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IRCT20200206046394N1 IRCT 2020-07-16 Islamic Azad University Comparison of Effectiveness of Cognitive Behavioral Therapy and Dialectic Behavioral Therapy on Medication Adherence in Patients Undergoing Hemodialysis Comparison of Effectiveness of Cognitive Behavioral Therapy and Dialectic Behavioral Therapy on Medication Adherence in Patients Undergoing Hemodialysis 2020-07-22 anticipated 60 Complete https://irct.ir/trial/46099 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Education/Guidance, Other design features: Due to the spread of the new corona virus in Iran, it is not possible to determine the exact time of onset and end of the choose a patient, so there is a possibility of a slight change in these times, Randomization description: Sixty patients are selected in a convenient way, by providing informed consent form to the hemodialysis patients, and then patients with poor and moderate medication adherence score in the Morisky Medication Adherence Scale will be selected and we will randomly place eligible individuals into three groups (two experimental and one control). The method of assigning individuals in control and intervention groups is simple randomization and randomization tool is the lottery. N/A Kidney failure. Intervention 1: Control group: They do not receive any intervention. Intervention 2: Cognitive-behavioral intervention will be performed by embezzlement from Farquhar. Its steps include: The first step is to identify the patient's problem and the reason for the patient's non-compliance through a face-to-face interview. (Questions such as: Why don't you follow your medication regimen? What is the biggest obstacle to your adherence to the medication regimen? ...). The second stage of the intervention is to create commitment and self-confidence in the patient in order to correct the wrong behavior. At this stage, with the help of the researcher, the patient recognizes the problems and obstacles related to his non-commitment, and at this time a contract is created between the patient and the researcher to improve compliance, which is through increasing the patient's motivation to change behavior. By saying positive affirmations, the researcher tries to increase the patient's self-confidence and create interest in changing the patient's misbehavior. At the end of the session, the patient is also asked to write down all the things he or she does during the next week and the next session as a daily report in order to follow the medication regimen throughout the day. In the second week of the third stage of the intervention, all the patient's daily reports on adherence to the medication regimen and the patient's self-reported statements are reviewed and summarized. In this way, according to the patients 'report, the obstacles and factors affecting the patients' adherence to the medication regimen are examined. In the fourth stage, the intervention of the designed program is provided to the patients face to face. This program includes training on following the medication regimen of hemodialysis patients (in the form of an educational pamphlet) and also provides patients with the necessary information about the implementation of the designed program. In the fourth week, the fifth and sixth stages of the intervention are performed, and in fact in this stage, it is evaluated to what extent the designed program is effective in improving patient compliance. It seems that this behavior is maintained through the use of motivational sentences. These steps will be followed by a structured face-to-face motivational interview in four 30-40 minute sessions. Intervention 3: Second intervention group: Dialectical behavioral therapy interventions are performed under the auspices of Marsha Linhan (1993), Mito McKay et al. (2007), and Melanie Gordon, Sheets (2009). Its steps include: The first session is familiar with the concept of mindfulness and three mental states (logical mind, emotional mind and mindfulness). The second session includes teaching two categories of skills to achieve mindfulness: the first category of "what" skills (including observation, description and description) and the second category of "how" skills (including non-judgmental, self-conscious and efficient self-awareness). to act, to act upon, surgery). The third step involves teaching strategies to distract and distract the mind with acceptance skills (activities, participation, comparisons, distractions, thoughts, and feelings). The fourth stage involves self-relaxation training with five senses. The fifth step involves teaching the pattern of identifying emotions and labeling them, which leads to increased emotion control. The sixth session includes training on creating positive emotional experiences by creating short-term positive emotional experiences. The seventh session includes situations for effective communication and interpersonal efficiency (proportionality of one's desires with the desires of others; the ratio of desires to needs). The eighth session includes effective communication goals and interpersonal efficiency (achieving goals in a situation and coping with resistance and conflict. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is There is no further information.
public Arman Mehrazin
3rd Floor, Block 319, Parking 3, Neighborhood A3., Esteghlal St
Fooladshahr Iran (Islamic Republic of) 84918-36489 +98 31 5263 0259 armanmehrazinn@gmail.com Islamic Azad University scientific Arman Mehrazin
3rd Floor, Block 319, Parking 3, Neighborhood A3, Esteghlal St
Fooladshahr Iran (Islamic Republic of) 84918-36489 +98 31 5263 0259 armanmehrazinn@gmail.com Islamic Azad University Iran (Islamic Republic of) Minimum 18 years and maximum 60 years Minimum diploma literacy Ability to complete the questionnaire Willingness to participate in the study Hemodialysis twice or more per week Lack of mental disability or known severe mental illness or functional (bone muscular) disability Fully alert Listening and speaking ability 18 years 60 years Both With known severe mental illness or functional disability (muscle, bone) Drug addiction Being hospitalized in the intensive care unit Unwillingness to participate in the study V15.81 (Z9 Nonadherence to Medical Treatment (726) N/A Treatment - Other Treatment - Other Control group: They do not receive any intervention. Cognitive-behavioral intervention will be performed by embezzlement from Farquhar. Its steps include: The first step is to identify the patient's problem and the reason for the patient's non-compliance through a face-to-face interview. (Questions such as: Why don't you follow your medication regimen? What is the biggest obstacle to your adherence to the medication regimen? ...). The second stage of the intervention is to create commitment and self-confidence in the patient in order to correct the wrong behavior. At this stage, with the help of the researcher, the patient recognizes the problems and obstacles related to his non-commitment, and at this time a contract is created between the patient and the researcher to improve compliance, which is through increasing the patient's motivation to change behavior. By saying positive affirmations, the researcher tries to increase the patient's self-confidence and create interest in changing the patient's misbehavior. At the end of the session, the patient is also asked to write down all the things he or she does during the next week and the next session as a daily report in order to follow the medication regimen throughout the day. In the second week of the third stage of the intervention, all the patient's daily reports on adherence to the medication regimen and the patient's self-reported statements are reviewed and summarized. In this way, according to the patients 'report, the obstacles and factors affecting the patients' adherence to the medication regimen are examined. In the fourth stage, the intervention of the designed program is provided to the patients face to face. This program includes training on following the medication regimen of hemodialysis patients (in the form of an educational pamphlet) and also provides patients with the necessary information about the implementation of the designed program. In the fourth week, the fifth and sixth stages of the intervention are performed, and in fact in this stage, it is evaluated to what extent the designed program is effective in improving patient compliance. It seems that this behavior is maintained through the use of motivational sentences. These steps will be followed by a structured face-to-face motivational interview in four 30-40 minute sessions. Second intervention group: Dialectical behavioral therapy interventions are performed under the auspices of Marsha Linhan (1993), Mito McKay et al. (2007), and Melanie Gordon, Sheets (2009). Its steps include: The first session is familiar with the concept of mindfulness and three mental states (logical mind, emotional mind and mindfulness). The second session includes teaching two categories of skills to achieve mindfulness: the first category of "what" skills (including observation, description and description) and the second category of "how" skills (including non-judgmental, self-conscious and efficient self-awareness). to act, to act upon, surgery). The third step involves teaching strategies to distract and distract the mind with acceptance skills (activities, participation, comparisons, distractions, thoughts, and feelings). The fourth stage involves self-relaxation training with five senses. The fifth step involves teaching the pattern of identifying emotions and labeling them, which leads to increased emotion control. The sixth session includes training on creating positive emotional experiences by creating short-term positive emotional experiences. The seventh session includes situations for effective communication and interpersonal efficiency (proportionality of one's desires with the desires of others; the ratio of desires to needs). The eighth session includes effective communication goals and interpersonal efficiency (achieving goals in a situation and coping with resistance and conflict. Medication adherence. Timepoint: Measurements of drug treatment adherence are completed before the intervention and 14 days after the start of the intervention and immediately after the intervention, and questionnaires are re-completed one month after the intervention. Method of measurement: Morisky Medication Adherence Scale. Accompanying depression score. Timepoint: Before and after the intervention, the questionnaires will be completed by the subjects in order to follow up on the effect of the interventions one month after the interventions. Method of measurement: Beck's second depression inventory. Accompanying anxiety score. Timepoint: Before and after the intervention, the questionnaires will be completed by the subjects in order to follow up on the effect of the interventions one month after the interventions. Method of measurement: Beck Anxiety Inventory. Medicinal beliefs of patients or medicinal beliefs of individuals. Timepoint: Before and after the intervention, the questionnaires will be completed by the subjects in order to follow up on the effect of the interventions one month after the interventions. Method of measurement: Questionnaire and drug belief tool for patients (BMQ), which higher scores indicate a stronger belief of patients in each of the subscales. Islamic Azad University, Khomeini Shahr Branch Approved 2020-06-10 Islamic Azad University - Isfahan Branch (Khorasgan) Esteghlal St., Neighborhood A3, Parking 3, Block 3 Khorasgan Isfehan Iran (Islamic Republic of)