چکیده:
به نظر می‌رسد که سالمندان به دلیل تغییرات جسمی، ناتوانی و از دست دادن عزیزان، بیشتر به مرگ فکر می‌کنند و در صورتی که این موضوع از حد طبیعی خود خارج شود، باعث ایجاد احساس افسردگی و درماندگی در آنها می‌شود. بنابراین پژوهش حاضر با هدف مقایسه اثربخشی درمان مثبت‌نگر و درمان مبتنی بر پذیرش و تعهد بر اضطراب مرگ و افسردگی سالمندان انجام شد. پژوهش حاضر، نیمه‌آزمایشی با طرح پیش‌آزمون-پس‌آزمون و پیگیری با گروه کنترل بود. جامعه پژوهش حاضر شامل کلیه سالمندان سنین ۷۵-۶۵ سال ساکن سراهای سالمندان شهر تهران بودند که از میان آنها سرای سالمندان کهریزک به صورت در دسترس انتخاب شد و ۳۰ نفر (سه گروه ۱۰ نفره) با روش در دسترس و بر اساس معیارهای ورود و خروج مطالعه انتخاب و به صورت تصادفی در دو گروه آزمایش و یک گروه کنترل جایگزین شدند. شرکت‌کنندگان حاضر در گروه‌های آزمایشی درمان مثبت‌نگر مگیار-موئه و درمان مبتنی بر پذیرش و تعهد هایز را طی ۸ جلسه ۹۰ دقیقه‌ای (۲ جلسه در هفته) دریافت کردند. پس از گذشت یک ماه از پس‌آزمون، آزمون پیگیری به عمل آمد. برای جمع‌آوری داده‌ها از پرسش‌نامه‌های اضطراب مرگ تمپلر و افسردگی بک استفاده شد. داده‌ها از طریق تحلیل کوواریانس تک‌متغیری و آزمون تعقیبی بونفرونی در نرم‌افزار SPSSنسخه ۲۲ مورد تجزیه و تحلیل قرار گرفتند. نتایج نشان داد که هر دو گروه درمان مثبت‌نگر و مبتنی بر پذیرش و تعهد در مقایسه با گروه گواه نمرات اضطراب مرگ و افسردگی پایین‌تری در پس‌آزمون و پیگیری داشتند. بدین معنی که هر دو روش درمانی موجب کاهش اضطراب مرگ و افسردگی در سالمندان شد. همچنین نتایج حاصل از آزمون تعقیبی بونفرونی نشان داد که درمان مثبت‌نگر چه در مرحله پس‌آزمون و چه در مرحله پیگیری تأثیر بیشتری بر کاهش افسردگی داشتند. اما این تفاوت برای اضطراب مرگ صادق نبود. طبق نتایج این مطالعه، می‌توان از درمان مثبت‌نگر و درمان مبتنی بر پذیرش و تعهد در جهت بهبود اضطراب مرگ و افسردگی در سالمندان ساکن سرای سالمندان استفاده کرد.
Experiencing physical disability, dissidents and loss of relatives, the elderly seems to think more about the death, and if this goes beyond its normal limits, it causes them to feel depressed and helpless. Therefore, the purpose of this study was to compare the effectiveness of positive therapy (PT) and acceptance and commitment therapy (ACT) on death anxiety and depression in the elderly. This was a quasi-experimental study with pretest-posttest and follow-up design with a control group. The statistical population of the current study included all the elderly (75-55 years old) living in the nursing homes of Tehran, Iran, among which Kahrizak nursing home was selected by convenience sampling, where 30 people (three groups of 10 individuals) were selected using convenience sampling and according to inclusion and exclusion criteria of the study, and randomly assigned into two experimental and one control groups. The Magyar-Moe’s PT and Hayes's ACT were conducted in shape of eight 90-minute sessions (twice a week). The follow-up phase test was performed one month after the post-test phase. Templer’s death anxiety and Beck’s depression questionnaires were used to collect data. Data were analyzed using univariate analysis of covariance and Bonferroni post-hoc test in SPSS-22 software. The results demonstrated that compare to control group, both PT and ACT groups had lower scores of death anxiety and depression in posttest and follow-up. That is both therapeutic methods resulted in the reduction of death anxiety and depression in the elderly. Besides, the results of post-hoc test revealed that PT is more effective in the reduction of depression in both posttest and follow-up phases. However, this difference did not hold for death anxiety. According to the mentioned results, PT and ACT can be used in order to improve the death anxiety and depression in the elderly living in nursing homes. 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