طراحی، اعتباریابی و اثربخشی برنامه مدیریت درد بر درد و امید به زندگی بیماران مبتلا به سرطان پستان دریافت‌کننده شیمی درمانی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری، دانشکده روانشناسی و علوم تربیتی، گروه روانشناسی، دانشگاه اصفهان، اصفهان، ایران.

2 دانشیار، دانشکده روانشناسی و علوم تربیتی، گروه روانشناسی، دانشگاه اصفهان، اصفهان، ایران.

10.22123/chj.2024.386418.1994

چکیده

مقدمه: درد به عنوان یکی از عوارض جانبی شیمی­درمانی با ناراحتی­های جسمانی و روان­شناختی همراه است. هدف از مطالعه حاضر تدوین و اعتباریابی برنامه مداخله مدیریت درد اختصاص­یافته برای بیماران مبتلا به سرطان پستان دریافت­کننده شیمی­درمانی و تعیین اثربخشی این مداخله بر درد و امید به زندگی این بیماران بود.
مواد و روش­ها: به منظور تدوین برنامه مداخله­ای از شیوه کیفی تحلیل مضمون استفاده شد. مطالعات مربوطه شناسایی و کدهای اولیه، ثانویه و مؤلفه اصلی مشخص و در قالب یک مداخله 6 جلسه­ای گروهی تدوین گردید. سپس از 10 متخصص درخواست شد تا اعتبار درونی این برنامه را ارزیابی نمایند. برای ارزیابی اثربخشی این برنامه، از شیوه نیمه­تجربی با پیش­آزمون، پس­آزمون با گروه کنترل و پی­گیری یک ماهه استفاده شد. تعداد 28 بیمار از مراکز درمانی شهرستان شیراز در سال 1401 به شیوه هدفمند انتخاب و به صورت تصادفی در دو گروه 14 نفره گمارده شدند. هر دو گروه به وسیله پرسش­نامه کوتاه درد و پرسش­نامه امید به زندگی در سه مرحله ارزیابی شدند. داده­ها توسط آنالیز واریانس دوطرفه با اندازه­گیری­های مکرر تجزیه­وتحلیل شد.
یافته­ ها: مداخله مدیریت درد از اعتبار درونی و پایایی مناسبی برخوردار بود. گروه مداخله در پس­آزمون به طور معنی­داری نمرات کمتر درد و نمرات بیشتر امید به زندگی را گزارش کردند (001/0p<). تفاوت نمرات در پی­گیری یک ماهه معنی­دار بود (001/0p<).
نتیجه­ گیری: مداخله مدیریت درد از کارآمدی مناسبی به منظور تعدیل درد و امید به زندگی بیماران سرطان برخوردار است. این برنامه می­تواند گزینه مناسبی برای متخصصین مربوطه جهت تعدیل عوارض جانبی شیمی­درمانی باشد.
 

کلیدواژه‌ها


عنوان مقاله [English]

Designing, Validating and the Effectiveness of A Pain Management Program for Pain and Life Expectancy in Breast Cancer Patients During Chemotherapy

نویسندگان [English]

  • M Arefian 1
  • K Asgari Mobarake 2
1 Ph.D. Student, Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
2 Associate Professor, Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
چکیده [English]

Introduction: Pain as one of the side effects of chemotherapy is associated with physical and psychological discomforts in breast cancer patients. The aim of this study was designing, validating and evaluate the effectiveness of a pain management program for pain and life expectancy in breast cancer patients during chemotherapy.
Materials and Methods: The program was designed using a qualitative thematic analysis method. Relevant studies were identified from the background and used to develop a six-session program by identifying primary, secondary, and main component codes. Then, to evaluate the validity, 10 experts in this field were asked to assess the program. A semi-experimental method was used to assess the effectiveness of the program. In 2022, 28 breast cancer patients with a cancer severity of 1 to 3 undergoing chemotherapy at Namazi and Amir hospitals in Shiraz city were randomly assigned to intervention and control groups (n=14). Both groups were evaluated by Brief Pain Inventory and Hope Scale in three phases: pre-test, post-test, and one-month follow-up. Moreover, the variance analysis with repeated measures was used to analyze the data.
Results: Based on the evaluation results, the pain management program demonstrated sufficient content validity and reliability. In addition, the intervention group reported significantly lower pain and higher life expectancy scores in post-test (p<0.01). The difference reminded significant in follow-up (p<0.01).
Conclusion: Based on the study findings, the pain management program effectively moderates pain and improves the life expectancy of breast cancer patients during chemotherapy. Hence, this program is a suitable option to moderate the side effects of chemotherapy.

کلیدواژه‌ها [English]

  • Breast Cancer
  • Chemotherapy
  • Pain Management Program
  • Pain
  • Life Expectancy
  1. Sung H, Ferlay J, Siegel R L, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians 2021; 71(3): 209-249.
  2. Van Den Beuken-Van M H, Hochstenbach L M, Joosten E A, Tjan-Heijnen V C, and Janssen D J. Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. JPSM 2016; 51(6): 1070-1090.
  3. Arefian M, Asgari K, Fazilatpour M, Zanguri V, and Akrami M. Proposing and evaluating a model of depression, stress, resilience and spirituality in relation to pain in women with breast cancer: Investigating the mediating role of mindfulness. EJON 2023;62: 102268.
  4. Raja S, Carr D, Cohen M, Finnerup N, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain 2020; 161(9): 1976-1982.
  5. Andersen K G and Kehlet H. Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention.The journal of Pain 2011; 12(7): 725-746.
  6. Costa W A, Monteiro M N, Queiroz J F, and Gonçalves A K. Pain and quality of life in breast cancer patients. Clinics 2017; 72(12): 758-763.
  7. Invernizzi M, de Sire A, Venetis K, Cigna E, Carda S, Borg M, et al. Quality of Life interventions in breast cancer survivors: state of the art in targeted rehabilitation strategies. Anticancer Agents Medical Chemistery 2022; 22(4): 801-810.
  8. Wang B, Gao P, Wang J, and Zheng H. Association between aesthetic satisfaction and chronic postsurgical pain in breast cancer patients treated with one stage prosthesis implantation. Scientific Reports 2022; 12(1): 1258.
  9. Satija A, Ahmed S M, Gupta R, Ahmed A, Rana S P S, Singh S P, et al. Breast cancer pain management-A review of current & novel therapies. IJMR 2014; 139(2): 216.
  10. Waddell G, Newton M, Henderson I, Somerville D, and Main C J. A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 1993; 52(2): 157-168.

11.Vlaeyen J W and Linton S J. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000; 85(3): 317-332.

12.Olsson Möller U, Beck I, Rydén L, and Malmström M. A comprehensive approach to rehabilitation interventions following breast cancer treatment-a systematic review of systematic reviews. BMC cancer 2019; 19(1): 1-20.

13.Osypiuk K, Ligibel J, Giobbie-Hurder A, Vergara-Diaz G, Bonato P, Quinn R, et al. Qigong mind-body exercise as a biopsychosocial therapy for persistent post-surgical pain in breast cancer: a pilot study. ICT 2020; 19: 1534735419893766.

14.Zainal N Z, Booth S, and Huppert F A. The efficacy of mindfulness‐based stress reduction on mental health of breast cancer patients: A meta‐analysis. Psycho‐Oncology 2013; 22(7): 1457-1465.

15.Kwekkeboom K L, Abbott-Anderson K, Cherwin C, Roiland R, Serlin R C, and Ward S E. Pilot randomized controlled trial of a patient-controlled cognitive-behavioral intervention for the pain, fatigue, and sleep disturbance symptom cluster in cancer. JPSM 2012; 44(6): 810-822.

16.Shergill Y, Rice D B, Khoo E-L, Jarvis V, Zhang T, Taljaard M, et al. Mindfulness-based stress reduction in breast cancer survivors with chronic neuropathic pain: a randomized controlled trial. Pain Research and Management  2022; 10(1): 1-14.

17.Boing L, Vieira M d C S, Moratelli J, Bergmann A, and de Azevedo Guimarães A C. Effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy–a systematic review and meta-analysis. Maturitas 2020; 141: 71-81.

18.Al Onazi M M, Yurick J L, Harris C, Nishimura K, Suderman K, Pituskin E, et al. Therapeutic ultrasound for chemotherapy-related pain and sensory disturbance in the hands and feet in patients with colorectal cancer: a pilot randomized controlled trial. JPSM 2021; 61(6): 1127-1138.

19.Lee H and Singh G K. Psychological distress, life expectancy, and all-cause mortality in the United States: results from the 1997–2014 NHIS-NDI record linkage study. Annals of Epidemiology  2021; 56: 9-17.

20.Heydari M, Hajiheydari A, Roozitalab M, and Rohani A. The effectiveness of resilience training on anxiety, depression, stress, life expectancy and psychological well-being of women with breast cancer. Revista Latinoamericana de Hipertension 2022; 17(5): 307-313.

21.Golestanifar S and DashtBozorgi Z. The Effectiveness of acceptance and commitment based therapy on depression, psychological health and life expectancy of the elderly with nonclinical depression. Aging Psychology 2020; 6(3): 191-203. [Persian]

22.Yeh J M, Ward Z J, Chaudhry A, Liu Q, Yasui Y, Armstrong G T, et al. Life expectancy of adult survivors of childhood cancer over 3 decades. JAMA oncology 2020; 6(3): 350-357.

23.Arefian M. Developing and Evaluating a Model of the Relationship between Stress, Depression, Resilience, and Spirituality with Experienced Pain by the Mediating Role of Mindfulness and Comparing the Effectiveness of Intervention based on this Model with Mindfulness-Based Interoceptive Exposure Task [MIET] on Experienced Pain and Life Expectancy of the Patients with Breast Cancer Receiving Chemotherapy. 2023, Isfahan University of Educational sciences and Psychology: (Unpublished doctoral dissertation). [Persian]

24.Zimmaro L A, Carson J W, Olsen M K, Sanders L L, Keefe F J, and Porter L S. Greater mindfulness associated with lower pain, fatigue, and psychological distress in women with metastatic breast cancer. Psycho‐Oncology 2020; 29(2): 263-270.

25.Neff K and Germer C. The Mindful Self-Compassion Workbook: A Proven Way to Accept Yourself, Build Inner Strength, and Thriveÿ. 2018: Guilford Publications.

26.Wang X and Ji X. Sample size estimation in clinical research: from randomized controlled trials to observational studies. Chest 2020; 158(1): S12-S20.

27.Vakilzadeh P and Nakhaee N. The reliability and validity of the Persian version of the brief pain inventory in cancer patients. JRUMS 2006; 5(4): 253-258. [Persian]

28.Majedi H, Dehghani S S, Soleyman-Jahi S, Meibodi S A E, Mireskandari S M, Hajiaghababaei M, et al. Validation of the Persian version of the brief pain inventory (BPI-P) in chronic pain patients. JPSM 2017; 54(1): 132-138.

29.Snyder C R, Harris C, Anderson J R, Holleran S A, Irving L M, Sigmon S T, et al. The will and the ways: development and validation of an individual-differences measure of hope. JPSP 1991; 60(4): 570.

30.Ghasemi A, Abedi A, and Baghban I. The impact of group education based on snyder’s hop theory on the rate of happiness in eldery’s life. Perspect Med Educ 2009; 11(41): 17-40. [Persian]

31.Oldenmenger W H, Geerling J I, Mostovaya I, Vissers K C, de Graeff A, Reyners A K, et al. A systematic review of the effectiveness of patient-based educational interventions to improve cancer-related pain. Cancer Treatment Reviews  2018; 63: 96-103.

32.Opsomer S, Lauwerier E, De Lepeleire J, and Pype P. Resilience in advanced cancer caregiving. A systematic review and meta-synthesis. Palliative Medicine 2022; 36(1): 44-58.

33.Park S, Sato Y, Takita Y, Tamura N, Ninomiya A, Kosugi T, et al. Mindfulness-Based Cognitive Therapy for Psychological Distress, Fear of Cancer Recurrence, Fatigue, Spiritual Well-Being, and Quality of Life in Patients With Breast Cancer—A Randomized Controlled Trial. JPSM 2020; 60(2): 381-389.

34.Utne I, Miaskowski C, Bjordal K, Paul S M, and Rustoen T. The relationships between mood disturbances and pain, hope, and quality of life in hospitalized cancer patients with pain on regularly scheduled opioid analgesic. Palliativwe Medicine 2010; 13(3): 311-318.

35.Hadjistavropoulos T and Craig K D. Pain: psychological perspectives. 2004: Psychology Press.