ﭘﯿﺶ ﺑﯿﻨﯽ اﻣﯿﺪ ﺑﻪ زﻧﺪﮔﯽ ﺑﺮ ﻣﺒﻨﺎي ﺳﻼﻣﺖ رواﻧﯽ و ﺳﺮﺳﺨﺘﯽ رواﻧﺸﻨﺎﺧﺘﯽ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺑﻌﺪ از ﺟﺮاﺣﯽ

Prediction of Hope of Life Based on Mental Health and Psychological Hardiness in Women with Cancer after Surgery

زﻣﯿﻨﻪ و ﻫﺪف: ﻋﻮاﻣﻞ رواﻧﯽ ﺑﻪ ﺳﺒﺐ ﺗﺄﺛﯿﺮ ﺑﺮ روي ﺳﯿﺴﺘﻢ اﯾﻤﻨﯽ ﺑﺪن ﻣﯽ ﺗﻮاﻧﻨﺪ ﻧﻘﺶ ﻣﻬﻤﯽ در ﺑﻬﺒﻮد ﯾﺎ ﮔﺴﺘﺮش ﺑﯿﻤﺎري در اﻓﺮاد ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن داﺷﺘﻪ ﺑﺎﺷﻨﺪ. ﻫﺪف از اﯾﻦ ﭘﮋوﻫﺶ ﺑﺮرﺳﯽ ﻧﻘﺶ ﺳﻼﻣﺖ رواﻧﯽ و ﺳﺮﺳﺨﺘﯽ رواﻧﺸﻨﺎﺧﺘﯽ در ﭘﯿﺶ ﺑﯿﻨﯽ اﻣﯿﺪ ﺑﻪ زﻧﺪﮔﯽ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺑﻌﺪ از ﻋﻤﻞ ﺟﺮاﺣﯽ ﺑﻮد. ﻣﻮاد و روش ﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻮﺻﯿﻔﯽ و از ﻧﻮع ﻫﻤﺒﺴﺘﮕﯽ ﺑﻮد. ﻧﻤﻮﻧﻪ ﻫﺎي ﻣﻮرد ﺑﺮرﺳﯽ ﺷﺎﻣﻞ 122 ﻧﻔﺮ از زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺑﻮد ﮐﻪ ﻣﻮرد ﻋﻤﻞ ﺟﺮاﺣﯽ ﻗﺮار ﮔﺮﻓﺘﻪ ﺑﻮدﻧﺪ و ﺑﺮاي ﭘﯿﮕﯿﺮي ﺑﯿﻤﺎري ﺧﻮد ﺑﻪ اﻧﺴﺘﯿﺘﻮ ﮐﺎﻧﺴﺮ اﯾﺮان ﻣﺮاﺟﻌﻪ ﮐﺮده ﺑﻮدﻧﺪ. اﯾﻦ اﻓﺮاد ﺑﺎ روش ﻧﻤﻮﻧﻪ ﮔﯿﺮي ﻏﯿﺮ ﺗﺼﺎدﻓﯽ ﻫﺪﻓﻤﻨﺪ اﻧﺘﺨﺎب ﺷﺪﻧﺪ و ﺑﻪ ﭘﺮﺳﺸﻨﺎﻣﻪ ﻫﺎي اﻣﯿﺪ ﺑﻪ زﻧﺪﮔﯽ اﺳﻨﺎﯾﺪر )1991(؛ ﺳﻼﻣﺖ رواﻧﯽ ﮐﯽ ﯾﺰ و ﻣﺎﮔﯿﺎرﻣﻮ )2003( و ﻓﺮم ﮐﻮﺗﺎه ﺷﺪه ﺳﺮﺳﺨﺘﯽ ﮐﻮﺑﺎﺳﺎ )1982( ﭘﺎﺳﺦ دادﻧﺪ. داده ﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﺿﺮﯾﺐ ﻫﻤﺒﺴﺘﮕﯽ ﭘﯿﺮﺳﻮن و ﺗﺤﻠﯿﻞ رﮔﺮﺳﯿﻮن ﭼﻨﺪ ﻣﺘﻐﯿﺮي ﺑﺎ روﯾﮑﺮد ﺳﻠﺴﻠﻪ ﻣﺮاﺗﺒﯽ ﺑﺎ اﺳﺘﻔﺎده از ﻧﺴﺨﻪ 21 ﻧﺮم اﻓﺰار آﻣﺎري SPSS ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺖ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻧﺘﺎﯾﺞ ﺣﺎﺻﻞ از ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ داده ﻫﺎ ﻧﺸﺎن داد ﮐﻪ ﻫﺮ ﺳﻪ زﯾﺮ ﻣﻘﯿﺎس ﺑﻬﺰﯾﺴﺘﯽ ﻫﯿﺠﺎﻧﯽ، ﺑﻬﺰﯾﺴﺘﯽ رواﻧﺸﻨﺎﺧﺘﯽ و ﺑﻬﺰﯾﺴﺘﯽ اﺟﺘﻤﺎﻋﯽ ﻣﺮﺑﻮط ﺑﻪ ﺳﻼﻣﺖ رواﻧﯽ و ﻫﺮ ﺳﻪ ﻣﺆﻟﻔﻪ ﺗﻌﻬﺪ، ﮐﻨﺘﺮل و ﭼﺎﻟﺶ ﻣﺮﺑﻮط ﺑﻪ ﺳﺮﺳﺨﺘﯽ رواﻧﺸﻨﺎﺧﺘﯽ ﺑﻪ ﺻﻮرت ﻣﺜﺒﺖ و ﻣﻌﻨﺎدار در ﺳﻄﺢ 0/01 ﺑﺎ اﻣﯿﺪ ﺑﻪ زﻧﺪﮔﯽ راﺑﻄﻪ داﺷﺘﻨﺪ. ﻣﺆﻟﻔﻪ ﻫﺎي ﺳﺮﺳﺨﺘﯽ 49/8 درﺻﺪ از وارﯾﺎﻧﺲ اﻣﯿﺪ ﺑﻪ زﻧﺪﮔﯽ و ﻣﺆﻟﻔﻪ ﻫﺎي ﺳﻼﻣﺖ رواﻧﯽ، 25/4 درﺻﺪ از وارﯾﺎﻧﺲ اﻣﯿﺪ ﺑﻪ زﻧﺪﮔﯽ را ﺑﻪ ﺻﻮرت ﻣﺜﺒﺖ و ﻣﻌﻨﺎدار در ﺳﻄﺢ 0/01 در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺗﺒﯿﯿﻦ ﮐﺮدﻧﺪ. از ﺑﯿﻦ ﻣـﺆﻟﻔﻪ ﻫﺎي ﺳﺮﺳﺨﺘﯽ ﻓﻘﻂ ﻣﺆﻟﻔﻪ ﺗﻌﻬﺪ ﺑﻪ ﺻﻮرت ﻣﺜﺒﺖ و ﻣﻌﻨﺎدار در ﺳﻄﺢ 0/05 و از ﺑﯿﻦ زﯾﺮ ﻣﻘﯿﺎس ﻫﺎي ﺳﻼﻣﺖ رواﻧﯽ، ﺑﻬـﺰﯾﺴﺘﯽ ﻫﯿﺠـﺎﻧﯽ و ﺑﻬﺰﯾﺴﺘﯽ رواﻧﺸﻨﺎﺧﺘﯽ ﺑﻪ ﺻﻮرت ﻣﺜﺒﺖ و ﻣﻌﻨﺎدار در ﺳﻄﺢ 0/01 اﻣﯿﺪ ﺑﻪ زﻧﺪﮔﯽ را در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﯿﺶ ﺑﯿﻨﯽ ﮐﺮدﻧﺪ. ﻧﺘﯿﺠﻪ ﮔﯿـﺮي: ﺑﺮاﺳﺎس ﯾﺎﻓﺘﻪ ﻫﺎي ﭘﮋوﻫﺶ ﺑﯿﻤﺎراﻧﯽ ﮐﻪ از ﺑﻬﺰﯾﺴﺘﯽ ﻫﯿﺠﺎﻧﯽ، ﺑﻬﺰﯾﺴﺘﯽ رواﻧﺸﻨﺎﺧﺘﯽ و ﺗﻌﻬﺪ ﺑﺎﻻﺗﺮي ﺑﺮﺧﻮردار ﺑﻮدﻧﺪ، اﻣﯿﺪ ﺑﻪ زﻧﺪﮔﯽ ﺑﯿﺸﺘﺮي داﺷﺘﻨﺪ. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻣﯿﺰان ﭘﯿﺶ ﺑﯿﻨﯽ ﻫﺮﯾﮏ از ﻣﺘﻐﯿﺮﻫﺎ، ﻣﺪاﺧﻼت رواﻧﺸﻨﺎﺧﺘﯽ ﺑﺮاي ﺗﻘﻮﯾﺖ اﯾﻦ ﻣﺘﻐﯿﺮﻫﺎ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﺑﻌﺪ از ﻋﻤﻞ ﺟﺮاﺣﯽ ﺗﻮﺻﯿﻪ ﻣﯽ ﺷﻮد.

Introduction & Objective: Psychological factors as hope of life can reduce or promote cancer progression because of the influence of these factors on the immune system that protected body against illness and may help to fight cancer. The present study investigated the predictability of hope of life based on mental health and psychological hardiness in women with cancer after surgery. Materials & Methods: The population of this study was all women with cancer after surgery who were referred to Cancer Institute of Iran for follow up. 122 patients recruited in this study based on purposive sampling. They completed the validated questionnaires for hope (Snyder, 1991); mental health (Keyes & Magyar-Moe, 2003); and short form of hardiness scale (Kubasa, 1982). Data were analyzed by using Pearson’s correlation coefficient and hierarchical multiple regression. Results: Findings indicated a significant positive relationship between hope of life and mental health (emotional well-being, psychological well-being and social well-being), as well as psychological hardiness (commitment, control and challenge) in women with cancer (P < 0.01). Hardiness explained 49.8% of the variance in hope of life (P < 0.01) and mental health explained 25.4% of the variance in hope of life (P < 0.01). Commitment (P < 0.05), emotional well-being and psychological well-being (P < 0.01) predicted hope of life in women with cancer. Conclusions: According to this study, the patients with higher, emotional well-being, Psychological well-being and commitment had greater hope of life. Psychological interventions for strengthening these factors in women with cancer after surgery are suggested.