The clinical trial of patients improved from Covid-19. The effectiveness of mindfulness-based cognitive therapy on mental health and life expectancy (single-subject study)

introduction In early January 2020, a new corona virus called corona was identified as an infectious agent by the World Health Organization and caused a viral pneumonia outbreak, the first of which was reported in Wuhan, China in December 2019. The virus has so far infected most countries in the world and has become a global problem. By this time in December 2021, about 265 million people in the world have been infected with this virus and 5 million 270 thousand people have died from this disease. According to the World Health Organization, the incidence of this disease is still increasing and will become the third leading cause of death in the world by 2030. This disease has a special complexity and has multiple dimensions and consequences that have caused many problems in the field of health, social and economic as well as psychological for people. The emergence of this disease is now a public health crisis. According to this research, exposure to news and restrictions caused by this disease can lead to many mental health problems. In fact, one of the situations that puts a lot of stress on people during the outbreak of covid 19 disease is the inability to predict and uncertainty about the control and end of the disease. Mental health is defined as a harmonious and harmonious behavior with society, recognizing and accepting social realities, the power to adapt to them and meeting one's balanced needs and is an important factor for the health of society. The prevalence of the disease can also increase feelings of loneliness, decrease social support, feelings of fear and anxiety to clinical stress and anxiety, obsessive-compulsive disorder associated with the disease, and decreased life expectancy. One of the hopeful factors is health and the disease can cause despair, fear and even despair of the patient. The outbreak of a disease has a much deeper and wider impact and affects not only the affected community and relatives, but the entire community. Because everyone finds themselves at risk, and therefore people's feel of safe and healthy changes, and this situation causes people to despair. Hope is the capacity to imagine the ability to create paths to desirable goals and to imagine the motivation to move in those paths. Hope predicts physical and mental health such as positive response to medical interventions, mental health, effective getting along, and health-promoting behaviors. Covid 19 disease can also lead to psychological problems due to its infectious nature and unpredictable nature. In this regard, various researchers consider the implementation of public health policies, including areas related to individual and collective mental health in accordance with the different stages of the epidemic of this disease is very necessary. Mindfulness can be an effective tool for achieving peace of mind and body that helps people become aware of their current feelings. Mindfulness-based interventions are considered as one of the third generation or third wave cognitive-behavioral therapies. Mindfulness is a form of meditation rooted in Eastern religious teachings and rituals, especially Buddhism. Segal has defined mindfulness as paying attention to specific and purposeful ways, in the present time, without judgment or prejudice. Linhan stressed for the first time the need to pay attention to mindfulness as one of the essential components of psychological therapy. Mindfulness requires the development of three components: judgment avoidance, purposeful awareness, and focus on the present moment. Focusing on the present and processing all aspects of the above experience makes one aware of the daily activities and automatic functioning of the mind in the past and future world and he controls emotions, thoughts, and physical states through moment-to-moment awareness of thoughts. As a result, it is released from the everyday and automatic mind focused on the past and the future. Although general vaccination has reduced the virus in some countries, including Iran, and reduced the number of infected people, a large number of people are still infected with the virus on a daily basis. and the psychological effects of this situation have caused great concern on the part of the world health organization and the psychiatrists. Also, due to the fact that Covid 19 is a pandemic virus and its side effects are still unknown to the medical community around the world, a decrease in mental health and life expectancy has occurred in people infected with this virus. The information and research that exists about the covid 19 virus and most of the research that has been done has talked about the physical and psychological problems and consequences of this virus, and not much has been done to treat psychological problems. Therefore, considering the importance and necessity of this topic, the present study investigates the effectiveness of mindfulness-based cognitive therapy on mental health and life expectancy of patients with covid 19 disease. research method The present study was is applied and the research project was one of the single-subject clinical trial and multiple baseline projects. In this type of project, the researcher studies the effect of one variable on another variable on one or more triable. Three people were randomly selected from a sample of patients with covid 19 disease who recovered from the disease and were consistent with the purpose of the study. Research tools General Health Questionnaire: The General Health Questionnaire (GHQ) was designed by Goldberg and Hiller. The questions in this questionnaire examine a person's mental state over the past month, including symptoms such as abnormal thoughts and feelings and aspects of observable behavior that emphasize the here and now situation. Life expectancy questionnaire: The Life Expectancy Questionnaire (HQ) was developed by Schneider et al In 1991 to measure hope. It has 12 items and is self-assessment. It has two subscales. Data analysis method In this study, clinical significance has been used to analyze the data. Clinical significance refers to the scientific value or significance of the effect of the intervention performed. Two major and widely used approaches in clinical significance are the reliable change index approach and the normative comparison approach. Reliable change index (RCI) was first introduced by Trax &   Jacobson . for analyzing the data obtained from single case designs. In this index, the post-test score is subtracted from the pre-test score and the result is divided by the standard error of the difference between the two scores. Also the clinical significance was calculated through a formula which was first developed by Blanchard & Schwarz . to analyze the single subject data. The percent recovery formula is one of the methods to measure clients' progress in reducing target problems. In this formula, the pre-test score is subtracted from the post-test score and the result is divided by pre-test score. To analyze the data and evaluate the performance, visual inspection or graphic diagram, and diagnostic improvement were used and the results from before and after the intervention are presented in the table below. After the treatment sessions, the data were scored and interpreted. The tables related to findings are explained below. In Table 1, the scores of the three subjects on post-traumatic stress scale in baseline, treatment and follow-up stages are shown (baseline three times, treatment three times and in follow-up three times) along with a reliable index and overall recovery percentage based on different stages of treatment. Results The results of this study showed that mindfulness-based therapy has an effect on the mental health of patients with improved covid 19 and has increased the mental health of these people. The results of the present study showed that mindfulness-based therapy has an effect on the life expectancy of covid 19 disease patients and has increased life expectancy in these patients. Conclusion The aim of this study was to evaluate the effectiveness of mindfulness-based therapy on increasing mental health and life expectancy of undergraduate students of Lorestan University who had covid 19 disease and recovered from this disease. Mindfulness-base therapy has helped patients live in the present and become more aware and accepting of their current situation. Also, hope for the future and do not drown in negative thoughts. The results showed that mindfulness-based therapy increased mental health and life expectancy in patients recovering from covid 19.