جستجوی مقالات مرتبط با کلیدواژه « cognitive rehabilitation therapy » در نشریات گروه « پزشکی »

In today's world, learning disabilities are recognized as the most important factor in the weakness and dropout of students in primary school. Among students’ problems are learning disabilities, reading difficulties, and intolerability of uncertainty. Lack of treatment and control of children, in addition to creating numerous problems at the family, school and community level, future children also face challenges. Thus, it can be seen how these special education programs are important and effective for these children. Cognitive rehabilitation therapy and play therapy are among the most important programs in treating students with learning disabilities. Therefore, this study aimed to compare the effectiveness of cognitive rehabilitation therapy and play therapy on reading performance, reading problems, and intolerability of uncertainty and evaluate the persistence of its effects over time.

The research method was quasi–experimental with a pretest–posttest and follow–up test (three weeks after the implementation of treatment protocols) which was performed with two experimental groups and one control group. The first independent variable was cognitive rehabilitation intervention that was applied to the first experimental group and the second independent variable was cognitive play therapy which was performed on the second experimental group. Also, the control group did not receive any training. The study’s statistical population included all female students with special learning disabilities with reading defects in the fourth grade of elementary school studying in Hamadan primary schools, Iran, in the academic year of 2019–2020. The sample size was equal to 45 students in three groups that were selected by using Cochran's formula and convenience sampling method. They were randomly divided into groups of 15 into three groups: two experimental groups (cognitive rehabilitation therapy and play therapy) and one control group. The tools used to measure variables in three groups and three stages were 3 standard questionnaires: Uncertainty Intolerance Scale (UIS) (Freeston et al., 1994), Problem Type Assessment Table (Tabrizi et al., 2018), Reading and Dyslexia Test (NEMA) (Kormi Nouri & Moradi, 2005). For data sorting, central and dispersion indicators such as mean and standard deviation, and for data analysis, repeated measures analysis of variance and Tukey and Bonferroni post hoc tests were used. The mentioned statistical analyzes were performed in SPSS software version 25. The significance level of the tests was considered 0.05.

The effect of time, group, and interaction of time and group on the variables of reading performance, reading problems, and uncertainty intolerance were significant (p<0.001). The average reading performance variables and reading problems and intolerance of uncertainty were significantly different between the cognitive rehabilitation therapy and play therapy groups with the control group (p<0.001). In both experimental groups, there were significant differences between the pretest, posttest, and follow–up regarding the mentioned variables (p<0.001). However, there was no significant difference between the posttest and the follow–up regarding the mentioned variables, indicating the persistence of the effectiveness of both interventions in the follow–up phase (p>0.05). Also, a significant difference was observed between the effect of cognitive rehabilitation and play therapy on the aforementioned variables in the posttest and follow–up (p<0.001).

Both methods of cognitive rehabilitation therapy and play therapy are effective in increasing reading performance, reducing reading problems, and reducing uncertainty intolerance. But in comparison, the effect of cognitive rehabilitation therapy in improving reading performance is more than play therapy, while play therapy is more effective than cognitive rehabilitation therapy in reducing reading problems and reducing intolerability of uncertainty.

Hypertension is one of the most common chronic diseases in the world. It is considered one of the most important public health issues in the world and causes millions of deaths due to stroke and cardiovascular and kidney diseases. Research shows that people with hypertension suffer psychological, emotional, and social challenges. Stress, depression, and anxiety are among the most common psychological problems in this group of patients. Cognitive rehabilitation therapy and mindfulness–based therapy are among the treatments that studies have shown can affect anxiety. Therefore, the present study was conducted to compare the effects of cognitive rehabilitation therapy and mindfulness–based therapy on the anxiety of patients with hypertension.

This double–blind clinical trial and quasi–experimental study has a pretest–posttest and follow–up design with a control group. The statistical population consisted of all the people with hypertension living in Rasht City, Iran, who were referred to the specialized heart hospital in the city in 2021. From this community, 51 qualified volunteers entered the study by the convenience sampling method and were randomly assigned to groups of cognitive rehabilitation therapy, mindfulness–based therapy, and control group (17 people in each group). The inclusion criteria were as follows: informed consent and willingness to participate in the research, having high blood pressure (according to the medical record), anxiety more than average (anxiety score 16–40 according to the Beck Anxiety Inventory), ability to read and write, age range from 30 to 60 years, not abusing drugs and alcohol, not suffering from severe personality and clinical disorders, lacking a history of head trauma and recent brain injuries, not receiving electric shock or special treatment in the last six months, and not participating in psychotherapy courses at the same time or in the last two months. The exclusion criteria were as follows: absence of more than two sessions, unwillingness to continue psychotherapy, a possible complication of the subject and the occurrence of an accident and the absence or event affecting the research variables. Beck Anxiety Inventory (Beck et al., 1988) was employed in this research. Cognitive rehabilitation therapy was conducted face–to–face and individually for the first experimental group (using the computer in 10 sessions of 60 minutes once a week) at the Cardiovascular Diseases Research Center located in Heshmat Hospital in Rasht. Mindfulness–based therapy sessions were held for 2 months (8 sessions, one 90–minute session each week) for another experimental group online (through Skyroom software) and the control group did not undergo any type of psychotherapy at the same time. For data analysis in descriptive statistics, mean and standard deviation chart were used. For inferential statistics, the Chi–square test, 1–way analysis of variance, analysis of variance of repeated measurements, and Bonferroni post hoc test were used. Data analysis was done in SPSS software version 26 at a significance level of 0.05.

The results showed that the effects of time (p<0.001), group (p<0.001), and the interaction of group and time (p<0.001) on the anxiety variable were significant. The posttest (p<0.001) and follow–up scores (p<0.001) of the anxiety variable in the mindfulness group and cognitive rehabilitation group decreased significantly compared to the pretest scores. In contrast, there was no significant difference between the anxiety scores of the control group at different times (p>0.05). There was a significant difference between cognitive rehabilitation and mindfulness groups in terms of effectiveness in the posttest and follow–up on reducing anxiety compared to the control group (p<0.001). While there was no significant difference between the two experimental groups in the posttest (p=0.616) and follow–up (p=0.221) in terms of effectiveness in reducing anxiety.

According to the research findings, cognitive rehabilitation therapy and mindfulness–based therapy were effective on the anxiety of patients with hypertension, and there was no significant difference between the two therapies. Therefore, both types of psychotherapies are equally beneficial to help patients with hypertension manage a chronic and life–threatening disease.