پیش‌بینی کیفیت زندگی بیماران مبتلا به سرطان پیشرفته مراجعه‌کننده به بخش مراقبت تسکینی براساس اضطراب و افسردگی

زمینه و هدف: مراقبت تسکینی رویکردی جامع شامل مدیریت و مراقبت از نیازهای جسمانی، روانی، اجتماعی و معنوی جهت ارتقا و حفظ کیفیت زندگی افرادی با بیماری‌های پیشرفته و خانوادهٔ آنان است که سرطان نیز ازجملهٔ آن‌ها به‌شمار می‌رود؛ ازاین‌رو پژوهش حاضر به‌منظور بررسی کیفیت زندگی بیماران مبتلا به سرطان پیشرفته، مراجعه‌کننده به بخش مراقبت تسکینی و پیش‌بینی آن براساس اضطراب و افسردگی اجرا شد.روش‌بررسی: این پژوهش از نوع مقطعی‌ و همبستگی بود. تعداد 150 نفر از بیمارانی که از مهر تا آذر 1397 به بخش طب تسکینی بیمارستان فیروزگر تهران مراجعه کردند، به‌روش نمونه‌گیری دردسترس انتخاب شده و تحت مطالعه قرار گرفتند. برای گردآوری داده‌ها، پرسشنامهٔ کیفیت زندگی مک‌گیل (1995) و پرسشنامهٔ اضطراب و افسردگی بیمارستانی زیگموند و اسنیت (1983) به‌کار رفت. داده‌ها با استفاده از روش همبستگی پیرسون و رگرسیون چندگانه بررسی و آزمون شد (0٫05p و 0٫33-=r) و افسردگی (0٫01>p و 0٫37-=r) با کیفیت زندگی شرکت‌کنندگان رابطهٔ منفی معناداری وجود دارد. همچنین، اضطراب (0٫002=p و 0٫248- =b) و افسردگی (0٫001˂p و 0٫298- =b) توانسته‌اند 19درصد از واریانس متغیر ملاک یعنی کیفیت زندگی بیماران مبتلا به سرطان پیشرفته را پیش‌بینی کنند.نتیجه‌گیری: باتوجه به نتایج مطالعه، بیماران مراجعه‌کننده به بخش مراقبت تسکینی دارای کیفیت زندگی نسبتاً ضعیفی هستند و اضطراب و افسردگی قادر به پیش‌بینی کیفیت زندگی آ‌نان است؛ بنابراین، ارزیابی و سنجش سطح علائم روان‌شناختی ازجمله اضطراب و افسردگی و اقدامات روان‌درمانی مناسب جهت کاهش آن‌ها می‌تواند به‌صورت غیرمستقیم موجب بهبود کیفیت زندگی بیماران شود.

Predicting the Quality of Life Concerning Anxiety and Depression in Advanced Cancer Patients Receiving Palliative Care

Background & Objectives: Palliative care is a comprehensive approach, including managing and caring for biopsychosocial and spiritual needs for the promotion and maintenance of the quality of life of patients under palliative care and their families. Cancer is disease considered in palliative care. Two predictors of the quality of life in patients with cancer are anxiety and depression. Therefore, the current study aimed to evaluate the quality of life in terms of anxiety and depression in patients with advanced cancer referring to palliative care unit. Methods: This cross–sectional and correlational study was conducted on 150 patients with advanced cancer referring to the palliative care unit of Firoozgar Hospital in Tehran City, Iran from October 2017 to December 2017. The study participants were selected via convenience sampling technique. The sample size was estimated using the proposed formula of the Tabachnick and Fidell (2007) sample size. Accordingly, the minimum sample size in the correlation studies is calculated from the 8M + 50 ≤N formula (N represents the sample size, and M is the number of independent variables). Inclusion criteria of the present research included age (18–75 y), literacy level (minimum reading and writing literacy), Iranian nationality, the lack of diagnosis of brain metastasis, and willingness to participate in this research. Additionally, individuals who simultaneously received psychological and counseling services were excluded from the research. The required data were collected using McGill Quality of Life Questionnaire (MQOL) (1995) and Zigmond & Snaith Hospital Anxiety and Depression Scale (HADS) (1983). The collected data were analyzed using Pearson correlation confident and multiple regression analysis by SPSS at p<0.05.Results: In total, 150 participants were studied, of which 96(64%) and 54(36%) were women and men, respectively. In addition, breast cancer (24.7%) and ovarian cancer (21.3%) were the most frequent cancer types in the studied subjects. The mean scores of the quality of life, anxiety, and depression were 29, 9.74, and 9.46, respectively; these data indicate the borderline detection of the second two variables in the study participants. The obtained data suggested a significant and negative correlation between anxiety (p>0.01 & r= –0.33) and depression (p>0.01 & r= –0.37). as well as the quality of life of patients with advanced cancer referring to the palliative care unit. Furthermore, anxiety (p=0.002 & B= –0.248) and depression (p>0.001 & r= –0.298) could predict 19% of the variance of the quality of life in the investigated patients.Conclusion: Patients receiving palliative care have a relatively low quality of life; anxiety and depression could predict their quality of life. Thus, assessing the severity of psychological symptoms, such as anxiety and depression and providing appropriate psychotherapies to reduce them, could indirectly improve their quality of life, as a goal of palliative care. It is suggested that these results be applied in providing palliative services to these patients and their caregivers.