تاثیر درمان اکت و فراتشخیص بر اجتناب تجربه ای و کیفیت زندگی بیماران لوپوس اریتماتوز سیستمیک.

The Effect of Act and Meta-Diagnosis Treatment on Experiential Avoidance and Quality of Life in Patients with Systemic Lupus Erythematosus.

Background & Aims: Systemic lupus erythematosus is a chronic, autoimmune, multisystem inflammatory disease that can cause skin lesions, inflammation of the joints and membranes covering the lungs and heart, nephritis, cardiovascular, hematological, gastrointestinal, and neurological diseases. In this way, the symptoms can appear slowly and gradually or quickly and change with the stages of activity and recovery (1). This disease significantly affects the quality of life in physical, emotional and social aspects (2). On the other hand, the results show that about 80% of lupus patients complain of psychological problems that cause damage to their lives (7). In the meantime, the use of experiential avoidance is known as a maladaptive strategy that is the product and continuation of anxiety and depression (8). Research shows that the set of inflexible emotional avoidance measures is a factor of vulnerability and psychological risk factor for the development, persistence and exacerbation of psychological symptoms (10) and significantly reduces the quality of life (9). Therefore, for these patients, treatment methods or therapies are used to minimize the consequences of the disease and improve the quality of life and psychological symptoms. Performing effective interventions aimed at reducing the psychological and cognitive consequences of these patients can be effective in improving the quality of life as well as psychological symptoms such as experiential avoidance of these people. In this regard, one of the effective psychological therapies that has been able to be effective on a wide range of emotional disorders and anxiety, is Barlow integrated meta-diagnostic therapy. Transdiagnostic intervention focuses on emotion regulation, but sometimes due to lack of emotional control, there are approaches that do not target emotion regulation and behavioral change is targeted, including act intervention. Acceptance and commitment therapy or act is a behavioral therapy that focuses on valuable involvement in life. The results showed that act-based therapy was effective in reducing depression, anxiety, and increasing quality of life (14,15,16). In general, due to the effectiveness of act in the treatment of anxiety and depression, this treatment is used for patients with systemic lupus erythematosus. Therefore, this study, in continuation of the evolution of non-drug therapies effective in reducing the symptoms and psychological symptoms of lupus erythematosus, systematically intends to study these two treatments (act and meta-diagnosis). Therefore, the present study seeks to ask whether the treatment of acceptance and commitment (act) and integrated meta-diagnosis affect the quality of life and cognitive symptoms of patients with systemic lupus erythematosus? Methods: The research was a quasi-experimental study with a pretest-posttest design with a control group. The statistical population of the study included all patients with systemic lupus erythematosus in 2019 in the rheumatology clinic of Imam Ali hospital in Zahedan and private rheumatology clinics, 45 people were replaced in two experimental groups (act and meta-diagnosis) and one group (control) based on purposive sampling method. The Lupus McIlham et al. (2007) Quality of Life Scale and the experience avoidance acceptance and practice of Bones et al. (2011) were used to collect data. Act Hayes et al. (2011) and integrated transdiagnostic therapy of Barlow et al. (2017) including were used 10 sessions of 60 minutes twice in a week. Results: The results showed a significant difference between the post-test means of the experimental and control groups; This means that act therapy and meta-diagnosis training can improve the level of experiential avoidance as well (p <0.001). [ABSTRACT FROM AUTHOR]

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