اثربخشی درمان مبتنی بر پذیرش و تعهد بر کیفیت زندگی و اضطراب مرگ سالمندان

Aging appears to be a global phenomenon that will be considered as one of the most important social and welfare challenges in developing countries in the near future, and it seems necessary to try to solve the problems of the elderly, namely their psychological problems. Therefore, the present study was conducted to determine the effectiveness of acceptance and commitment-based therapy (ACT) on the quality of life and death anxiety in the elderly living in Kermanshah, Iran. This was a quasi-experimental study with pretest-posttest and control group design. The statistical population included all the elderly living in Kermanshah in 2020. The sample size included 30 aged people (60 to 70 years old) selected by convenience sampling method and according to the inclusion and exclusion criteria of the study. The experimental group received ten 90-minute sessions of ACT, twice a week, and the control group assigned to a waiting list for the treatment. The measures used in this study included the WHO Quality of Life Questionnaire and Cult-Leicester’s Death Anxiety Questionnaire. Data were analyzed using analysis of covariance (ANCOVA) in SPSS-25. The results indicated that there is a significant difference between experimental and control groups in terms of both quality of life and death anxiety. In other words, ACT caused an improvement in quality of life and a reduction in death anxiety in the elderly (p < 0.05). Given the results of the present study, therapists and health-related practitioners can take advantages of ACT in conducting health-related interventions, particularly in order to improve the quality of life and to reduce the death anxiety in the elderly.

References
Abbasi, M., Khazan, K., Pirani, Z., & Ghasemi Jobneh, R. (2016). The effectiveness of acceptance and commitment based therapy on veterans' cognitive-emotional functions. Journal of Veteran Medicine, 4 (8), 203-208. [Persian] http://noo.rs/Hl4U0
Abdul Azimi, M., & Niknam, M. (2019). The Effectiveness of acceptance and commitment therapy on perceptions of social support and body dissatisfaction in the elderly. Journal of Aging Psychology, 5(1), 13-25. [Persian]
Ahmadi, A., Ghaemi, F., & Farrokhi, N. (2019).  Effectiveness of mindfulness education and commitment and acceptance therapy on psychological distress and death anxiety in cancer patients in Isfahan. Journal of Psychological Science, 72(17), 951-956. [Persian] http://psychologicalscience.ir/article-1-328-fa.html
Askari, Z., Tahan, M., and Ahangari, A. (2019). The effectiveness of acceptance and commitment group therapy on the quality of life of the elderly with empty nest syndrome. Journal of Sabzevar University of Medical Sciences, 26(5), 587-591. [Persian]
Azeem, F., & Naz, A. (2015). Resilience, death anxiety, and depression among institutionalized and non-institutionalized elderly. Pakistan Journal of Psychological Research, 30(1), 111-130. https://doi.org/10.22126/JAP.2020.5456.1436
Baharvandi, B., Kazemianmoghadam, K., & Haroon Rashidi, H. (2020). The Effectiveness of compassion-focused therapy on ambiguity tolerance and death anxiety in the elderly. Aging Psychology, 6(1), 13-26. [Persian]
Barr, P., & Cacciatore, J. (2008). Personal fear of death and grief in bereaved mothers. Death Studies, 32(1), 445–460. https://doi.org/10.1080/07481180801974752
Batink, T., Bakker, J., Vaessen, T., Kasanova, Z., & Collip, D. (2016). Acceptance and commitment therapy in daily life      training: a feasibility study of a Health intervention. Health Research Publisher, 4(3), 1-10.

Bishop, M. (2007). Psychological adaptation and quality of life in multiplescelerosis: assessment of the disability centrality model.Journal of Rehabilitation, 1(73), 25-36. https://doi.org/10.1177/00343552050480040301
Bonomi, A., Patrick, D., Bushnell, D., & Martin, M. (2000). Validation of the United States version of the World Health Organization Quality of Life (WHOQOL) instrument. Journal of Clinical Epidemiology, 53(1), 1-12. https://doi.org/10.1016/S0895-4356(99)00123-7
Bunyathikan, T., Soonthornchaiya, R., & Charenboon, T. (2020). The effects of an acceptance and commitment therapy program on the depressive symptoms of elderly patients with major depressive disorder. The Journal of Psychiatric Nursing and Mental Health, 34(2), 118-131.
Cassell, A., & Dubey, B. (2018). Anatomical rorschach responses and death symbolism. Journal of Projective Psychology & Mental Health, 25(2), 109-119. https://doi.org/10.22126/JAP.2020.5833.1478
Dawane, J., Pandit, V., & Rajopadhye, B. (2014). Functional assessment of elderly in Pune, India: Preliminary study. Journal of Gerontol Geriatric Research, 3(3), 155-156. https://doi.org/10.4172/2167-7182.1000155
Dehghani, A., & Dehnavi, p. (2018). The effectiveness of acceptance and commitment-based therapy on the quality of life of patients receiving methadone maintenance treatment. The Horizon of Medical Sciences, 24(3), 246-252. [Persian] http://hms.gmu.ac.ir/article-1-2855-fa.html
Esmaeili, A. (2008). Validation of Death Anxiety Scale and comparison of death anxiety rate, suicidal ideation and life satisfaction in male and female students of Islamic Azad University, Ahvaz Branch (unpublished master's thesis). Islamic Azad University, Ahvaz. [Persian]
Esmaeilishad, B. (2020). The Effectiveness of self-care training on quality of life, self-care behaviors and blood sugar in elderly without self-care behaviors. Aging Psychology, 6(1), 1-11. [Persian]
Forman, E. M., & Herbert, J. D. (2008). General princioles And Empirically supported techniques of behavior therapy. In J.E. Fisher (ED.), New Directions in cognitive behavior therapy: Acceptance based therapies inCognitive behavior therapy (pp. 77-101). New York, NY: Researchgate.
French, C., Greenauer, N., & Mello, C. (2017). Multifactorial approach to predicting death anxiety: Assessing the role of religiosity, susceptibility to mortality cues, and individual differences. Journal of social work in end-of-life, 13(23), 151-172. https://doi.org/10.1080/15524256.2017.1331181
Ghadampour, E., Moradizadeh, S., & Shahkarami, M. (2018). The Effectiveness of Mindfulness Training on Increasing Happiness and Improving Quality of Life in Elderly. Aging Psychology, 4(1), 27-38. [Persian]
Golestani Far, S., & Dasht-e Bozorgi, Z. (2020). The effectiveness of acceptance and commitment-based therapy on depression, mental health and life expectancy of the elderly with non-clinical depression. Journal of Aging Psychology, 6(3), 203-191. [Persian]
Habibi, A., Neekpoor, S., Seyedolshohda, M., & Haghani, H. (2008). Health promotion behaviours and Quality of life among elderly people: A cross-sectional survey. Journal of Ardabil University of Medical Sciences, 8(1), 29-36. [Persian] http://jarums.arums.ac.ir/article-1-340-fa.html
Haghshenas, n. (2011). Dimensions of Sociology of Population Aging and the Challenge of Active Aging in Iran. Iranian Journal of Sociological Studies, 1(2), 147-133. [Persian]
Hayes, S., Levin, M., Plumb, J., Villatte, J., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. National Library of Medicine National Center for Biotechnology Information, 44(2), 180-198. https://doi.org/10.1016/j.beth.2009.08.002
Irandoost, F., Neshat Doost, H., & Nadi, M. (2017). The effect of acceptance and commitment therapy on the quality of life of women with chronic low back pain. Journal of Behavioral Sciences, 8(1), 96-89. [Persian] 10.22075/JCP.2017.2165
Iranmanesh, R., & Dasht-e Bozorgi, Zahra. (2019). The Effectiveness of health-oriented lifestyle training on psychological well-being, blood pressure and death anxiety in older women. Aging Psychology, 4(4), 263-273. [Persian]
Kaisa, E., Sirpa, H., & Irma, N. (2016). Is loneliness associated with malnutrition in older people? International Journal of Gerontology, 10(1), 43-45. https://doi.org/10.1016/j.ijge.2015.09.001
Khajebishak, Y., Payahoo, L., Pourghasem, B., & Asghari Jafarabadi, M. (2014). Assessing the quality of life in elderly people and related factors in Tabriz. Journal of Caring Sciences, 3(4), 257-263. https://doi.org/10.5681/jcs.2014.028
Lee, T. (2005). Health promotion behaviors and quality of life among community- dwelling elderly in Korea. International Journal of Nursing Studies, 49(2), 129-137. https://doi.org/10.1016/j.ijnurstu.2005.06.009
Mirzaei Dostan, Z., Zargar, Y., & Zandi Payam, A. (2019). The effectiveness of acceptance and commitment based therapy on death anxiety and mental health of HIV-infected women in Abadan. Iranian Journal of Psychiatry and Clinical Psychology, 25(1), 2-13. [Persian] http://ijpcp.iums.ac.ir/article-1-2869-fa.html
Mohammadi, S., & Sufi, A. (2020). The effectiveness of acceptance and commitment based therapy on quality of life and perceived stress in cancer patients. Journal of Educational Sciences and Psychology, 32(8), 57-72. [Persian] https://doi.org/10.30473/HPJ.2020.45019.4308
Mohammadi, Z., Borjali, A., & Sohrabi, F. (2018). The effectiveness of acceptance and commitment based treatment on the quality of life of female-headed households under the auspices of the Tehran Welfare Organization. Shenakht Journal of Psychology and Psychiatry, 5(5), 81-91. [Persian] http://shenakht.muk.ac.ir/article-1-538-fa.html
Motamedi, A., Mostafapour, V., & Farokhi, H. (2018). The Effectiveness of Hope Group therapy on Enhancement of Happiness and Quality of Life in Elderly Women in tasouj. Aging Psychology, 3(4), 243-252. [Persian]
Naderi, F., & Roshani, Kh. (2011). The relationship between spiritual intelligence and social intelligence with death anxiety in older women. Journal of Women and Culture, 2(6), 55-67. [Persian]
Nasiri, P., Ghorbani, M., & Adibi, p. (2015). The effectiveness of acceptance and commitment-based therapy on the quality of life of patients with functional gastrointestinal syndrome. Journal of Clinical Psychology, 7(4), 93-105. [Persian] https://doi.org/10.22075/JCP.2017.2221
Nejat, S., Montazeri, A., Holakouee, K., Mohammad, K., & Mujadzadeh, S. (2006). Standardization of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF): Translation and psychometrics of the Iranian species. Journal of the School of Health and the Institute of Health Research, 4(3), 1-12. [Persian] http://sjsph.tums.ac.ir/article-۱-۱۸۷-fa.html
Orfila, F., Ferrer, M., Lamarca, R., Tebe, C., DomingoSalvany, A., & Alonso, J. (2006). Gender differences in healthrelated quality of life among the elderly: the role of objective functional capacity and chronic conditions. Social Science & Medicine, 63(1), 2367-2380. https://doi.org/10.1016/j.socscimed.2006.06.017
Payalsharma, H. (2019). Death Anxiety among Elderly People: Role of Gender, Spirituality and Mental Health, Indian. Journal of Gerontology, 3(33), 240-254. http://hnmj.gums.ac.ir/article-1-1385-en.html
Peterson, J., & Ifret, S. (2011). Comparison of motivational interviewing with acceptance and commitment therapy: A conceptual and clinical review. Behavioural and Cognitive Psychotherapy, 39(5), 541-559.
Pirhiati, Z., & Barghi Irani, Z. (2017). The effectiveness of acceptance and commitment-based therapy on mental health and cognitive function in the elderly with age-related macular degeneration. Journal of Aging Psychology, 3(2), 137-146. [Persian]
Pourfarahani, M. Ahmad Barabadi., H., & Hydernia, a. (2019). The effectiveness of acceptance and commitment group therapy on reducing fear of negative evaluation of homeless adolescent girls with social anxiety disorder. Journal of Social Psychology, 7(51), 33-42. [Persian]
Rezaeidehnavi, P., Tavakoli, G., & Muntajbian, Z. (2020). The effectiveness of positive psychotherapy on pain perception and death anxiety in the elderly. Aging Psychology, 5 (4), 321-332. [Persian]
Safari Mousavi, S., Ghazanfari, F., & Mirdrikund, F. (2019). The Effectiveness of Acceptance and Commitment Therapy on Death Anxiety in Women with Inflammation in Khorramabad. Journal of Clinical Nursing and Midwifery, 4(3), 234-241. [Persian] http://jcnm.skums.ac.ir/article-1-650-fa.html
Semenova, V., & Stadtlander, M. (2016). Death anxiety, depression, and coping in family caregivers. Journal of Social, Behavioral, and Health Sciences, 10(1), 34–48. https://doi.org/10.5590/JSBHS.2016.10.1.05
Seyed Jafari, J., Motamedi, A., Mehrad Sadr, M., olamai Koopai, M., & Hashemian, S. (2017). The effectiveness of commitment and acceptance education on resilience of the elderly. Journal of Aging Psychology, 3(1), 21-29. [Persian]
Statistical Center of Iran. (2016). Results of the general population and housing census of the whole country during the years, 1956-2016. Tehran: Statistics Center of Iran. [Persian] https://www.amar.org.ir
Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013). Acceptance and commitment therapy in the treatment of anxiety: A systematic review. Clinical Psychology Review, 33(8), 965-978. https://doi.org/10.1016/j.cpr.2013.07.002
Tabebordbar, F., Esmaeili, M., & Asadi, R. (2019). Prediction of death anxiety in the elderly based on personality types and mental health. Journal of Aging Psychology, 3(15), 249-239. [Persian] 10.22126/JAP.2019.4788.1374
Tajvar, M., Arab, M., & Montazeri, A. (2008). Determinants of health-related quality of life in elderly in Tehran, Iran. BMC public health, 8(1), 323-330.  https://doi.org/10.1186/1471-2458-8-323
Templer, D. (2005). The Construction and validation of a death anxiety scale. The Journal of General Psychology, 82(2), 165-177. https://doi.org/10.1027/1015-5759.21.2.108
Tesaei, R. G., & Calhoun, L. (2004). Post-traumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18.
White, R. G., Gumley, A. I., McTaggart, J., Rattrie, L., McConville, D., & Cleare S. (2015). Acceptance and commitment therapy for depression following psychosis: An examination of clinically significant change. Journal of Contextual Behavioral Science, 4(3), 203-209.
Yuan, Y., Li, J., Jing, Z., Yu, C., Zhao, D., Hao, W., & Zhou, C. (2020). The role of mental health and physical activity in the association between sleep quality and quality of life among rural elderly in China: A moderated mediation model. Journal of Affective Disorders, 273(1), 462-467. https://doi.org/10.1016/j.jad.2020.05.093
Zare Bidaki, Z., & Jahangiri, M. (2019). The effectiveness of acceptance and commitment-based therapy on the quality of life of mothers with children with autism. Journal of Health Education and Health Promotion, 37(10), 29-44. [Persian] http://journal.ihepsa.ir/article-1-1007-fa.htm