رابطه افسردگي و بهزيستي روان شناختي با ادراك بيماري در زنان مبتلا به سرطان پستان

Relationship between Depression and Psychological Well-being Perception in Women with Breast Cancer

زﻣﯿﻨﻪ و ﻫﺪف: ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﺷﺎﯾﻊ ﺗﺮﯾﻦ ﺳﺮﻃﺎن زﻧﺎن ﺑﻮده و زﻧﺎن اﯾﺮاﻧﯽ را ﯾﮏ دﻫﻪ زودﺗﺮ از ﻫﻤﺘﺎﯾﺎﻧﺸﺎن در ﮐﺸﻮرﻫﺎي ﭘﯿﺸﺮﻓﺘﻪ ﺗﺤﺖ ﺗﺄﺛﯿﺮ ﻗﺮار ﻣﯽ دﻫﺪ. اﯾﻦ ﺳﺮﻃﺎن داراي ﻋﻮارض ﺳﺎﯾﮑﻮﻟﻮژﯾﮑﺎل از ﺟﻤﻠﻪ اﻓﺴﺮدﮔﯽ ﻣﯽﺑﺎﺷﺪ. اﮔﺮﭼﻪ ﺳﺎزﮔﺎري ﺑﺎ ﺳﺮﻃﺎن ﺑﺴﯿﺎر ﻣﺸﮑﻞ اﺳﺖ، اﻣﺎ ﻫﻤﺎن ﻃﻮر ﮐﻪ ﺗﺤﻘﯿﻘﺎت ﻧﺸﺎن داده ﺗﺎ ﺣﺪ زﯾﺎد ﺑﻪ ﺟﻨﺒﻪ ﻫﺎي ﺑﯿﻤﺎري و ﻣﻮﻗﻌﯿﺖ روان ﺷﻨﺎﺧﺘﯽ و ﭘﺰﺷﮑﯽ ﺑﯿﻤﺎر ﺑﺴﺘﮕﯽ دارد. ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺑﺮرﺳﯽ راﺑﻄﻪ اﻓﺴﺮدﮔﯽ و ﺑﻬﺰﯾﺴﺘﯽ روان ﺷﻨﺎﺧﺘﯽ ﺑﺎ ادراك ﺑﯿﻤﺎري در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﺻﻮرت ﮔﺮﻓﺖ. ﻣﻮاد و روش ﻫﺎ: ﻣﻄﺎﻟﻌﻪ ﯾﮏ ﻃﺮح ﻫﻤﺒﺴﺘﮕﯽ و ﺟﺎﻣﻌﻪ آﻣﺎري اﯾﻦ ﭘﮋوﻫﺶ ﺷﺎﻣﻞ زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﮐﻪ در اﻧﺴﺘﯿﺘﻮ ﺳﺮﻃﺎن ﻣﺠﺘﻤﻊ ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ اﻣﺎم ﺧﻤﯿﻨﯽ و ﻣﺠﺘﻤﻊ ﺟﻬﺎد داﻧﺸﮕﺎﻫﯽ ﻃﯽ ﺳﺎلﻫﺎي 1393-1394 ﺗﺤﺖ درﻣﺎن ﻗﺮار ﮔﺮﻓﺘﻨﺪ، ﻣﯽﺑﺎﺷﺪ. ﻧﻤﻮﻧﻪ آﻣﺎري ﭘﮋوﻫﺶ 160 زن ﻣﺘﺄﻫﻞ ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﺴﺘﺎن و روش ﻧﻤﻮﻧﻪ ﮔﯿﺮي ﺑﻪ ﺻﻮرت ﻧﻤﻮﻧﻪ در دﺳﺘﺮس از ﻣﯿﺎن ﺟﺎﻣﻌﻪ آﻣﺎري ﺑﻮد. اﻃﻼﻋﺎت اﯾﻦ ﭘﮋوﻫﺶ ﺑﺎ اﺟﺮاي ﭘﺮﺳﺸﻨﺎﻣﻪ اﻓﺴﺮدﮔﯽ )ﺑﮏ، 1972( ﭘﺮﺳﺸﻨﺎﻣﻪ ﺑﻬﺰﯾﺴﺘﯽ روان ﺷﻨﺎﺧﺘﯽ )رﯾﻒ 1989( و ﭘﺮﺳﺸﻨﺎﻣﻪ ادراك ﺑﯿﻤﺎري )IPQ-R( ﺟﻤﻊ آوري ﺷﺪ. ﺟﻬﺖ ﺑﺮرﺳﯽ داده ﻫﺎي ﭘﮋوﻫﺶ از ﻧﺮم اﻓﺰار 18 SPSS و از ﺷﺎﺧﺺ ﻫﺎ و روش ﻫﺎي آﻣﺎري ﺷﺎﻣﻞ ﻣﯿﺎﻧﮕﯿﻦ، اﻧﺤﺮاف ﻣﻌﯿﺎر اﺳﺘﺎﻧﺪارد و ﺿﺮاﯾﺐ ﻫﻤﺒﺴﺘﮕﯽ اﺳﺘﻔﺎده ﺷﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻓﺮﺿﯿﻪ ﻫﺎي ﭘﮋوﻫﺶ ﺣﺎﺿﺮ از ﻃﺮﯾﻖ روش ﺗﺤﻠﯿﻞ رﮔﺮﺳﯿﻮن ﻫﻤﺰﻣﺎن ﭼﻨﺪﻣﺘﻐﯿـﺮي آزﻣﻮن ﺷﺪه اﻧﺪ، از آﻧﺠﺎﺋﯽ ﮐﻪ ﻣﺘﻐﯿﺮ ﻣﻼك )ادراك ﺑﯿﻤﺎري( از ﺳﻪ ﺳﻄﺢ در اﺑﻌـﺎد ﻣﺜﺒﺖ )ادراك واﺿﺢ ﺑﯿﻤﺎري، ﮐﻨﺘﺮل ﺷﺨﺼﯽ و ﮐﻨﺘﺮل ﺑﯿﻤﺎري( ﺗﺸﮑﯿﻞ ﺷﺪه، ﻟﺬا ﺷﺶ ﻓﺮﺿﯿﻪ در ﺳﻪ ﮔﺎم ﻃﺮح و در ﻫﺮ ﮔﺎم ﯾﮏ ﺳﻄﺢ از ﻣﺘﻐﯿﺮ ﻣﻼك )ادراك ﺑﯿﻤﺎري( ﭘﯿﺶ ﺑﯿﻨﯽ ﺷﺪ، در ﻫﺮ ﺳﻪ ﺳﻄﺢ و ﻫﺮ 6 ﻓﺮﺿﯿﻪ ﭘﮋوﻫﺶ راﺑﻄﻪ اﺑﻌﺎد ﻣﺘﻐﯿﺮ ﺑﻬـﺰﯾﺴﺘﯽ رواﻧﺸﻨﺎﺧﺘﯽ ﺑﻪ ﺻﻮرت ﻣﻌﻨﺎداري ادراك ﺑﯿﻤﺎري را ﭘﯿﺶ ﺑﯿﻨﯽ ﮐﺮد )0/01

Introduction & Objective: Breast cancer is the most common cancer among women, and Iranian women a decade earlier than their counterparts in developed countries are affected. This cancer has psychologically effects, including depression. Although coping with cancer is very difficult, but as research shows it is largely dependent on psychological and medical aspects of the disease and the patient's position. This study aimed to investigate the relationship between depression and psychological well-being perception in women with breast cancer. Materials & Methods: This is a correlation study and the population included women with breast cancer at the Cancer Institute of Imam Khomeini Hospital and Jahad Daneshgahi institute who were treated over the years was 2015-2016. The sample consisted of 160 married women diagnosed with breast cancer and cases were in access sample. Data collected with Depression Inventory (Beck, 1972); Psychological Well-Being Scale (Reef 1989) and illness perception questionnaire (IPQ-R). 18 SPSS software and statistical methods such as mean, standard deviation and correlation coefficients were used to evaluate data and indicators. Results: TThe study hypotheses were tested by multivariate regression analysis, since the criterion variables (perceived illness) were formed of three positive aspects (clear understanding of the disease, personal control and disease control) , then six hypotheses in three steps were planned and in each step a level of criterion variables (perceived illness) was predicted. All three levels and each of 6 hypothesis significantly predicted relationship between psychological well-being variables and perception of the disease (P<0.01). Also regression coefficient study between depression and 3 positive aspects of disease perception showed significant reverse relationship between depression and perception of disease (P<0.01). Conclusions: Depression significantly reverse and psychological well-being significantly had meaningful impact on the perception of breast cancer symptoms in disease women. This result confirms the hypothesis of depression and psychological well-being impact on the positive aspects of the disease perception, and also has shown the importance of evaluating and interpreting behavioral and clinical interventions in people with breast cancer.