Volume 23, Issue 4 (10-2024)
TB 2024, 23(4): 31-43 |
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Ethics code: IR.IAU.SRB.REC.1402.227
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Seyfi Avarsin A, Pirkhaefi A, Kalhornia Golkar M. The Effectiveness of Cognitive-Behavioral Group Therapy on Depression and Self-Efficacy of Patients with Hypertension. TB 2024; 23 (4) :31-43
URL: http://tbj.ssu.ac.ir/article-1-3645-en.html
URL: http://tbj.ssu.ac.ir/article-1-3645-en.html
Garmsar, Iran , Apirkhaefi@gmail.com
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The Effectiveness of Cognitive-Behavioral Group Therapy on Depression and Self-Efficacy of Patients with Hypertension
Aziz Seyfi Avarsin (Ph.D.)1, Alireza Pirkhaefi (Ph.D.)2, Maryam Kalhornia Golkar (Ph.D.)3
1.Ph.D. student of Health psychology, Department of Health Psychology, UAE Branch, Islamic Azad University, Dubai. United Arab Emirates
2.Corresponding Author: Associate Professor of Department of Clinical psychology, Garmsar branch, Islamic Azad University, Garmsar, Iran Tel: 09123779022 Email: Apirkhaefi@gmail.com
3.Assistant Professor of Department of psychology, Karaj branch, Islamic Azad University, Karaj, Iran
Abstract
Introduction: Hypertension is one of the most common chronic diseases, which if not properly managed, can lead to not only physical health issues but also reduced psychological well-being and efficiency. Therefore, the aim of the present study was to determine the effectiveness of cognitive-behavioral group therapy on depression and self-efficacy in patients with hypertension.
Methods: The present study was a quasi-experimental intervention, conducted as a pre-test, post-test design with experimental and control groups, and with a 90-day follow-up. The study population consisted of all hypertension patients who referred to healthcare centers in Tehran in 2023, from which 38 subjects were selected through purposive sampling and randomly assigned to experimental and control groups. The data collection tools included a demographic form, the Beck’s Depression Inventory (BDI-II), and the General Self-Efficacy Scale (GSE-17). Data were analyzed using repeated measures ANOVA with a significance level of 0.05, using SPSS-21 software.
Results: Cognitive-behavioral group therapy was effective in reducing depression (F=78/6, P< 0/001) and increasing self-efficacy (F=12/7, P < 0/001) among patients with hypertension. Additionally, the effect size of cognitive-behavioral therapy was 70% for depression and 27% for self-efficacy, with the effects persisting up to three months post-treatment.
Conclusion: The finding indicated that cognitive-behavioral therapy can lead to improvements in depression and an increase in psychological self-efficacy in patients with hypertension. Therefore, this cost-effective and affordable treatment method can be utilized alongside routine treatment (medication) to enhance the psychological well-being of these patients.
Keywords: Depression, Self-Efficacy, Cognitive Behavioral Therapy, Hypertension
References
1-Purnomo E, Nur A, Rahim R & et al. The effectiveness of instrumental music therapy and self-hypnosis on decreasing blood pressure level among hypertension patients. International Journal of Nursing Health Services. 2020;3(2):214-23.
2-Wang Z, Chen Z, Zhang L & et al. Status of hypertension in China: results from the China hypertension survey, 2012–2015. Circulation. 2018;137(22):2344-56.
3-Yin R, Yin L, Li L & et al. Hypertension in China: burdens, guidelines and policy responses: a state-of-the-art review. Journal of human hypertension. 2022;36(2):126-34.
4-Mahdavi M, Parsaeian M, Mohajer B & et al. Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines. BMC Public Health. 2020;20:1-9.
5-Sabetfar N, Meschi F, Hosseinzade M. The effectiveness of mindfulness-based group therapy on perceived stress, emotional cognitive regulation, and self-care behaviors in patients with hypertension. Internal Medicine Today. 2021;27(2):246-63.
6-Zhang X, Li C. Major depressive disorder increased the risk of hypertension: A Mendelian randomization study. Journal of Affective Disorders. 2024;355:184-9.
7-Kraynak TE, Andreescu C. Pathways linking hypertension and depression with mild cognitive impairment in older adults. International Psychogeriatrics. 2022;34(6):515-7.
8-Wright R, Roberson K, Onsomu EO & et al. Examining the relationship between mindfulness, perceived stress, and blood pressure in African-American college students. Journal of best practices in health professions diversity: research, education policy. 2018;11(1):13.
9-Mujahid EH, Limoa E. The Effect of Supportive Psychotherapy Ventilation Techniques on Blood Pressure and Pulse rate in Depressed and Anxious Patients. Scientific Journal of Medical Faculty of Halu Oleo University. 2023;10(3):1-6.
10-Zhang Y, Zhang H, Zhang Y & et al. Effect of MBSR, DBT and CBT on the hypertension patients with depression/anxiety: Protocol of a systematic review and Bayesian network meta-analysis. Plos one. 2023;18(2):e0281469.
11-Zhang H, Zhang X, Jiang X & et al. Mindfulness-based intervention for hypertension patients with depression and/or anxiety in the community: a randomized controlled trial. Trials. 2024;25(1):299.
12-Woodcock S, Tournaki N. Bandura’s Triadic Reciprocal Determinism model and teacher self-efficacy scales: a revisit. Teacher Development. 2023;27(1):75-91.
13-Pakdel H, Shorabi F, Hajializade K. The efficacy of intensive short-term dynamic psychotherapy on job stress coping strategies, health-related quality of life, and self-efficacy of iran air traffic controler staff. Journal of psychologicalscience. 2022;21(111):543-58.
14-Hamidi S, Gholamnezhad Z, Kasraie N & et al. The effects of self-efficacy and physical activity improving methods on the quality of life in patients with diabetes: A systematic review. Journal of Diabetes Research. 2022; 22:1-14.
15-Mercader-Rubio I, Ángel NG, Silva S & et al. Levels of somatic anxiety, cognitive anxiety, and self-efficacy in university athletes from a Spanish public university and their relationship with basic psychological needs. International Journal of Environmental Research Public Health. 2023;20(3):24-35.
16-Liu Y-L, Mi Y-J, Zhang B & et al. The Impact of Hypertension definition based on two-visit strategy on estimate of hypertension burden: results from the china health and nutrition survey 1989–2011. Journal of Epidemiology. 2021;31(3):180-6.
17-Acelajado MC, Hughes ZH, Oparil S & et al. Treatment of resistant and refractory hypertension. Circulation research. 2019;124(7):1061-70.
18-Williams B, Mancia G, Spiering W & et al. ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European heart journal. 2018;39(33):3021-104.
19-Schaare HL, Blöchl M, Kumral D & et al. Associations between mental health, blood pressure and the development of hypertension. Nature communications. 2023;14(1):1953.
20-Li Y, Buys N, Li Z & et al. The efficacy of cognitive behavioral therapy-based interventions on patients with hypertension: A systematic review and meta-analysis. Preventive medicine reports. 2021;23:101477.
21-Creswell C, Hentges F, Parkinson M & et al. Feasibility of guided cognitive behaviour therapy (CBT) self‐help for childhood anxiety disorders in primary care. Mental health in family medicine. 2010;7(1):49.
22-McMain S, Newman MG, Segal ZV & et al. Cognitive behavioral therapy: current status and future research directions. Psychotherapy Research. 2015;25(3):321-329.
23-Rawlings GH, Novakova B, Armstrong I & et al. A systematic review of psychological interventions in adults with pulmonary hypertension: Is the evidence‐base disproportionate to the problem? The Clinical Respiratory Journal. 2023;17(9):966-72.
24-Salimpour M, Dehghan M, Ahmadi A & et al. Effectiveness of cognitive‐behavioral therapy on perceived stress among patients undergoing percutaneous coronary intervention: A randomized controlled trial. Perspectives in Psychiatric Care. 2022;58(4):2962-9.
25-Sorbi MH, Issazadegan A, Soleimani E & et al. Relationship between Demographic Characteristics, Depression and Insomnia with Restless Legs Syndrome: a Study of Adults Aged 17-70 Years in Yazd 2019. Journal of Community Health Research. 2020;9(2):81-9.
26-Di W, Nie Y, Chua BL & et al. Developing a single-item general self-efficacy scale: An initial study. Journal of Psychoeducational Assessment. 2023;41(5):583-98.
27-Free ML. Cognitive therapy in groups: Guidelines and resources for practice: John Wiley & Sons; 2007.
28-Johansson P, Lundgren J, Andersson G & et al. Internet-based cognitive behavioral therapy and its association with self-efficacy, depressive symptoms, and physical activity: secondary analysis of a randomized controlled trial in patients with cardiovascular disease. JMIR cardio. 2022;6(1):e29926.
Aziz Seyfi Avarsin (Ph.D.)1, Alireza Pirkhaefi (Ph.D.)2, Maryam Kalhornia Golkar (Ph.D.)3
1.Ph.D. student of Health psychology, Department of Health Psychology, UAE Branch, Islamic Azad University, Dubai. United Arab Emirates
2.Corresponding Author: Associate Professor of Department of Clinical psychology, Garmsar branch, Islamic Azad University, Garmsar, Iran Tel: 09123779022 Email: Apirkhaefi@gmail.com
3.Assistant Professor of Department of psychology, Karaj branch, Islamic Azad University, Karaj, Iran
Abstract
Introduction: Hypertension is one of the most common chronic diseases, which if not properly managed, can lead to not only physical health issues but also reduced psychological well-being and efficiency. Therefore, the aim of the present study was to determine the effectiveness of cognitive-behavioral group therapy on depression and self-efficacy in patients with hypertension.
Methods: The present study was a quasi-experimental intervention, conducted as a pre-test, post-test design with experimental and control groups, and with a 90-day follow-up. The study population consisted of all hypertension patients who referred to healthcare centers in Tehran in 2023, from which 38 subjects were selected through purposive sampling and randomly assigned to experimental and control groups. The data collection tools included a demographic form, the Beck’s Depression Inventory (BDI-II), and the General Self-Efficacy Scale (GSE-17). Data were analyzed using repeated measures ANOVA with a significance level of 0.05, using SPSS-21 software.
Results: Cognitive-behavioral group therapy was effective in reducing depression (F=78/6, P< 0/001) and increasing self-efficacy (F=12/7, P < 0/001) among patients with hypertension. Additionally, the effect size of cognitive-behavioral therapy was 70% for depression and 27% for self-efficacy, with the effects persisting up to three months post-treatment.
Conclusion: The finding indicated that cognitive-behavioral therapy can lead to improvements in depression and an increase in psychological self-efficacy in patients with hypertension. Therefore, this cost-effective and affordable treatment method can be utilized alongside routine treatment (medication) to enhance the psychological well-being of these patients.
Keywords: Depression, Self-Efficacy, Cognitive Behavioral Therapy, Hypertension
References
1-Purnomo E, Nur A, Rahim R & et al. The effectiveness of instrumental music therapy and self-hypnosis on decreasing blood pressure level among hypertension patients. International Journal of Nursing Health Services. 2020;3(2):214-23.
2-Wang Z, Chen Z, Zhang L & et al. Status of hypertension in China: results from the China hypertension survey, 2012–2015. Circulation. 2018;137(22):2344-56.
3-Yin R, Yin L, Li L & et al. Hypertension in China: burdens, guidelines and policy responses: a state-of-the-art review. Journal of human hypertension. 2022;36(2):126-34.
4-Mahdavi M, Parsaeian M, Mohajer B & et al. Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines. BMC Public Health. 2020;20:1-9.
5-Sabetfar N, Meschi F, Hosseinzade M. The effectiveness of mindfulness-based group therapy on perceived stress, emotional cognitive regulation, and self-care behaviors in patients with hypertension. Internal Medicine Today. 2021;27(2):246-63.
6-Zhang X, Li C. Major depressive disorder increased the risk of hypertension: A Mendelian randomization study. Journal of Affective Disorders. 2024;355:184-9.
7-Kraynak TE, Andreescu C. Pathways linking hypertension and depression with mild cognitive impairment in older adults. International Psychogeriatrics. 2022;34(6):515-7.
8-Wright R, Roberson K, Onsomu EO & et al. Examining the relationship between mindfulness, perceived stress, and blood pressure in African-American college students. Journal of best practices in health professions diversity: research, education policy. 2018;11(1):13.
9-Mujahid EH, Limoa E. The Effect of Supportive Psychotherapy Ventilation Techniques on Blood Pressure and Pulse rate in Depressed and Anxious Patients. Scientific Journal of Medical Faculty of Halu Oleo University. 2023;10(3):1-6.
10-Zhang Y, Zhang H, Zhang Y & et al. Effect of MBSR, DBT and CBT on the hypertension patients with depression/anxiety: Protocol of a systematic review and Bayesian network meta-analysis. Plos one. 2023;18(2):e0281469.
11-Zhang H, Zhang X, Jiang X & et al. Mindfulness-based intervention for hypertension patients with depression and/or anxiety in the community: a randomized controlled trial. Trials. 2024;25(1):299.
12-Woodcock S, Tournaki N. Bandura’s Triadic Reciprocal Determinism model and teacher self-efficacy scales: a revisit. Teacher Development. 2023;27(1):75-91.
13-Pakdel H, Shorabi F, Hajializade K. The efficacy of intensive short-term dynamic psychotherapy on job stress coping strategies, health-related quality of life, and self-efficacy of iran air traffic controler staff. Journal of psychologicalscience. 2022;21(111):543-58.
14-Hamidi S, Gholamnezhad Z, Kasraie N & et al. The effects of self-efficacy and physical activity improving methods on the quality of life in patients with diabetes: A systematic review. Journal of Diabetes Research. 2022; 22:1-14.
15-Mercader-Rubio I, Ángel NG, Silva S & et al. Levels of somatic anxiety, cognitive anxiety, and self-efficacy in university athletes from a Spanish public university and their relationship with basic psychological needs. International Journal of Environmental Research Public Health. 2023;20(3):24-35.
16-Liu Y-L, Mi Y-J, Zhang B & et al. The Impact of Hypertension definition based on two-visit strategy on estimate of hypertension burden: results from the china health and nutrition survey 1989–2011. Journal of Epidemiology. 2021;31(3):180-6.
17-Acelajado MC, Hughes ZH, Oparil S & et al. Treatment of resistant and refractory hypertension. Circulation research. 2019;124(7):1061-70.
18-Williams B, Mancia G, Spiering W & et al. ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European heart journal. 2018;39(33):3021-104.
19-Schaare HL, Blöchl M, Kumral D & et al. Associations between mental health, blood pressure and the development of hypertension. Nature communications. 2023;14(1):1953.
20-Li Y, Buys N, Li Z & et al. The efficacy of cognitive behavioral therapy-based interventions on patients with hypertension: A systematic review and meta-analysis. Preventive medicine reports. 2021;23:101477.
21-Creswell C, Hentges F, Parkinson M & et al. Feasibility of guided cognitive behaviour therapy (CBT) self‐help for childhood anxiety disorders in primary care. Mental health in family medicine. 2010;7(1):49.
22-McMain S, Newman MG, Segal ZV & et al. Cognitive behavioral therapy: current status and future research directions. Psychotherapy Research. 2015;25(3):321-329.
23-Rawlings GH, Novakova B, Armstrong I & et al. A systematic review of psychological interventions in adults with pulmonary hypertension: Is the evidence‐base disproportionate to the problem? The Clinical Respiratory Journal. 2023;17(9):966-72.
24-Salimpour M, Dehghan M, Ahmadi A & et al. Effectiveness of cognitive‐behavioral therapy on perceived stress among patients undergoing percutaneous coronary intervention: A randomized controlled trial. Perspectives in Psychiatric Care. 2022;58(4):2962-9.
25-Sorbi MH, Issazadegan A, Soleimani E & et al. Relationship between Demographic Characteristics, Depression and Insomnia with Restless Legs Syndrome: a Study of Adults Aged 17-70 Years in Yazd 2019. Journal of Community Health Research. 2020;9(2):81-9.
26-Di W, Nie Y, Chua BL & et al. Developing a single-item general self-efficacy scale: An initial study. Journal of Psychoeducational Assessment. 2023;41(5):583-98.
27-Free ML. Cognitive therapy in groups: Guidelines and resources for practice: John Wiley & Sons; 2007.
28-Johansson P, Lundgren J, Andersson G & et al. Internet-based cognitive behavioral therapy and its association with self-efficacy, depressive symptoms, and physical activity: secondary analysis of a randomized controlled trial in patients with cardiovascular disease. JMIR cardio. 2022;6(1):e29926.
Type of Study: Applicable |
Subject:
Psychology
Received: 2024/06/2 | Accepted: 2024/09/18 | Published: 2024/11/18
Received: 2024/06/2 | Accepted: 2024/09/18 | Published: 2024/11/18
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