Department of midwifery, Faculty of Nursing and Midwifery, Tabriz University of medical sciences, Tabriz, Iran.
Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Psychiatry. 2022 Feb 11;22(1):108. doi: 10.1186/s12888-022-03768-8.
One of the most critical periods in a woman's life is menopause. During menopause, depression and anxiety are among the most common mood changes. Sleep disorders also increase during menopause, which leads to quality of life disorders. Different methods such as medication, psychotherapy, or a combination of them are used to treat these disorders. Acceptance and commitment-based therapy is one of the newest methods in psychotherapy that recently has been used a lot. Therefore, this study was conducted to determine the effect of acceptance and commitment therapy (ACT) on mood (primary outcome), sleep quality, and quality of life (secondary outcomes) of menopausal women.
This randomized controlled trial was performed on 86 menopausal women in Tabriz, Iran in 2021. Using the blocking method, participants were randomly assigned into the intervention and control groups. The intervention group received counseling based on ACT approach in 8 sessions of 60 to 90 min. The control group received only routine health care. Depression, Anxiety, Stress Scale-21 (DASS 21), Menopause Quality of Life (MENQOL), and Pittsburgh Sleep Quality Index (PSQI) questionnaires were completed before intervention and immediately after the intervention. Independent t-test and Mann-Whitney U test were used to compare the outcomes between the two groups.
In terms of sociodemographic characteristics and baseline values of the studied variables, there was no statistically significant difference between the study groups before the intervention. At the end of the intervention, the mean (SD: standard deviation) scores of anxiety, stress, and depression in the counseling group were 2.66 (1.28), 2.91 (1.62), and 1.98 (1.59) and in the control group were 4.19 (1.85), 5.61 (1.49) and 3.59 (1.91). In the intervention group, the mean score of all three variables was significantly lower than the control group (P < 0.001). After the intervention, the mean (SD) of the total sleep quality score was 4.04 (2.52) in the counseling group and 4.13 (2.63) in the control group. In addition, the mean (SD) of the total quality of life score was 23.47 (20.13) in the counseling group and 23.14 (17.76) in the control group. Between the study groups, there were no statistically significant differences in the mean of the overall score of sleep quality (P = 0.867) and the overall score of quality of life (P = 0.759).
Using ACT-based counseling can improve the mood of menopausal women. However, further randomized clinical trials are needed before making a definitive conclusions.
Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N65. Date of registration: 2/19/2021. Date of first registration: 2/19/2021. URL: https://en.irct.ir/user/trial/53544/view; Date of recruitment start date: 2/22/2021.
女性生命中最关键的时期之一是更年期。在此期间，抑郁和焦虑是最常见的情绪变化之一。睡眠障碍也会在更年期增加，从而导致生活质量障碍。不同的方法，如药物治疗、心理治疗或两者的结合，被用于治疗这些障碍。接纳与承诺疗法（ACT）是心理治疗中最新的方法之一，最近已被广泛应用。因此，本研究旨在确定接纳与承诺疗法（ACT）对（主要结果）更年期妇女的情绪、睡眠质量和生活质量（次要结果）的影响。
本随机对照试验于 2021 年在伊朗大不里士对 86 名更年期妇女进行。采用分组法，将参与者随机分为干预组和对照组。干预组接受了 8 次 60-90 分钟的基于 ACT 方法的咨询。对照组仅接受常规保健。在干预前和干预后立即完成抑郁、焦虑和压力量表 21 项（DASS 21）、更年期生活质量（MENQOL）和匹兹堡睡眠质量指数（PSQI）问卷。采用独立 t 检验和曼-惠特尼 U 检验比较两组结果。
在社会人口统计学特征和研究变量的基线值方面，两组在干预前无统计学差异。在干预结束时，咨询组的焦虑、压力和抑郁的平均（SD：标准差）评分分别为 2.66（1.28）、2.91（1.62）和 1.98（1.59），对照组分别为 4.19（1.85）、5.61（1.49）和 3.59（1.91）。在干预组中，所有三个变量的平均评分均显著低于对照组（P<0.001）。干预后，咨询组的总睡眠质量评分平均（SD）为 4.04（2.52），对照组为 4.13（2.63）。此外，咨询组的总生活质量评分平均（SD）为 23.47（20.13），对照组为 23.14（17.76）。两组之间，睡眠质量的总评分（P=0.867）和生活质量的总评分（P=0.759）的平均值无统计学差异。
基于 ACT 的咨询可以改善更年期妇女的情绪。然而，在得出明确结论之前，还需要进行更多的随机临床试验。
伊朗临床试验注册中心（IRCT）：IRCT20120718010324N65。注册日期：2021 年 7 月 19 日。首次注册日期：2021 年 7 月 19 日。网址：https://en.irct.ir/user/trial/53544/view；招募开始日期：2021 年 7 月 22 日。
