Shahkaram Homa, Sadeghi Amir, Masjedi Arani Abbas, Bakhtiari Maryam, Kianimoghadam Amir Sam
Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Gastroenterol Hepatol Bed Bench. 2024;17(3):288-296. doi: 10.22037/ghfbb.v17i3.2920.
This study aimed to investigate whether transdiagnostic treatment as well as acceptance and commitment therapy (ACT) could improve treatment adherence and alleviate gastrointestinal symptoms plus perceived stress in patients suffering from irritable bowel syndrome.
Research has shown that people with chronic diseases often have negative attitudes toward medications, especially when they also have psychiatric disorders. This, along with the complex dosing requirements and inadequate knowledge about medication adherence among irritable bowel syndrome patients, can affect the treatment efficacy.
A randomized clinical trial was conducted using a pre-test-post-test design. The statistical population included patients with irritable bowel syndrome referring to Taleghani Hospital in Tehran between winter 2021 and spring 2022. Convenience sampling was used to select 30 individuals, with 15 people assigned to each group. Two types of psychotherapy were provided online and individually to the participants. The desired treatments were given to the transdiagnostic treatment and ACT groups in eight weekly sessions of 45-60 minutes.
There was no significant difference between the transdiagnostic treatment pre-test and ACT regarding perceived stress, medication adherence, and gastrointestinal symptoms (P>0.05). There was no significant difference either between the transdiagnostic treatment and ACT post-test. However, there was a significant difference between the pre-test and post-test phases of ACT regarding adherence, gastrointestinal symptoms, plus perceived stress (P<0.05) and transdiagnostic treatment regarding gastrointestinal symptoms (P<0.05).
Specialists may use transdiagnostic treatment and ACT as effective psychological treatments to alleviate gastrointestinal symptoms and perceived stress, thereby increasing treatment adherence in patients with irritable bowel syndrome.
本研究旨在调查跨诊断治疗以及接纳与承诺疗法（ACT）是否能够提高肠易激综合征患者的治疗依从性，并缓解其胃肠道症状及感知到的压力。
研究表明，患有慢性病的人通常对药物有消极态度，尤其是当他们同时患有精神疾病时。这一点，再加上肠易激综合征患者复杂的用药要求以及对药物依从性的了解不足，会影响治疗效果。
采用前后测设计进行随机临床试验。统计人群包括2021年冬季至2022年春季期间转诊至德黑兰塔莱哈尼医院的肠易激综合征患者。采用便利抽样法选取30名个体，每组15人。为参与者在线提供两种类型的心理治疗，并单独进行。在为期八周、每次45 - 60分钟的疗程中，为跨诊断治疗组和ACT组提供所需治疗。
在感知到的压力、药物依从性和胃肠道症状方面，跨诊断治疗前测与ACT之间无显著差异（P>0.05）。跨诊断治疗与ACT后测之间也无显著差异。然而，ACT在依从性、胃肠道症状以及感知到的压力方面的前测和后测阶段之间存在显著差异（P<0.05），跨诊断治疗在胃肠道症状方面也存在显著差异（P<0.05）。
专家们可以将跨诊断治疗和ACT作为有效的心理治疗方法，以缓解胃肠道症状和感知到的压力，从而提高肠易激综合征患者的治疗依从性。
