Обозрение психиатрии и медицинской психологии имени В.М. Бехтерева (Apr 2022)
Psychological adaptation and quality of life of patients who underwent lower limb amputation due to cancer
Abstract
Patients who face a stressful situation related to cancer and loss of a limb have not been thoroughly studied form a psychological perspective, what limits the possibilities of targeted psychological assistance and social rehabilitation. In this regard, the aim of the research was to study the clinical and psychological status, strategies and personal resources for coping with the stress of the disease, as well as the main parameters of the quality of life (QoL) of patients who underwent lower limb amputation due to cancer (group 1, n = 24, men — 62.5%, average age 47.25 ± 3.17), in comparison with patients amputated due to other somatic diseases not accompanied by an actual vital threat (group 2, n = 15, men — 93.3%, average age 59.67 ± 2.27), as well as with normative psychodiagnostic data. Methods of clinical and psychological diagnostics were used, including “Ways of Coping Questionnaire”, “Big V Questionnaire”, “Purpose in Life Test”, EORTC “Quality of Life of Cancer Patients Questionnaire” (QLQ-C30). It was found that functional capability (p<0.01), objective (p<0.001) and subjective (p<0.001) severity of pain syndrome, as well as employment (p=0.05) have the lowest indicators in group 1 compared with group 2; at the same time, the levels of QoL in both groups of patients do not differ and do not correspond the expert assessment, exceeding it; patients rate their cognitive and emotional activity most highly; the lowest, physical and role activity, and financial impact. In the structure of coping of group 1, the strategy “Seeking for social support” predominates; the values of the scales “Distancing” (p=0.05), “Escape–avoidance” (0.1<p<0.05), “Positive reappraisal” (p<0.05) are higher than in group 2, but lower than average normative values. In the personality of patients in group 1, “Conscientiousness” (p=0.01) and “Openness” (0.1<p<0.05) prevail in comparison with patients in group 2, as well as “Extraversion” (0.1<p<0.05), “Conscientiousness” (p<0.001) and “Emotional stability / Neuroticism” (p<0.05) — compared with the mean values of the test. The indicators of the scales “Meaning of life” (p<0.01), “Fullness of life” (p<0.01), “Life satisfaction” (p<0.01) in group 1 are higher than in group 2; patients’ internality is higher than in the control sample of men (0.1<p<0.05) and women (p<0.01). The results obtained can be used in the process of rehabilitation of orthopedic cancer patients.
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