Document Type : research
Author
Department psychology,Payam-E-Noor university,Tehran,Iran
Abstract
Objective: Hemodialysis patients suffer many problems including feelings of loneliness, fatigue, and low lifestyle quality. This study aimed to investigate the effectiveness of online existential consciousness therapy on these patients’ loneliness, fatigue, and lifestyle.
Methods: The research method was quasi-experimental with a pretest-posttest and follow-up design with a control group. The research population was all hemodialysis patients who were referred to the dialysis center of Nikan Hospital in Tehran. Using the convenience sampling method, 30 participants were selected as study samples. Research instruments for collecting data were the Rasel’s Loneliness Questionnaire (1978), the Fick's Fatigue Impact Questionnaire (1944), and the Corona Virus Lifestyle Scale (Ali Akbari Dehkordi, et al., 2020). For the experimental group, ten 90-minutes sessions were performed through Sky-room.
Results: MANCOVA and ANCOVA showed that existential consciousness training reduced the feeling of loneliness in the sub-components of not having a close friend, lack of loneliness, and isolation, but was not effective in the sub-component of sociability. This intervention also reduced the fatigue in the cognitive and social components but did not affect the physical component. It was also effective on the happy lifestyle but did not affect the healthy lifestyle.
Conclusions: Existential consciousness therapy was effective in reducing the loneliness feeling, fatigue impact, and lifestyle changes of hemodialysis patients during home quarantine. Therefore, this method can be used as a new therapeutic approach to reduce the loneliness and fatigue impact caused by hemodialysis and change patients' lifestyles during quarantine in medical centers and psychological services.
Keywords
Article Title [Persian]
اثربخشی آموزش آنلاین هشیاری وجودی در درمان گروهی بر احساس تنهایی ،اثرخستگی و سبک زندگی در زمان قرنطینه خانگی در بیماران همودیالیز
Author [Persian]
- فاطمه بیان فر
استادیار گروه روان شناسی دانشگاه پیام نور-تهران -ایران
Abstract [Persian]
Objective : هدف این پژوهش تعیین اثر بخشی آموزش آنلاین هشیاری وجودی در درمان گروهی بر احساس تنهایی، اثر خستگی و سبک زندگی در زمان قرنطینه خانگی در بیماران تحت درمان همودیالیز بود.
Method : روش پژوهش نیمه آزمایشی با طرح پیش آزمون-پس آزمون -پیگیری بود. جامعه ، کلیه بیماران تحت درمان با همودیالیز بیمارستان نیکان شهر تهران درسال 1399 بود. از میان این بیماران 30 نفر با روش نمونه گیری در دسترس انتخاب شدند. ابزار مورد استفاده شامل پرسشنامه احساس تنهایی ( راسل،1978)، تاثیر خستگی ( فیسک،1944) و مقیاس سبک زندگی در زمان همه گیری ابتلاء به ویروس کرونا ( علی اکبر دهکردی و همکاران2020) بود. برای گروه آزمایش، ده جلسه 90 دقیقه ای آموزش هشیاری وجودی به صورت گروهی در اسکای روم اجرا شد و گروه گواه هیچ گونه مداخله ای دریافت نکرد. جهت تحلیل داده ها از روش آنالیز واریانس چند متغیره و تحلیل کواریانس چند متغیری استفاده شد.
Results : نتایجMANCOVA،, ANCOVA نشان داد که آموزش آنلاین هشیاری وجودی موجب کاهش احساس تنهائی در خرده مولفه های نداشتن دوست صمیمی، احساس تنهایی و انزوا بود ولی بر خرده مولفه اجتماعی بودن موثر نبود. همچنین موجب کاهش اثرخستگی شناختی و اجتماعی بود ولی بر خستگی جسمی اثرگذار نبود. بر سبک زندگی شاد موثر بود، ولی بر سبک زندگی سالم اثرگذار نبود.
Conclusion :با توجه به نتایج می توان از این روش جهت کاهش احساس تنهایی و اثر خستگی ناشی از همودیالیزو تغییر سبک زندگی بیماران در زمان قرنطینه خانگی در مراکز درمانی و خدمات روانشناختی استفاده نمود.
Keywords [Persian]
- هشیاری وجودی
- تنهایی
- خستگی
- سبک زندگی
- همودیالیز
Abadi,S.(2021).The effect of loneliness on self-care in the elderly with dialysis. National Conferences on Elderly Health.
Aghakhani, N. & Fooladi.S.(2020). Multimedia training, a good method to reduce fatigue in patients undergoing hemodialysis. Saudi Journal of Kidney Diseases and Transplantation.31(2).571. DOI: 10.4103/1319-2442.284044
Ahmadi, S., IIanlou, H., Razaee, M., Hassani, MB. & Mohammadian, D. (2019). Teaching existential consciousness on psychological well- being in Takestan Teachers. Journal of Disability Studies., 9(122), 1-5.
Alami, S., Bakhtiarpour. S., Asgari, P., & Seraj Khorrami, N. (2020). Comparison of the Effectiveness of Existential Group Therapy with Cognitive-Behavioral Group Therapy on Increasing Life Satisfaction among the Methadone Maintenance Patients. Avicenna Journal of Neuro Psycho Physiology.,7(3).172- 177.
Aliakbari Dehkordi ,M., Mohtashami,T , & Tadris Tabrizi,M. (2020). Developing, validity and validated Lifestyle Scale During COVID-19 Disease Pandemic. Quarterly Journal of Health Psychology.9(1).33.161-177. 10.30473/HPJ.2020.53009.4819
Aliakbari Dehkordi, M., Eisazadeh, F., & Aghjanbaglu, S. (2020). Psychological Consequences of Patients with Coronavirus (COVID- 19): A Qualitative Study. Iranian Journal of Health Psychology; 2 (2): 9-20.
Aliakbari Dehkordi, M., Mohtashami, T., Peymanfar, E., & Borjali, A. (2014). The Comparison of Different Levels of Religious Attitude on Sense of Meaning, Loneliness and Happiness in Life of the Elderly Under Cover of Social Welfare Organization of Urmia City.Salmand,9(4).297-329.
Al-Kandari, F., Victoria L. Vidal, V., & Thomas, D. (2008). Health-promoting lifestyle and body mass index among College of Nursing students in Kuwait: A correlational study. Nursing & Health Sciences. 10 (1)1 ,43 to 50. DOI: 10.1111/j.1442-2018.2007.00370.x
Asadi, N., Royani, Z., & Abbaszadeh, A.(2014). A study of some fatigue-related factors based on unpleasant symptoms theory in Kerman-resident hemodialysis patients. Modern Care, Scientific Quarterly of Birjand Nursing and Midwifery Faculty. 11 (2):119-126.
Asgarpoor, F., Amini,Z, Zeraati A, Esmaeli H.(2011). The effect of a care plan based on the Roy Adaptation Model on level of Fatigue in hemodialysis patients . Evidence -based care. 2011;1(1):77 -89.
Ashkari F., Brazparandjani Sh., Latifi SM., Chahkhoei M., Khalili A., Paymard, A., Dehghani F., (2016). The effect of collaborative care model on the fatigue in patients undergoing maintenance hemodialysis: A randomized clinical trial.
Bahat,K.A., Parmaksiz,E.,& Sert.S.(2020). The clinical characteristics and course of COVID‐19 in hemodialysis patients. Hemodialysis International. 24 (4).534-540. DOI: 10.1111/hdi.12861
Bahreni, N. (2016). Determining the effectiveness of cognitive-behavioral stress management on reducing anxiety and depression in dialysis patients. World Conference on Psychology and Educational Sciences, Law and Social Sciences at the beginning of the third millennium. https://civilica.com/doc/517067
Banovic, I., Montreuil, L., Derrey-Bunel, M., Scrima, F., Savoye, G., Laurent Beaugerie, & Gay, M-c. (2020). Toward Further Understanding of Crohn’s Disease-Related Fatigue: The Role of Depression and Emotional Processing. Frontiers in Psychology. 11. https://doi.org/10.3389/fpsyg.2020.00703
Basiri Moghadam, M., Madadkar Dehkordi, SH., Mohammadpour, A., & Vaezi, A. (2014). Effect of Progressive Muscle Relaxation Technique on Fatigue in Patients Undergoing Hemodialysis. (2013). Preventive Care in Nursing and Midwifery Journal (PCNM); 3(2), 24-32.
Berra, L. (2019). Existential Depression: A Nonpathological and Philosophical-Existential Approach. Journal of Humanistic Psychology .002216781983474. DOI: 10.1177/0022167819834747.
Carey, J., Pera, A., &., Balica, R. (2020). “Emotional Fatigue, Psychological Distress, and Clinically Significant Depression Associated with Being a COVID-19 Frontline Healthcare Worker,” Psychosociological Issues in Human Resource Management 8(2): 27–36. doi:10.22381/PIHRM8220203
Case Medical Research (2020). Benson Relaxation Technique Combined with Music Therapy for Fatigue, Anxiety, and Depression in Hemodialysis Patient. DOI: 10.31525/ct1-nct04299256.
Chan, L. E. (2018). Dietary Sodium and Blood Pressure Changes in Hemodialysis Patients Undergoing a Liberalized Renal Diet Intervention. Master’s thesis, Department of Family and Consumer Sciences ILLINOIS state University. https://search.proquest.com/docview/2066781624
Cooper, S. D. (2017). The Lived Experience of In-Center Hemodialysis Patients Receiving Treatment in DeKalb County, Georgia. doctoral dissertation. Walden University. College of Health Sciences. https://search.proquest.com/docview/1944207502
Corey, G. (2016). Theory and Practice of Group Counseling. Pacific Grove,CA; Brooks/Cole.
Debnath, S., Rueda, R., Bansal, Sh., Sharma, K., & Lorenzo, C. (2021). Assessment of fatigue in hemodialysis patients: Performance of the Brief Fatigue Inventory. General Hospital Psychiatry. 68 ,115 – 117. DOI:10.1016/j.genhosppsych.2020.08.006
Diamond, S.A. (2018). Existential Therapy and Jungian Analysis: Toward an Existential Depth Psychology. Journal of Humanistic Psychology. on page 002216781880991. DOI: 10.1177/0022167818809915.
Ejlali,F.R., Khazaei,M.R., Mostafavian,Z.,& Jalil ,M.(2019). The Effect of Discontinuation of Angiotensin-II Receptor Blocker on Therapeutic Effect of Synthetic Erythropoietin on Anemia Modification in Hemodialysis Patients. The Horizon of Medical Sciences. 25(3): 230-243
Field, T., Poling,S.,Mines, Sh., Bendell, D., &Veazey, C. (2020). Feeling Isolated and Lonely During Covid-19 Lockdown. Archives of Health Science.1-9.DOI: 10.31829/2641-7456/ahs2020-4(1)-121.
Fried,A. L., & Fisher, C.B. (2016). Moral stress and job burnout among frontline staff conducting clinical research on affective and anxiety disorders. National Institutes of Health. 47(3), 171 – 180. https://doi.org/10.1037/pro0000060
Gibson, C.A., Mason, C., & Stones, J. (2021). Living Well with Lifestyle Medicine: A group consultation approach to delivering Lifestyle Medicine Intervention in Primary Care. Lifestyle Medicine. 2 (1). https://doi.org/10.1002/lim2.19
Gruber, R., & Schwanda, M. (2021). Feeling fearful and lonely are indicative experiences of emotional distress for people with dementia. Evidence Based Nursing. 24(2). 50-51. DOI: 10.1136/ebnurs-2018-103003
Haisum Maqsood, M., & Rubab, K. (2019). Quality of Life of Patients Using the Hemodialysis Reliable Outflow (HeRO) Graft in Hemodialysis. Cureus. 11(1): e3915. doi:10.7759/cureus.3915
Hatami, A. ,Badrani, M.R., Mahnazadeh, M., & Hematipoor, A.(2018). Investigating the relationship between hope and feeling of loneliness with social support of hemodialysis patients in Shushtar city. Fifth Student Research Congress in the southwestern region of the country. https://civilica.com/doc/858339
Heidari, M., Akbarfahimi ,M., Salehi M.,& Nabavi, SM.(2012). Survey validity of translation for Persian and cultural adaptation of Fatigue Impact Scale (FIS) questionnaire in multiple sclerosis patients in Iran. Journal of Modern Rehabilitation.6(3).20-29.
Hernandez-Acevedo,B.(2021). Nursing faculty integrate simulation instruction into their teaching practice: A phenomenological study. Teaching and Learning in Nursing. https://doi.org/10.1016/j.teln.2021.03.003
Ison,M.G.(2020). Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19. DeckerMed Anesthesiology. DOI: 10.2310/anes.1422
Jannati,Y.,Zati Rostami,M.,&Emami,S.(2017). Spirituality and Its Related Factors in Hemodialysis Patients. Religion and Health.4(2).12-19.
John,M.(2021). The “existential” in existential psychotherapy: pressing issues of everyday life necessitate intuition informed practice. Australian Psychologist.1 – 10.DOI: 10.1080/00050067.2021.1893602
Johnson, S.L. (2008).The concept of fatigue in multiple sclerosis. Journal of Neuroscience Nursing.40(2):72-77. DOI: 10.1097/01376517-200804000-00005
Jones, J. (2020). COVID-19: lifestyle tips to stay healthy during the pandemic. Madigan Army Medical Center. https://www.aflcmc .af.mil/News/Article-Display/Article/2147181/staying-physically-activeduring-covid-19/.
Kang,H.,&Chae,Y.(2021). Effects of Integrated Indirect Forest Experience on Emotion, Fatigue, Stress, and Immune Function in Hemodialysis Patients. International Journal of Envir on mental Research and Public Health.18(4).1701. DOI: 10.3390/ijerph18041701
Kiani ,L., Rafeipoor,.A., Mashayekh ,M., Tajbakhsh ,R.,& Pouyamanesh.J(2020). The Relationship between Resilience and Post Traumatic Growth in Patients on Hemodialysis. Quarterly Journal of Health Psychology.8(4).93-104
Kim,S.,& Yang,J.(2021). An Alternative View of a Hemodialysis–Life Balance: Life Reorganization of Korean Patients Undergoing Hemodialysis. Journal of Transcultural Nursing.104365962098833. DOI:10.1177/1043659620988339
Lashkari,M.,Serafi,M.R.,&Bleyard,M.R.(2016). The mediating role of perceived stress in the relationship between hardiness and quality of life in patients on hemodialysis. Quarterly of Applied Psychology.9(1).91-107.
Lee,Y., Lay,J., Mahmood,A., Graf,P.,& Hoppmann,Ch.(2020). Loneliness and Social Engagement: The Unique Roles of State and Trait Loneliness for Daily Prosocial Behaviors. Innovation in Aging. 4 (1).627. https://doi.org/10.1093/geroni/igaa057.2140
Levkovich,I.(2021). Coping Strategies and Their Impact on Emotional Distress and Fatigue Among Breast Cancer Survivors. Cancer Journal .27 (2),83-89. doi: 10.1097/PPO.0000000000000505
Li, J., Wong,I.A.,& Kim,W.G.(2017). Does mindfulness reduce emotional exhaustion? A multilevel analysis of emotional labor among casino employees. International Journal of Hospitality Management. 64 .21 30. https://doi.org/10.1016/j.ijhm.2017.03.008
Liu, HE.(2006). Fatigue and associated factors in hemodialysis patients in Taiwan. Res Nurs Health.;29(1):40-50. DOI: 10.1002/nur.20109
Liu,X.,& Yu,K.(2019). Emotional stability and citizenship fatigue: The role of emotional exhaustion and job stressors. Personality and Individual Differences. 139, 254-262. https://doi.org/10.1016/j.paid.2018.11.033
Mathiowetz,V.(2003). Test-Retest Reliability and Convergent Validity of the Fatigue Impact Scale for Persons with Multiple Sclerosis. American Journal of Occupational Therapy. 57 ( 4 ).389- 395.
Millan, M. Nasimi,F.,Hafizi,I.,Gorbanzadeh,M.,&Hosseni,Y.(2018). Association of Spiritual Health and Quality of Life in the Hemodialysis Patients Admitted in Shahid Motahari Hospital in Jahrom, Iran(2016). Iran Journal of Nursing .31(13).42-51.
Mollaoglu,M.(2009). Fatigue in People Undergoing Hemodialysis. Dialysis & Transplantation.38(6). 216 – 220.DOI: 10.1002/dat.20330
Monye,I.,& Bamidele,A.(2020). Strengthening immunity through healthy lifestyle practices: Recommendations for lifestyle interventions in the management of COVID‐19. Lifestyle Medicine.1(1).https://doi.org/10.1002/lim2.7
Moon-Gue ,Sh.(2021). Jaspers’ Existential Philosophy and Philosophical Counseling to Overcome Existential Frustration. Theology and Praxis.73(2),439-471. DOI: 10.14387/jkspth.2021.73.439.
Muslim Nahi, S.,& Nawras,A.Khudaeer.(2020). Prevalence of Lifestyle risk factors among a sample of Hypertensive Patients in Al-Hussain Teaching Hospital during 2016. University of Thi-Qar. Journal of Medicine.12(2), DOI: 10.32792/utq/utjmed/12/2/7
Niihata,K., Fukuma,Sh., Akizawa,T.,& Fukuhara,Sh.(2017). Association of coping strategies with mortality and health-related quality of life in hemodialysis patients: The Japan Dialysis Outcomes and Practice Patterns Study. PLOS ONE ,12(7) 180498.DOI: 10.1371/journal.pone.0180498
Gruber,R.,& Schwanda,M.(2021). Feeling fearful and lonely are indicative experiences of emotional distress for people with dementia. Evidence Based Nursing. 24(2). 50-51. DOI: 10.1136/ebnurs-2018-103003
Gruber,R.,& Schwanda,M.(2021). Feeling fearful and lonely are indicative experiences of emotional distress for people with dementia. Evidence Based Nursing. 24(2). 50-51. DOI: 10.1136/ebnurs-2018-103003
Oshvandi,Kh., Salavati,M., Ahmadi,F.,& Soltanian,A.(2018). The Effect of Training on Hemodialysis Patients’ Lifestyle Promotion. Avicenna Journal of Nursing and Midwifery Care.26 (3): 165-172
Kim,S.,& Yang,J.(2021). An Alternative View of a Hemodialysis–Life Balance: Life Reorganization of Korean Patients Undergoing Hemodialysis. Journal of Transcultural Nursing.104365962098833. DOI:10.1177/1043659620988339
Paeen resketi;F. vahdat;Sh.,& hesam.S.(2019). Identifying Effective Factors on the Quality of Services Provided To Hemodialysis Patients in Iranian Hospitals.Journal of Healthcare Management.10(2).73-89.
Pan, H. (2020). A Glimpse of University Students’ Family Life amidst the COVID-19 Virus. Journal of Loss and Trauma. DOI:10.1080/15325024.2020.1750194
Pernido,M.(2011 ). Technical Problems in Patients on Hemodialysis. Publisher: Intech
Qom Univ Med Sci J;10(8):71-79.
Raeisi,D., Omrani,H.R., Seyedzadeh,A., Akbari,R., Tavasoli,M.,&Safari-Faramani,R.(2013). Quality of life and it’s determinant in hemodialysis patients in Kermanshah in 2010. Journal of Kermanshah University of Medical Sciences.16(8).772-778.
Rejeh,N., Hearavi-Karimoo,M., Bahrami,T.,Raeesi,M.,&Tadrisi,D.(2015). The assessment of factors affecting fatigue in older people with hemodialysis. Iranian Journal of Nursing Research. 10(3),108-117.10(3),108-117
Sadri Damirchi,E.,& Ramazani,SH.(2016). Effectiveness of Existential Therapy on Loneliness and Death Anxiety in the Elderly. Journal of Aging Psychology.2(1),1-12
Salomè,A., D’Elia,T.S., Franchini,G. Santilli,V.,& Paolucci,T.(2019). Occupational Therapy in Fatigue Management in Multiple Sclerosis: An Umbrella Review. Multiple Sclerosis International.1-7. https://doi.org/10.1155/2019/2027947
Shariatmadar, A. (2014). Existential Consciousness.Iran,Tehran,Danjeh.
Sharifi, L. Fallahi Khoshknab, M., Rahgoi ,A., &Kavehei,B .(2019). Impact of laughter therapy on fatigue and depression in patients undergoing hemodialysis in Sowmehsara and Fouman in 2017. Community Health journal.13(2): 65-73
Shigemura,J., Ursano,R.J., Morganstein,J.C., Kurosawa,M.,& Benedek,D.M.(2020). Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations. Psychiatry and Clinical Neurosciences. 74(4 ).281-282. https://doi.org/10.1111/pcn.12988
Siga,E.,Elso,W.,Gil,M., Basile,H., Benegas,M.,& Ibalo,N.(2021). Reduced frequency hemodialysis in times of COVID‐19: A prospective study in prevalent patient. Hemodialysis International. https://doi.org/10.1111/hdi.12915
Sondergaard,H.(2020). Fatigue While Undergoing Long-Term Hemodialysis. Clinical Journal of the American Society of Nephrology. 15(11).1539 -1540. DOI: 10.2215/cjn.14870920
Sorajjakool,S .,Aja,V., Beverly,Ch., Ramírez-Johnson,J.,&Art,E.(2008). Disconnection, Depression, and Spirituality: A Study of the Role of Spirituality and Meaning in the Lives of Individuals with Severe Depression. Pastoral Psychology, 56(5). 521- 532. DOI: 10.1007/s11089-008-0125-2
Sundström,M., Blomqvist,K., &Edberg ,A-k.(2020). Being a volunteer encountering older people’s loneliness and existential loneliness: alleviating loneliness for others and oneself. Scandinavian Journal of Caring Sciences. https://doi.org/10.1111/scs.12869
Tedadi Ajerlo,H.,&Sadri,E.(2020). The effectiveness of acceptance and commitment (ACT) treatment on depression, life expectancy and happiness of dialysis patients. Third National Conference on Psychology, Education and Lifestyle, Qazvin. https://civilica.com/doc/1020912/
Van Deurzen,E.,&Adams,M.(2016). Skills in Existential Counselling., & Psychotherapy. A handbook of existential psychotherapy. London: Routledge.
World Health Organisation. Rolling updates on coronavirus disease (COVID‐19). Summary. WHO 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen.
Yasaei sekeh,M., Shafiabadi,A.,& Farzad,V.(2018). Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on psychological well- being and Its Components in hemodialysis patients. Scientific Journal of education Research.13(55).149-162.
)