علیرضا محمودی راد

Since older people suffer from many physical and psychological problems due to their age, improving physical and psychological health is essential for planners and practitioners in any country's social health field. Among the risk factors in old age is the increased concentration of lipids in the plasma, which can increase the problems of patients in the health field. Another problem for older people is the reduction of their cognitive abilities, which can lead to emotional and behavioral problems. In this regard, finding low–cost and low–risk ways to reduce older people's problems is one of society's main and important issues. On the other hand, nowadays, paying attention to psychological treatments as an alternative without complications and high costs to reduce the problems of patients has gained particular importance. Therefore, the present study compared the effectiveness of cognitive–behavioral therapy combined with self–compassion and cognitive–motor activities with cognitive–motor therapy alone on the plasma lipoproteins and executive functions of older people.

The research method was quasi–experimental, with a pretest–posttest and follow–up design with a control group. The statistical population consisted of older people over 60 living in Mashhad Cirt, Iran, in 2021. Among these, 42 volunteers (21 women and 21 men) who met the inclusion criteria were recruited and randomly assigned to the three groups: the first experimental group (cognitive–behavioral therapy combined with self–compassion and cognitive–motor activities), the second experimental group (cognitive–motor activities), and the control group (without intervention). The experimental groups were subjected to 18 sessions of 90 minutes during 9 weeks of interventions. The research tool was the Behavior Rating Inventory of Executive Function (BRIEF) (Gioia et al., 2000(. To analyze the research data, descriptive statistics indices, including frequency, percentage, mean, and standard deviation were used. Also, inferential statistics, including analysis of covariance to examine blood lipoproteins, analysis of variance with repeated measurements to investigate scores of executive functions, and Bonferroni post hoc test for intergroup comparison and variable measurement steps, were used. The data were analyzed using SPSS version 22 software, and the significance level of the tests was set at 0.05.

The results indicated that only the two variables of triglyceride (p<0.001) and high–density lipoprotein (HDL) (p=0.003) had a significant difference between the three research groups in the posttest after removing the effect of the pretest. However, there were no significant differences between study groups regarding cholesterol (p=0.233) and low–density lipoprotein (LDL) (p=0.408). Both interventions significantly changed the amount of triglyceride (p=0.007) and HDL (p=0.006). Also, the effect of time, group, and the interaction effect of time and group on the variable of executive functions were significant (p<0.001). The difference between the averages in the first and second test groups between the pretest, posttest, and follow–up was significant (p<0.001). In both experimental groups, the difference between the average scores of the posttest and the follow–up was not significant, which indicated the persistence of the intervention's effect (p>0.05).

Based on the research findings, cognitive–behavioral therapy combined with self–compassion, cognitive–motor activities, and cognitive–motor therapy alone are effective and efficient in reducing plasma lipoproteins and improving the executive functions of older people. In comparison, cognitive–behavioral therapy combined with self–compassion and cognitive–motor activities has more effectiveness in triglyceride and HDL variables.

The aim of this study was to compare the effectiveness of cognitive-behavioral therapy combined with self-compassion along with cognitive-motor activities versus cognitive-motor intervention alone on death anxiety and aging perception in the elderly.

Methods and Materials: 

The research method was quasi-experimental and of the pre-test, post-test type with a control group and a follow-up period. To this end, a sample consisting of 42 individuals (21 women and 21 men) over the age of 60 residing in Mashhad in 2021, who met the inclusion criteria, was selected. They were randomly assigned to three groups: the first experimental group (with cognitive-behavioral therapy combined with self-compassion along with cognitive-motor activities), the second experimental group (with cognitive-motor activities alone), and the control group (with no intervention). They underwent 18 sessions of 90 minutes over 9 weeks. Data obtained from the Templer Death Anxiety Questionnaire (1970) and the Slotman Aging Perception Questionnaire (2017) were analyzed using SPSS software and multivariate covariance analysis with repeated measures.

The results showed that for both variables, death anxiety and aging perception, there was a significant difference between the two experimental groups and the control group in both post-test and follow-up periods. However, the difference between the two experimental groups was not significant.

It appears that cognitive-behavioral therapy combined with self-compassion along with cognitive-motor activities, as well as cognitive-motor intervention alone, can be used to reduce death anxiety and improve the perception of aging in the elderly. These interventions can contribute to enhancing the quality of life and developing appropriate educational programs for them.

High blood pressure is one of the most common risk factors for cardiovascular disease that leads to many problems and problems, Therefore, the aim of the present study was to compare the effectiveness of acceptance and commitment therapy and rational-emotional-behavioral therapy on depression and anxiety in patients with hypertension.

The present study was a quasi-experimental pre-test-post-test and follow-up with a control group. A total of 36 patients with hypertension in Birjand in the second six months of 2020 were selected by convenience sampling method and randomly divided into three groups of acceptance and commitment therapy (12 patients), rational-emotional-behavioral therapy (12 patients) and Witnesses (12 people) were replaced. The experimental groups were trained in 8 sessions of 60 minutes with acceptance and commitment and rational-emotional-behavioral methods, respectively, and the group did not receive a training certificate. Data collection tools were Beck Depression Inventory - Second Edition Beck et al. (2000) and Beck et al. (1988) Anxiety Inventory. Data were analyzed using SPSS software version 24 and repeated measures analysis of variance test .

The results showed that acceptance, commitment and rational-emotional-behavioral therapies reduced depression and anxiety in patients with hypertension compared to the control group (p <0.01); But there was no difference between acceptance and commitment therapy and rational-emotional-behavioral therapy in reducing depression and anxiety in patients with hypertension (p <0.01).

The results showed the importance of both acceptance and commitment and rational-emotional-behavioral therapies in reducing anxiety and depression in patients with hypertension

There exists a relationship between spirituality and depression. Moreover, psychological interventions are effective in this regard. Thus, this study aimed to investigate the effects of Acceptance and Commitment Therapy (ACT) with and without compassion on spiritual fatalism and depression in non-clinically depressed diabetic patients.

This was a quasi-experimental study with a pre-test, post-test and follow-up and a control group design. The statistical population included all non-clinical depressed patients with type 2 diabetes in the welfare centers of Mashhad City, Iran, in 2020. To form 3 research groups using the purposive sampling method, 33 subjects were selected and randomly divided into the study groups. Moreover, after 2 months, a follow-up test was performed on the research groups. The research instruments included the Patient Health Questionnaire (Depression) by Arbi et al. and the Diagnosis Scale of Egede and Ellis Diabetes.

The repeated measures analysis of variance data suggested that the ACT approaches with and without compassion intervention were effective in increasing spiritual fatalism (P<0.05) and reducing depression (P<0.05) in the explored nonclinical depressed diabetic patients. Moreover, the follow-up data revealed the stability of the collected results (P<0.05).

ACT, as an effective intervention can be used in medical centers to increase spiritual fatalism and reduce depression in diabetic patients with depression vulnerability

Understanding the severity of depression, stress and anxiety is essential to ensure adherence to treatment and achieve appropriate treatment outcomes in patients with hypertension; therefore, the aim of this study was to determine the effectiveness of rational-emotional-behavioral therapy on depression and anxiety in patients with hypertension.

The present study was a quasi-experimental pretest-posttest with a control group. From the statistical population that includes all people with hypertension referred to Dr. Mahmoudi Rad clinic in the first six months of 2020 in Birjand, 24 eligible people were selected by convenience sampling method and randomly divided into two groups (12 people tested And 12 controls were placed. The experimental group participated in eight sessions of Dryden and Newman (2013) rational-emotional-behavioral therapy, but the control group was on the waiting list. Data collection tools were Beck Depression Inventory - Second Edition Beck et al. (2000) and Beck et al. (1988) Anxiety Inventory. Data were analyzed using SPSS software version 24 and analysis of variance with repeated measures between groups at the significance level of α = 0.05.

The results showed that rational-emotional-behavioral was effective in reducing depression (p <0.01) and anxiety (p <0.01) in patients with hypertension and these results continued in the follow-up period (p <0.01).

Considering the effectiveness of rational-emotional-behavioral therapy, the results of this study can be used for psychiatric nursing processes as well as prevention of psychological problems in patients with hypertension for health system managers, for proper treatment planning, promotion of mental health services and related policies. It should be used in the community and they should pay more attention to non-drug therapies.

Due to the prevalence of depression in diabetes and the importance of negative self-referrals (worry and rumination) in the severity of depression, this study aimed to evaluate the comparative effectiveness of acceptance and commitment-based therapy with and without compassion on worry, anger rumination, and Self-Critical Rumination in Non-clinical depressed diabetic Patients.

The present study was a clinical trial with two intervention groups (first group: acceptance and commitment treatment without compassion intervention and second group: acceptance and commitment therapy with compassion) and a control group with two months follow-up. The statistical population consisted of all non-clinical depressed diabetic patients in the welfare centers of Mashhad in the spring of 2020. Using purposive sampling, 33 people were selected and then patients were divided into three groups and Interventions were assigned randomly. Data were collected by Sukhodolsky, Gotub & Cromwell Anger Rumination Questionnaire, Smart, Peter & Baer Self-Criticism Ruminant Questionnaire and Pennsylvania worry and analyzed by repeated measures analysis of variance in SPSS software version 25.

The results showed that in both intervention groups, the scores obtained on worry, rumination of anger and self-criticism in the post-test period decreased compared to the pre-test (p 0.05).

Acceptance and commitment based therapy as an effective intervention can be used in medical centers to reduce negative self-referral processes (worry and rumination) of diabetic patients with depression vulnerability.

Failure to treat hypertension often leads to fatal complications; thus, there is an urgent need to develop and expand effective psychological interventions in this respect. Therefore, this study aimed to determine the effects of Acceptance and Commitment Therapy (ACT) on depression and anxiety in patients with hypertension.

This was a quasi-experimental study with a pre-test, post-test and a control group design. In total, 24 patients with hypertension in Birjand city, Iran, in the second half of 2020 participated in this research. The study subjects were selected from the eligible subjects who volunteered to participate in the study. Besides, they were chosen by convenience sampling method and randomly assigned to the experimental and control groups (n=12/group). The experimental group participated in eight ACT sessions developed by Hayes et al. (2011); however, the control group remained on the waiting list. Data collection tools were the Beck Depres-sion Inventory – Second Edition (BDI-II) (2000) and Beck Anxiety Inventory (BAI; Beck et al., 1988). The col-lected data were analyzed in SPSS using repeated-measures Analysis of Variance (ANOVA) at the significance level of P=0.05.

The current study results revealed that ACT was effective in reducing depression (P<0.01) and anxiety (P<0.01) in patients with hypertension; these results remained consistent until the follow-up step (P<0.01).

The obtained data indicated the effectiveness of ACT in reducing depression and anxiety in patients with hypertension. Thus, this intervention can be used as a complementary therapy to improve psychological problems in patients with hypertension.