طب انتظامی (Jan 2022)
The Effect of Acceptance and Commitment Therapy on the Security and Mental health of Veterans' Wives
Abstract
INTRODUCTION ... [1]. It is the responsibility of the wives to cope with the physical and mental problems of the veteran, especially when the injury is high or the veteran is suffering from post-trauma stress disorder [2]. Therefore, the wives of veterans in terms of mental health can be considered an at-risk group in society [3]. ... [4-7]. The challenges of this group, especially psychosocial security as a component affecting the lives of these people, are problematic and one of the issues to be considered important [8]. ... [9, 10]. Based on the growing trend of various psychological and social disorders among women, the role of preventive and therapeutic psychological interventions is of particular importance. One of the approaches that has been noticed by psychologists in recent years is acceptance and commitment therapy [11]. Du et al. have shown that acceptance and commitment therapy in women reduces their negative feelings and, consequently, improves their level of psychosocial and emotional adjustment and security [13]. The results of Mahmoudi et al.'s study indicate a steady upward trend in the scores of the Hope and Belief in a Fair World Scale for patients with breast cancer, which indicates the effectiveness of acceptance and commitment therapy in increasing these variables [14]. Howells, Ivtzan, and Eiroa-Orosa have also reported in a study that acceptance and commitment therapy affects women's social desirability and improves their positive aspects of health [15]. Aslani and Azadeh have concluded in another study that acceptance and commitment therapy has an effect on social well-being and security and improves psychological security and well-being in women [16]. Shojaeian also reported in a study that commitment and acceptance therapy is effective on women's life expectancy and mental health. In fact, by using acceptance and commitment therapy the level of life expectancy and mental health of women improves [17, 18]. AIM(S) This study aimed to evaluate the effectiveness of acceptance and commitment therapy on the psychosocial security and mental health of veterans' wives. RESEARCH TYPE The present study is a quasi-experimental study using a pretest-posttest design with a control group. RESEARCH SOCIETY, PLACE &TIME The statistical population of this study was the wives of veterans admitted to Niayesh Hospital in Tehran, Iran in 2021 from which 30 women were selected by available sampling and were examined. SAMPLING METHOD & NUMBER The researcher called 64 people from the available samples by telephone and finally, 30 people were randomly divided into two groups of experimental (15 people) and control (15 people). Inclusion criteria included: physical and mental health of individuals and exclusion criteria, a complete dissatisfaction with participation in sessions, and absence of more than two training sessions. USED DEVICES & MATERIALS Mental health questionnaire (reliability 0.91) [19, 20] and psychosocial security questionnaire (reliability 0.89) [21] were used to collect data. In the mental health questionnaire, if a person gets a score of 6 and a total score of 22 or higher in each subscale, it indicates symptoms and a lower score indicates higher mental health [19]. METHODS After the training package of acceptance and commitment therapy was developed based on the experts’ opinions, its validation was performed and it was intensively implemented in a pilot group of five volunteers. After selecting the final groups of the study, the participants of the two groups participated in a briefing session. Then the pre-test was held for both experimental and control groups on the same day and they filled the questionnaires. Then, the training package for the experimental group for 8 sessions per week was implemented by the first author of the article, who was responsible for performing psychological therapies in Niayesh Hospital (Table 1). During the training period, the participants in the control group did not receive any training. After completing the training course and after two months, a follow-up was performed. ETHICAL PERMISSION The ethical permissions of the present study were fully observed; participants could leave the research at any time and all their confidential information was stored in the questionnaire without exploitation. STATISTICAL ANALYSIS In the inferential statistics section, the analysis of covariance using SPSS 25 software was used to analyze the research data. FINDING BY TEXT Demographic data of the statistical sample showed that the age range of veterans' wives was between 23 to 54 years and their mean age was 48.5±4.61 years. The level of education of 50% of the samples was under high school diploma, 20% high school diploma, 25% an associate degree, and 5% higher than a bachelor. The results of the Kolmogorov-Smirnov test showed that the data were normal. In the pre-test stage, the mean scores of mental health and psychosocial security in the control and experimental groups were almost equal, but the results in the post-test showed that the mean scores of psychosocial security in the experimental group were higher than the control group (Table 2). Based on the Leven test and lack of significance for mental health and security variables, the condition of equality of intergroup variances was observed and the groups were homogeneous (Table 3). The value of F of the interaction of independent and covariant variables in the psychosocial security variable was also 3.04, which was not significant and it can be said that the correlation between covariant and independent variables was observed (Table 4). Therefore, an analysis of covariance was used. According to the obtained figures, after adjusting the pre-test scores, there was a significant effect on the factor between the subjects (F=6.42; p=0.01) and the mean scores of the experimental group increased significantly (Table 5). Also, the value of F was the interaction of independent and covariant in the mental health variable 2.76, which was not significant and it can be said that the correlation between variable and independent was observed (Table 6). According to the results obtained after adjusting the pre-test scores, there was a significant effect on the factor between the subjects (F=4.75; p=0.03) and the mean scores of the experimental group decreased significantly (Table 7). MAIN COMPARISION TO THE SIMILAR STUDIES The results showed that acceptance and commitment therapy had an effect on the psychological security of veterans' wives and increased women's psychosocial security. This finding is consistent with the results of Junkin as well as Mohammadi, Borjali, and Sohrabi studies [11, 12]. In explaining the obtained results, it can be said that acceptance and commitment therapy allows people to change their relationships with internal experiences, reduce empirical avoidance and increase acceptance flexibility and increase action in valuable ways in the first stage. Emphasis is also placed on strengthening a non-judgmental and enthusiastic relationship with experiences. Lack of judgment and flexibility can help increase psychological security. ... [22]. Howells, Ivtzan, and Eiroa-Orosa have also reported in a study entitled "Acceptance and Commitment Therapy on Happiness in Women" that acceptance and commitment therapy has an effect on women's happiness and social well-being and improves their positive health aspects [15]. By explaining the findings, it can be said that in acceptance and commitment therapy, the main emphasis is on accepting reality, accepting responsibility and the present. Therefore, the counselor helps the clients to evaluate their behavior and see if this behavior is practical and useful for them or not, and to set a realistic plan for better behaviors. Therefore, to achieve their goals, they must be committed to that plan. In other words, the goal of acceptance and commitment therapy is to reduce empirical avoidance and increase psychological flexibility by accepting unavoidable and distressing unpleasant feelings such as anxiety, cultivating mindfulness, and defining personal values related to behavioral goals. ... [23]. Also, the results of the research of Hartley and Shojaeian [6, 17] are consistent with the present study. ... [24]. SUGGESTIONS It is suggested that responsible institutions provide conditions for free psychological interventions, including acceptance and commitment therapy, along with appropriate economic, educational, and cultural support, for these families so that women have a positive evaluation of their social status. It is suggested to the practitioners that in real treatment sessions, regardless of the theoretical perspective or the style of counseling and treatment adopted, a plan to increase acceptance as well as a life based on the value of clients be considered to optimize the treatment of this disorder. LIMITATIONS The generalization of results requires caution due to cultural, ethnic, and social differences. Another limitation of the present study was the use of self-report scales. Coincidence of conducting research with the corona virus (Covid-19) epidemic was another limitation that made it difficult to collect data. CONCLUSIONS Psychological security and mental health are among the variables related to the health of veterans' wives and they can predict it. CLINICAL & PRACTICAL TIPS IN POLICE MEDICINE According to the results of the present study on the effectiveness of acceptance and commitment therapies in increasing psychological security and mental health, such interventions can be used in counseling and treatment centers of police headquarters. It is also possible to hold similar classes for wives and their family members in these centers to increase their awareness and skills, using the results of studies conducted. ACKNOWLEDGMENTS This article is taken from a research paper. We would like to thank all the participants in the research and all who helped us in this research. CONFLICT OF INTEREST The authors hereby declare that there is no conflict of interest in the present study. FUNDING SOURCES The present study had no financial support.
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