Empirijska procena efekta psihološke grupne intervencije sa integrativnim pristupom kod žena sa karcinomom dojke – preliminarni rezultati
Sažetak
Apstrakt
Uvod/Cilj. Dijagnoza karcinoma dojke predstavlja izuzetno stresan životni događaj koji donosi niz fizičkih i psiholoških izazova. Međutim, intervencije u vidu suportivnih ili psiho-edukativnih grupa mogu u značajnoj meri ublažiti psihološki distres kod bolesnika. Cilj istraživanja bio je da se empirijski validiraju efekti psihološke grupne intervencije sa integrativnim pristupom na afektivno stanje žena koje su operisane zbog karcinoma dojke na Institutu za onkologiju Vojvodine. Metode. Istraživanje je sprovedeno na uzorku od 30 ispitanica, prosečne starosti 53,17 godina [standardna devijacija (SD) = 10,09]. Nakon operacije, hospitalizovane pacijentkinje su učesvovale u integrativnoj grupnoj sesiji koja se sastojala od: 1) suportivno-ekspresivnog dela, 2) psiho-edukativnog i 3) zdravstveno-edukativnog segmenta. Pre učešća u intervenciji, pacijentkinje su popunile upitnik o demografskim podacima, meru pozitivnog i negativnog afekta (PANAS), skalu optimizma (LOT-R), nade (AHS), meru neuroticizma (BFI) i simptoma depresije (DASS-21), a na kraju grupne sesije, ponovo su popunile PANAS. Rezultati. T-test za zavisne uzorke pokazao je da, nakon učešća u psihološkoj grupnoj intervenciji, dolazi do statistički značajnog povećanja pozitivnog afekta (t(29) = -4.44, p < 0.001), kao i do statistički značajnog smanjenja negativnog afekta (t(29) = 5.60, p < 0.001). Neparametrijski Vilkoksonov test rangova takođe je pokazao da su dobijene razlike statistički značajne. Multipla regresiona analiza (F(4, 25) = 3.46, p = 0.02) pokazala je da povišen neuroticizam i sniženi simptomi depresije značajno predviđaju povećanje pozitivnog afekta. Druga regresiona analiza (F(4, 25) = 3.32, p = 0.03) pokazala je da žene koje imaju povišene simptome depresije i, marginalno značajno, višu nadu, ostvaruju izrazitije smanjenje negativnog afekta nakon intervencije. Zaključak. Rezultati studije su pokazali da integrativna psihološka grupna intervencija ima pozitivan kratkoročni efekat na afektivno stanje pacijentkinja operisanih zbog karcinoma dojke, te da različite psihološke varijable mogu igrati značajnu ulogu u predikciji promene na planu afektivnog stanja.
Reference
REFERENCES
Mehnert A, Koch U. Psychological comorbidity and health-related quality of life and its association with awareness, utilization, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. J Psychosom Res 2008; 64(4): 383–91.
Deshields T, Tibbs T, Fan M, Taylor M. Differences in patterns of depression after treatment for breast cancer. Psychooncology 2006; 15(5): 398–406.
Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A. Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ 2005; 330(7493): 702.
Jadoulle V, Rokbani L, Ogez D, Maccioni J, Lories G, Bruchon-Schweitzer M, et al. Coping and adapting to breast cancer: a six-month prospective study. Bull Cancer 2006;93(7): 67–72.
Bang S, Park SH, Kang HG, Jue JI, Cho IH, Yun YH, et al. Changes in quality of life during palliative chemotherapy for solid cancer. Support Care Cancer 2005; 13(7): 515–21.
Iconomou G, Mega V, Koutras A, Iconomou AV, Kalofonos HP. Prospective assessment of emotional distress, cognitive func-tion, and quality of life in patients with cancer treated with chemotherapy. Cancer 2004; 101(2): 404–11.
Meyerowitz BE. Psychosocial correlates of breast cancer and its treatments. Psychol Bull 1980; 87(1): 108–31.
Schou BI, Kåresen R, Smeby NA, Espe R, Sørensen EM, Amundsen M, et al. Effects of a Psychoeducational Versus a Support Group Intervention in Patients With Early-Stage Breast Can-cer: results of a randomized controlled trial. Cancer Nurs 2014; 37(3): 198–207.
Ferlic M, Goldman A, Kennedy BJ. Group counseling in adult patients with advanced cancer. Cancer 1979; 43(2): 760–6.
Vachon MLS, Lyall WA, Rogers J, Cochrane J, Freeman SJ. The Effectiveness of Psychosocial Support during Post-Surgical Treatment of Breast Cancer. Int J Psychiatry Med 1982; 11(4): 365–72.
Weisman AD, Worden JW, Sobel HJ. Psychosocial screening and intervention with cancer patients. Boston, MA: Project Ome-ga; 1980.
Edelman S, Craig A, Kidman AD. Group Interventions with Cancer Patients: efficacy of psychoeducational versus suppor-tive groups. J Psychosoc Oncol 2000; 18(3): 67–85.
Telch CF, Telch MJ. Group coping skills instruction and supportive group therapy for cancer patients: A comparison of strategies. J Consult Clin Psychol 1986; 54(6): 802–8.
Helgeson VS, Cohen S, Schulz R, Yasko J. Group support inter-ventions for women with breast cancer: Who benefits from what?. Health Psychol 2000; 19(2): 107–14.
Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: The PANAS scales. J Pers Soc Psychol 1988; 54(6): 1063–70.
Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test. J Pers Soc Psychol 1994; 67(6): 1063–78.
Snyder CR, Harris C, Anderson JR, Holleran SA, Irving LM, Sigmon ST, et al. The will and the ways: Development and validation of an individual-differences measure of hope. J Pers Soc Psychol 1991; 60(4): 570–85.
John OP, Donahue EM, Kentle RL. The big five inventory. Ver-sions 4a and 54. Berkeley, CA: University of California, Berkeley, Institute of Personality and Social Research; 1991.
Lovibond SH, Lovibond PF. Manual for the depression anxiety stress scales. 2nd ed. Sydney: Psychology Foundation of Aus-tralia; 1995.
Henry JD, Crawford JR. The short-form version of the Depres-sion Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. Br J Clin Psychol 2011; 44(Pt 2): 227–39.
Tabachnick BG, Fidell LS. Using multivariate statistic. 6th ed. Boston: Pearson; 2013.
Chentsova-Dutton Y, Hanley K. The effects of anhedonia and de-pression on hedonic responses. Psychiatry Res 2010; 179(2): 176–80.
Ng W. Neuroticism and well-being? Let's work on the positive rather than negative aspects. J Positive Psychol 2012; 7(5): 416–26.
Roelofs J, Huibers M, Peeters F, Arntz A. Effects of neuroticism on depression and anxiety: Rumination as a possible mediator. Pers Individ Diff 2008; 44(3): 576–86.