Abstract
Background & Objectives: Asthma is a psychosomatic disease with different physical and mental dimensions, each of which can aggravate the other. Properly treating this disease requires appropriate medical and psychological measures. Psychologists are interested in the widespread prevalence of psychological disorders, especially anxiety and depression, among patients with asthma. Research shows that people with asthma who report more symptoms of anxiety are more likely to need medical treatment, frequent hospitalizations, and emergencies. These people are more incapable of daily activities and show more behavioral problems. One of the most critical issues among patients is adherence to treatment because non –compliance is always an important and multifaceted problem in the field of health. So, the present study aimed to investigate the effectiveness of stress inoculation and positive psychology on anxiety and adherence to treatment in patients with asthma.
Methods: The present quasi –experimental study employed a pretest –posttest and three –month follow –up design with a control group. The statistical population included all patients with asthma referred to the specialized and sub –specialized center of Milad Hospital in Tehran City, Iran, in 2019. Of whom, 45 eligible individuals (based on inclusion and exclusion criteria) volunteered to participate in the study. They were randomly assigned to three groups: positive psychology training, stress inoculation training, and the control group. Data were collected using the Beck Anxiety Inventory (Beck et al., 1988) and the Morisky Medication Adherence Scale (Morisky et al., 1986). Positive psychotherapy training was conducted in fourteen 90 –minute sessions twice a week for two months. Immunization training against stress was conducted during nine 90 –minute sessions. No intervention was provided for the control group. Central and dispersion indices such as mean and standard deviation were used to describe the data. For data analysis, repeated measures analysis of variance, Tukey and Bonferroni post hoc tests, analysis of variance, and the Chi –square test were used in SPSS.22 software. The significance level of the tests was considered 0.05.
Results: The analysis of variance of variables of anxiety and adherence to treatment was significant for time effect (p<0.001), group effect (p<0.001), and time*group effect (p<0.001). Positive psychology training and stress inoculation training were effective on anxiety (p<0.001) and adherence to treatment (p<0.001). Also, there was a significant difference between the two types of training in variables of anxiety (p=0.017) and adherence to treatment (p<0.001). In the experimental groups, the mean scores of variables of anxiety and adherence to treatment in the posttest and follow –up stages were significantly different from the pretest stage (p<0.001), but there was no significant difference between the posttest and follow –up stages in the mean scores of variables of anxiety (p=0.105) and adherence to treatment (p=0.804), indicating the durability of the effectiveness of the two types of training over time.
Conclusion: Based on the findings of this study, positive psychology training had a greater effect on reducing anxiety and increasing adherence to treatment of patients with asthma than stress inoculation training.