span b="" lang="AR-SA" mitra="" style="font-family:"> بر اساس نتایج این مطالعه فراشناخت درمانی با</span> <span b="" lang="AR-SA" mitra="" style="font-family:">بهره گیری</span> <span b="" lang="AR-SA" mitra="" style="font-family:">از</span> <span b="" lang="AR-SA" mitra="" style="font-family:">فنونی</span> <span b="" lang="AR-SA" mitra="" style="font-family:">همچون</span> <span b="" lang="AR-SA" mitra="" style="font-family:">به</span> <span b="" lang="AR-SA" mitra="" style="font-family:">تعویق</span> <span b="" lang="AR-SA" mitra="" style="font-family:">انداختن</span> <span b="" lang="AR-SA" mitra="" style="font-family:">نگرانی،</span> <span b="" lang="AR-SA" mitra="" style="font-family:">چالش</span> <span b="" lang="AR-SA" mitra="" style="font-family:">با</span> <span b="" lang="AR-SA" mitra="" style="font-family:">باورهای</span> <span b="" lang="AR-SA" mitra="" style="font-family:">مربوط</span> <span b="" lang="AR-SA" mitra="" style="font-family:">به خطر و</span> <span b="" lang="AR-SA" mitra="" style="font-family:">متوقف</span> <span b="" lang="AR-SA" mitra="" style="font-family:">کردن</span> <span b="" lang="AR-SA" mitra="" style="font-family:">مهار</span> <span b="" lang="AR-SA" mitra="" style="font-family:">رفتارهای</span> <span b="" lang="AR-SA" mitra="" style="font-family:">اجتنابی،</span> <span b="" lang="AR-SA" mitra="" style="font-family:">دارای</span> <span b="" lang="AR-SA" mitra="" style="font-family:">کارآیی</span> <span b="" lang="AR-SA" mitra="" style="font-family:">بالینی</span> <span b="" lang="AR-SA" mitra="" style="font-family:">مناسبی</span> <span b="" lang="AR-SA" mitra="" style="font-family:">در</span> <span b="" lang="AR-SA" mitra="" style="font-family:">جهت</span> <span b="" lang="AR-SA" mitra="" style="font-family:">بهبود علائم افسردگی و رشد پس از سانحه در بیماران تحت همو دیالیز به شمار می‌رود. درضمن انجام مطالعات وسیع</span>‌<span b="" lang="AR-SA" mitra="" style="font-family:">تر فراشناخت درمانی به عنوان یک روش مداخله ای مؤثر برای بهبود افسردگی و رشد پس از سانحه بیماران تحت همو</span>‌<span b="" lang="AR-SA" mitra="" style="font-family:">دیالیز پیشنهاد می شود.</span></span></span></span></span></span><br> <br> &nbsp; <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:18.0pt"><span new="" roman="" style="font-family:" times=""><b><span style="color:#222222">Introduction</span></b><b><span dir="RTL" lang="FA" style="color:#222222">:</span></b>&nbsp;<span style="color:#222222">Dialysis is a stressful process and causes depression in more than half of&nbsp;patients&nbsp;under hemodialysis. The present study was conducted with the aim of determining the effect of metacognitive therapy on depression and post-traumatic growth of patients under hemodialysis.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:18.0pt"><span new="" roman="" style="font-family:" times=""><b><span style="color:#222222">Methods</span></b><b><span dir="RTL" lang="FA" style="color:#222222">:</span></b>&nbsp;<span style="color:#222222">The present study was a clinical trial with a pre-test and post-test and a three-month follow-up. This study was conducted on 36 patients (18 in each of the control and intervention groups) referred to Imam Ali (AS) and Shahid Rajaei Hospital in Karaj city in 2020. In this study, patients were included in the study by using the convenience sampling method with random assignment. For the intervention group, eight sessions 60-minute of metacognitive therapy were held individually and face-to-face in the wards of dialysis in the two hospitals. Beck depression questionnaire and post-traumatic growth questionnaire were used to collect data in this study. Then the data were analyzed using the covariance analysis method in SPSS version 23 with a significance level of less than 0.05.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:18.0pt"><span new="" roman="" style="font-family:" times=""><b><span style="color:#222222">Results:</span></b><span style="color:#222222">&nbsp;The results of univariate covariance analysis showed that there are significant differences between the intervention and control groups in the post-test and follow-up stages (p<0.001) in the intervention group in terms of reducing depression symptoms (F=342.17) and in growth after an accident (F=267.44) in the post-test stage, there are significant differences, which were not observed in the control group.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:18.0pt"><span new="" roman="" style="font-family:" times=""><b><span style="color:#222222">Conclusion:</span></b><span style="color:#222222">&nbsp;Based on the findings of this study, metacognitive therapy using techniques such as postponing worry, challenging beliefs related to risk, and stopping the inhibition of avoidance behaviors, has good clinical efficacy in improving depression symptoms and post-traumatic growth in patients under hemodialysis.&nbsp;&nbsp;In addition, it is suggested to carry out wider metacognitive therapy studies as an effective intervention method to improve depression and post-traumatic growth of patients&nbsp;under hemodialysis.</span></span></span></span></span><br> &nbsp; همودیالیز, فراشناخت درمانی, افسردگی, رشد پس از سانحه Hemodialysis, Metacognitive therapy, Depression, Post traumatic growth. 1 11 http://ijpn.ir/browse.php?a_code=A-10-2074-1&slc_lang=fa&sid=1 samira Haddadi سمیرا حدادی shaddadi657@gmail.com 0071294597 27900319475328460014961 No Islamic Azad University, Karaj دانشگاه آزاد اسلامی ،کرج Saied Malihi Alzakerini سعید ملیحی الذاکرینی zuckeri99@yahoo.com 0037226940 27900319475328460014962 No Islamic Azad University, Karaj دانشگاه آزاد اسلامی،کرج Ramin Tajbakhsh رامین تاجبخش r_tajbakhsh@yahoo.com 0040168271 27900319475328460014963 No Alborz University of Medical Sciences دانشگاه علوم پزشکی البرز Mansoureh Tajvidi منصوره تجویدی mansooreh_tajvidi@yahoo.com 0055596533 27900319475328460014964 Yes Islamic Azad University, Karaj دانشگاه آزاد اسلامی،کرج Alireza Kakavand علیرضا کاکاوند ali.reza_kakavand@yahoo.com 0492481997 27900319475328460014965 No Imam Khomeini international university Qazvin دانشگاه بین المللی امام خمینی قزوین