@2024 Afarand., IRAN

---

ISSN: 2008-2630    Iranian Journal of War & Public Health 2018;10(2):61-67

Background
.. [1-3]. Amputation is one of the most disturbing and most harmful events an individual may experience in his life [4]. ... [5-7]. Efforts to understand the psychological sufferers of the war to help them require psychiatric and psychological interventions to improve their health status and maintain it [8].
Previous Studies
Self-compassion training is one of the medical training that can affect the mental health of veterans, which has so far not been taken into consideration by the researchers. ... [9-13]. Increase in self-compassion predicts self-improvement of psychological well-being over time [14, 15]. ... [16-18].Other research findings showed that increasing self-compassion may be the most important factor for the recovery of those who are facing harmful events [19]. ... [20, 21]. Cognitive flexibility refers to human ability to adapt cognitive process approaches that are used to deal with new and unexpected conditions in the environment [22]. ... [23]. Cognitive flexibility has a moderating role in relation to traumatic accidents and subsequent mental health [24]. ... [25].The meaning of life is one of the variables that can be related to the mental health of those who encountered a harmful event. ... [26-32].
Aim(s)
The purpose of this study was to investigate the effect of self-compassion training on cognitive flexibility and meaning of life in amputees who had been exposed to explosion of land mines.
Research type
This experimental research was conducted using a pretest-posttest design with control group.
Research society, place and time
The statistical population consisted of all amputees who had been exposed to explosion of land mine (60 people) supported by the martyr Foundation of Guilan West in the first half of 2017. From this statistical population, 40 people were selected by simple random sampling and randomly replaced in two groups of 20 (self-centered self-centered self-directed learning group and control group). Having experienced the defect of the mammal due to exposure to a mine injury explosion event, lack of acute illness, non-use of psychological drugs, and reading and writing literacy in order to respond to the questionnaires were criteria for admission of subjects, and the absence of more than one-third of treatment sessions, non-cooperation, and homework assignments. Exit subjects.
Sampling method and number

Used devices&materials
To comply with ethical principles, all subjects were fully free to participate in the research, and tried to have free treatment sessions for the subjects and the time for the next meeting was determined in coordination with them. The information obtained from the subjects were fully protected and, after completing the research to help the control group and those who had poor responses to group therapy, subjects were given the address of the researcher`s private counselling center to use the facilities freely. A Cognitive Flexibility Questionnaire [33, 34] and Meaning of Life Questionnaire (MLQ) [35] were used for data collection. To conduct this research, after the necessary administrative coordination and referring to the center of the Martyr Foundation of the West Gilan (there was only one center for the martyr Foundation in this city), the list of all individuals who had been exposed to the explosion of land mine and who were supported by the Martyr Foundation in the first half of 2017, was obtained. Then, 40 of them were randomly assigned to experimental and control groups. In this phase, Cognitive Flexibility Questionnaire and Meaning of Life questionnaire were implemented as pretest. Training focused on self-compassion was administrated for the experimental group in 8 sessions and each session for 1 hour held at the same center of the martyr Foundation of Guilan West City. For the second group (control) no training was applied. The content of the intervention included self-compassion education, and was presented in accordance with the Gilbert Protocol (2009), which is one of the methods of psychotherapy in which empathy, sympathy and compassion, acceptability and tolerance, responsibility, and worthiness are taught [36] (Table 1). In the final stage, all subjects responded to the questionnaire of cognitive flexibility and meaning of life as a post-test. Data were analyzed using SPSS 21 software and analyzed by multivariate analysis of covariance test. Before applying the covariance test, its assumptions were tested. Box test was used for homogeneity analysis of variance-covariance matrix homogeneity. Levine test was used to examine the equality of variance in the two groups in the level of community.
Findings by Text
In the experimental and control groups, the mean age was 49.8 ± 7.94 and 45.43 ± 8.53 years respectively. In the experimental group, 9 persons had elementary education, 7 were undergraduate and 4 had master degree and in control group 7 had junior high school education, 8 had senior high school education and 5 were undergraduate. After adjusting for the pre-test scores, there was a significant difference between the self-compassion training group and the control group in cognitive flexibility (F = 11.22), and in the subscales of perceptions of control (F = 13.61), in the perception of multiple solutions (F=5.64), in the meaning of life (F = 13.28), in current meaning of life (F = 3.78) and the search for meaning in life (F = 19.07) (Table 2).
Main comparison to the similar studies
After moderating the pre-test scores, the mean scores of cognitive flexibility and sub-components of perceived control and understanding of several solutions in the self-compassion learning group were significantly higher than the control group. Therefore, this treatment method was used to increase the perception of control and perception of several solutions in the individuals affected by the land mine blast caused an amputation. These results were consistent with the findings of Dick et al. [26] Miron et al. [19] and Caldwell et al. [25]. ... [37-43]. After moderating pre-test scores, mean scores of meaning of life and sub-components of current meaning of life and the search for meaning in life in the self-compassion education group were significantly higher than the control group. Therefore, this method of treatment was effective for increasing the current meaning of life and searching for meaning in life in people facing the land mine blast resulted in the amputation. These results were consistent with the findings of Foa et al. [30], Park et al. [31], and Schroder et al. [32]. ... [44, 45].
Suggestions
It is suggested that future research be carried out by controlling these disturbing variables; also, the effectiveness of the approach used in this study can be studied in clinical samples with different psychological problems.
Limitations
In this research, only individuals affected by land mines explosion leading to amputation were studied that all were men. The effect of pre-test implementation on post-test scores and non-implementation of follow-up in order to investigate the continuity of the effectiveness of methods used for amputees exposed to land mine explosion as well as lack of comparison of this method with other treatment methods were other limitations of this study.
Conclusions
Self-compassion therapy by educating effective coping strategies with life-threatening events is effective in improving cognitive flexibility and the meaning of life in amputees affected by land mine explosions.
Acknowledgments
Thanks to the cooperation and support of Martyrs and Veterans Foundation of Gilan West City and the veterans participated in this research.
Conflict of interest
Non-declared
Ethical Permissions
Ensuring confidentiality of information and mental and psychological preparation of research samples to participate in the research were ethical considerations observed in this research.
Funding Sources
The budget of this research was provided by the authors.

TABLES and CHARTS

Show attach file