Psihološki status i percepcija bolesti u bolesnika s melanomom

Vurnek Živković, Maja (2011) Psihološki status i percepcija bolesti u bolesnika s melanomom. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Melanoma is a malignant tumour of melanocytes. One of the major avoidable risk factors for melanoma is UV protection which makes appropriate sun protection extremely important. Melanoma is a serious illness with potential intensive influence on the patient’s quality of life and psychological state. In total, 240 participants were included in this study: 120 patients suffering from melanoma and 120 participants in the control group. Melanoma patients were divided into two groups: patients with melanoma thinner than, and thicker than 1 mm Breslow thickness. Following questionnaires were used in this study: General data questionnaire, Sun behaviours questionnaire and Brief Illness perceptions questionnaire for all participants, and World Health Organization Quality of Life Questionnaire, Subjective quality of life, Becks Depression Index, State Trait Anxiety Inventory, Negative life events scale, Coping with stress questionnaire and Eysencks personality questionnaire for melanoma patients only. The aims of this study encompassed risk factors for melanoma, sun behaviour patterns and perception of melanoma among all participants and comparison of their results. Quality of life and psychological characteristics of melanoma patients were also investigated, and results of patients with melanoma less and over 1 mm Breslow thickness were compared. Finally, the aim was to investigate significant predictors of quality of life. Patients in this group showed responsible sun behaviour patterns, but with significant differences between melanoma and control group. Patients suffering from melanoma spend less time in the sun, are more careful about using sun protection and have a milder perception of melanoma than the control group. In the melanoma group there are more fair tanned people, more people with more than 50 moles and with more sunburn during childhood. Patients suffering from melanoma have high quality of life and melanoma has a mild influence on their quality of life. On average, patients with melanoma have low anxiety and depression scores, but 30% of patients were highly anxious and 7% of them were depressed. Another chronic illness, non cancer stress, personality traits, coping and illness perceptions were all significant predictors of subjective quality of life, with more than 93% of the QoL variance explained.

Abstract in Croatian

Melanom je zloćudni tumor melanocita u čijem nastanku značajnu ulogu ima izlaganje UV zračenju zbog čega je pravilna zaštita od sunca od iznimnog značaja. Melanom je bolest koja zbog svoje težine i ozbiljnosti može imati značajan utjecaj na psihološki status bolesnika. U opisanom istraživanju je sudjelovalo 240 ispitanika, 120 bolesnika s melanomom i 120 ispitanika u kontrolnoj skupini. Bolesnici s melanomom podijeljeni su u dvije skupine; na one s melanomom debljine do i iznad 1 mm prema Breslowu. U istraživanju su korišteni sljedeći upitnici: Upitnik općih podataka, Upitnik ponašanja na suncu i Kratki upitnik percepcije bolesti za obje skupine ispitanika, a Upitnik kvalitete života Svjetske zdravstvene organizacije, Subjektivna kvaliteta života, Beckov indeks depresije, Upitnik anksioznosti kao stanja i kao osobine, Skala negativnih životnih događaja, Upitnik stilova suočavanja sa stresom i Eysenckov upitnik osobina ličnosti za bolesnike s melamomom. Cilj istraživanja obuhvatio je rizične čimbenike za melanom, ponašanje na suncu i percepciju bolesti kod svih ispitanika, te usporedbu rezultata bolesnika s melanomom i kontrolne skupine. Istraživali smo i kvalitetu života i psihološki status bolesnika s melanomom i usporedili bolesnike s melanomom debljine do i iznad 1 mm prema Breslowu. Konačno, cilj je bio ispitati i prediktore kvalitete života kod bolesnika s melanomom. U rezultatima smo pokazali da se svi ispitanici relativno odgovorno ponašaju na suncu, uz postojanje značajnih razlika između bolesnika s melanomom i kontrolne skupine. Bolesnici s melanomom manje se izlažu suncu, pažljivije se štite od sunca i imaju negativniji stav prema sunčanju, no imaju blažu percepciju melanoma od ispitanika iz kontrolne skupine. U skupini bolesnika s melanomom ima značajno veći broj osoba sa svijetlom kožom i kosom, većim brojem madeža i više opeklina od sunca iz djetinjstva. Bolesnici s melanomom imaju visoku kvalitetu života, a bolest ima srednje visok utjecaj na kvalitetu života. Među bolesnicima s melanomom ima 30% visoko anksioznih i 7% depresivnih. Prisustvo druge kronične bolesti, stres koji nije vezan za bolest, osobine ličnosti, stil suočavanja sa stresom i percepcija bolesti značajni su prediktori kvalitete života bolesnika s melanomom i objašnjavaju čak 93% njene varijance.

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