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The Effectiveness of Acceptance and Commitment Therapy on Sexual Function, Coping Strategies and Distress Tolerance of Employees with Rheumatoid Arthritis

Document Type : Original Article

Authors

1 PhD Candidate in Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran

2 Master of Clinical Psychology, Islamic Azad University of Ardabil Branch, Ardabil, Iran

3 Master of Clinical Psychology, Islamic Azad University of Urmia Branch, Urmia, Iran

4 Master of Family Counseling, Islamic Azad University, Quchan Branch, Quchan, Iran

5 Master student of Clinical Psychology, Faculty of Humanities and Social Sciences, University of Kurdistan, Kurdistan, Iran

6 Professor, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

Abstract

Introduction: Rheumatoid arthritis is a multifactorial disease that has many psychological consequences. In this regard, the present study investigated the effectiveness of acceptance and commitment therapy on sexual function, coping strategies, and distress tolerance of employees with rheumatoid arthritis.
Methods: The present research has a quasi-experimental design, with pre-test-post-test and a control group. The statistical population of the research included the employees of Tehran province in 2019. Thirty patients were quasi-experimental divided into intervention (n=15) and control (n=15) groups. The data collection tools included sexual function, coping strategies, and distress tolerance questionnaires. The intervention group received eight 90-minute sessions of acceptance and commitment therapy, but the control group did not. Data were analyzed using multivariate covariance analysis by SPSS-24 software.
Results: Acceptance and commitment therapy significantly reduced emotional and avoidant coping styles. On the contrary, it has increased sexual function, problem-oriented coping style, and distress tolerance (tolerance, absorption, evaluation, adjustment) in employees with rheumatoid arthritis (P<0.001). Also, according to the calculated effect size, 76% of the total variances of the intervention and control groups are due to the effect of the independent variable.
Conclusion: This research findings indicated the effectiveness of acceptance and commitment therapy in increasing the rheumatoid arthritis patients’ mental health. Since patients with rheumatoid arthritis are psychologically vulnerable, it is necessary to take measures to improve their psychological health.

Keywords

References
  1. Bergstra SA, Sepriano A, Kerschbaumer A, van der Heijde D, Caporali R, Edwards CJ, Verschueren P, de Souza S, Pope JE, Takeuchi T, Hyrich KL. Efficacy, duration of use and safety of glucocorticoids: a systematic literature review Informing the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis. Annals of the Rheumatic Diseases. 2023;82(1):81-94.
  2. Lin YJ, Anzaghe M, Schülke S. Update on the pathomechanism, diagnosis, and treatment options for rheumatoid arthritis. Cells. 2020;9(4):880.
  3. Conigliaro P, Triggianese P, De Martino E, Fonti GL, Chimenti MS, Sunzini F, Viola A, Canofari C, Perricone R. Challenges in the treatment of rheumatoid arthritis. Autoimmunity reviews. 2019;18(7):706-13.
  4. Almutairi K, Nossent J, Preen D, Keen H, Inderjeeth C. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatology international. 2021;41(5):863-77.
  5. Chancay MG, Guendsechadze SN, Blanco I. Types of pain and their psychosocial impact in women with rheumatoid arthritis. Women’s midlife health. 2019;5(1):1-9.
  6. Jamshidi T, Gheshlagh RG, Ebtekar F, Dalvand S, Azimi AV, Kurdi A. Prevalence of depression among Iranian patients with rheumatoid arthritis: a systematic review and meta-analysis. Open Access Rheumatology: Research and Reviews. 2019;2019(11):53-9.
  7. Bay LT, Graugaard C, Nielsen DS, Möller S, Ellingsen T, Giraldi A. Sexual health and dysfunction in patients with rheumatoid arthritis: a cross-sectional single-center study. Sexual Medicine. 2020;8(4):615-30.
  8. Boone D, Ronson A, Karsh J. Comparison of female sexual function index in patients with psoriatic and rheumatoid arthritis and healthy controls. Musculoskeletal Care. 2019;17(3):226-30.
  9. Aras H, Aras B, Icagasioglu A, Yumusakhuylu Y, Kemahli E, Haliloglu S, Oguz FM. Sexual dysfunction in women with rheumatoid arthritis. Med Glas (Zenica). 2013;10(2):327-31.
  10. Hari A, Rostom S, Lahlou R, Bahiri R, Hajjaj-Hassouni N. Sexual function in Moroccan women with rheumatoid arthritis and its relationship with disease activity. Clinical Rheumatology. 2015;34(6):1047-51.
  11. Yazdi F, Shakibi MR, Gharavi Roudsari E, Nakhaee N, Salajegheh P. The effect of suffering from rheumatoid arthritis, systemic lupus erythematosus, and back pain on sexual functioning and marital satisfaction in Iran. International Journal of Rheumatic Diseases. 2021;24(3):373-9.
  12. Yilmaz H, Polat HA, Yilmaz SD, Erkin G, Kucuksen S, Salli A, Ugurlu H. Evaluation of sexual dysfunction in women with rheumatoid arthritis: a controlled study. The Journal of Sexual Medicine. 2012;9(10):2664-70.
  13. Zhang Q, Zhou C, Chen H, Zhao Q, Li L, Cui Y, Shen B. Rheumatoid arthritis is associated with negatively variable impacts on domains of female sexual function: evidence from a systematic review and meta-analysis. Psychology, Health & Medicine. 2018;23(1):114-25.
  14. Alia F, Rim BS, Miladi S, Ouenniche K, Kassab S, Chekili S, Zakraoui L, Abdelghani KB, Laatar A. Comparison of sexual function in Tunisian women with rheumatoid arthritis and healthy controls. Clinical Rheumatology. 2019;38(12):3361-5.
  15. Lazarus RS, Folkaman S. Stress, appraisal and coping. New York: Springe 1984:127-139.
  16. Endler NS, Parker JD. Multidimensional assessment of coping: A critical evaluation. Journal of personality and social psychology. 1990;58(5):844-854.
  17. Nebhinani N, Mattoo SK, Wanchu A. Quality of Life, Social Support, Coping Strategies, and Psychiatric Morbidity in Patients with Rheumatoid Arthritis. Journal of Neurosciences in Rural Practice. 2022;13(01):119-22.
  18. Gåfvels C, Hägerström M, Rane K, Wajngot A, Wändell PE. Coping strategies among patients newly diagnosed with diabetes or rheumatoid arthritis at baseline and after 24 months. Journal of Health Psychology. 2018;23(10):1273-86.
  19. Rzeszutek M, Oniszczenko W, Kwiatkowska B. Stress coping strategies, spirituality, social support and posttraumatic growth in a Polish sample of rheumatoid arthritis patients. Psychology, health & medicine. 2017;22(9):1082-8.
  20. Bucourt E, Martaillé V, Goupille P, Joncker-Vannier I, Huttenberger B, Réveillère C, Mulleman D, Courtois AR. A comparative study of fibromyalgia, rheumatoid arthritis, spondyloarthritis, and Sjögren’s syndrome; impact of the disease on quality of life, psychological adjustment, and use of coping strategies. Pain Medicine. 2021;22(2):372-81.
  21. Flurey CA, Hewlett S, Rodham K, White A, Noddings R, Kirwan JR. Coping strategies, psychological impact, and support preferences of men with rheumatoid arthritis: a multicenter survey. Arthritis Care & Research. 2018;70(6):851-60.
  22. Tosato S, Bonetto C, Zanini A, Montanari I, Piccinelli A, Bixio R, Rossini M, Pacenza G, Cristofalo D, Fracassi E, Carletto A. Coping strategies, emotional distress and perceived disease severity in a cohort of patients with rheumatoid arthritis: a mediation analysis. Rheumatology. 2023;62(3):1078-86.
  23. Hruschak VJ, Yuan Y, Ringwald W, Beaugard C, Repine M, Pacella-LaBarbara M, Rosen D, Cochran G. Pain Appraisals in Patients with Physical Injury: Assessing the Role of Distress Tolerance in the Relationship between Depression and Pain Catastrophizing. Health & Social Work. 2021;46(3):187-98.
  24. McHugh RK, Weiss RD, Cornelius M, Martel MO, Jamison RN, Edwards RR. Distress intolerance and prescription opioid misuse among patients with chronic pain. The Journal of Pain. 2016;17(7):806-14.
  25. Goulia P, Voulgari PV, Tsifetaki N, Andreoulakis E, Drosos AA, Carvalho AF, Hyphantis T. Sense of coherence and self-sacrificing defense style as predictors of psychological distress and quality of life in rheumatoid arthritis: a 5-year prospective study. Rheumatology international. 2015;35(4):691-700.
  26. Nyklíček I, Hoogwegt F, Westgeest T. Psychological distress across twelve months in patients with rheumatoid arthritis: The role of disease activity, disability, and mindfulness. Journal of psychosomatic research. 2015;78(2):162-7.
  27. Vriezekolk JE, van Lankveld WG, Geenen R, van den Ende CH. Longitudinal association between coping and psychological distress in rheumatoid arthritis: a systematic review. Annals of the rheumatic diseases. 2011;70(7):1243-50.
  28. Benka J, Nagyova I, Rosenberger J, Calfova A, Macejova Z, Middel B, Lazurova I, van Dijk JP, Groothoff JW. Social support and psychological distress in rheumatoid arthritis: a 4-year prospective study. Disability and rehabilitation. 2012;34(9):754-61.
  29. Russell BS, Lincoln CR, Starkweather AR. Distress tolerance intervention for improving self-management of chronic conditions: A systematic review. Journal of Holistic Nursing. 2019;37(1):74-86.
  30. McHugh RK, Kneeland ET, Edwards RR, Jamison R, Weiss RD. Pain catastrophizing and distress intolerance: prediction of pain and emotional stress reactivity. Journal of Behavioral Medicine. 2020;43(4):623-9.
  31. Simister HD, Tkachuk GA, Shay BL, Vincent N, Pear JJ, Skrabek RQ. Randomized controlled trial of online acceptance and commitment therapy for fibromyalgia. The Journal of Pain. 2018;19(7):741-53.
  32. Scott W, Chilcot J, Guildford B, Daly‐Eichenhardt A, McCracken LM. Feasibility randomized‐controlled trial of online Acceptance and Commitment Therapy for patients with complex chronic pain in the United Kingdom. European Journal of Pain. 2018;22(8):1473-84.
  33. Hann KE, McCracken LM. A systematic review of randomized controlled trials of Acceptance and Commitment Therapy for adults with chronic pain: Outcome domains, design quality, and efficacy. Journal of contextual behavioral science. 2014;3(4):217-27.
  34. Du S, Dong J, Jin S, Zhang H, Zhang Y. Acceptance and commitment therapy for chronic pain conditions on functioning: A systematic review protocol. Journal of advanced nursing. 2021;77(1):417-26.
  35. Hegarty RS, Fletcher BD, Conner TS, Stebbings S, Treharne GJ. Acceptance and commitment therapy for people with rheumatic disease: Existing evidence and future directions. Musculoskeletal Care. 2020;18(3):330-41.
  36. Maher-Edwards L, Ng N, Gillanders D. P060 Pilot study showing the efficacy and acceptability of an acceptance and commitment therapy based brief psychological intervention on mood and disability in patients with early inflammatory arthritis. Rheumatology. 2021;60(1):247-057.
  37. Sharpe L. Psychosocial management of chronic pain in patients with rheumatoid arthritis: challenges and solutions. Journal of pain research. 2016; 9:137.
  38. Faul F, Erdfelder E, Lang AG, & Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39(2): 175-191.
  39. Isidori AM, Pozza C, Esposito K, Giugliano D, Morano S, Vignozzi L, Corona G, Lenzi A, Jannini EA. Outcomes assessment: Development and validation of a 6-item version of the Female Sexual Function Index (FSFI) as a diagnostic tool for female sexual dysfunction. The journal of sexual medicine. 2010;7(3):1139-46.
  40. Ghassami M, Shairi M R, Asghari Moghadam M A, Rahmati N. The Study of the Psychometric Properties of the 6-Item Version of the Female Sexual Function Index (FSFI-6) amongst Iranian Women. Nursing and Midwifery Journal 2014; 12(7):532-543. (Persian)
  41. Bagheri Sheykhangafshe F, Tajbakhsh K, Savabi Niri V, Nakhostin Asef Z, Fathi-Ashtiani A. The Efficacy of Cognitive-behavioral Therapy on Psychological Distress and Coping Strategies of Employees with Chronic Low Back Pain. Iran J Health Sci 2023; 11(2):93-102.
  42. Simons JS, Gaher RM. The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and emotion. 2005;29(2):83-102.
  43. Alavi Kh, Modarres Gharavi M, Amin-Yazdi SA, Salehi Fadardi J. Effectiveness of group dialectical behavior therapy (based on core mindfulness, distress tolerance, and emotion regulation components) on depressive symptoms in university students. Journal of Fundamentals of Mental Health. 2011;13(2):35-124. (Persian)
  44. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press; 2011.
Sadra Medical Journal
Volume 11, Issue 4
October 2023
Pages 360-373
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