PSYCHOLOGICAL ADJUSTMENT AND QUALITY OF LIFE IN PATIENTS WITH BONE TUMOR

The article reflects the results of empirical research and theoretical understanding of the interaction of mechanisms of psychological adjustment to the disease and the main parameters of quality of life in chronic somatic disease. We examined139 patients suffering from different forms of oncological damage of bones of the musculoskeletal system, who treated in «N. N. Blokhin National Medical Research Centre of Oncology». Such psychodiagnostic methods as «BIG 5», «Ways of coping», «Purpose-in-Life Test», «Questionnaire of relation to disease «TOBOL», «SF-36 Health Status Survey», «Quality of Life Questionnaire» EORTC QLQ-C30 with additional module BM-22 for patients with bone tumor were used; Karnofsky scale and ECOG-WHO scale (from medical records) were used to assess the objective somatic status of patients. Cluster, factor and multifactorial dispersion analysis of data was performed, which showed the influence of the selected «profiles» (clusters) of personality («Neurotic person», «Mature, adapted person», «Person with a high level of self-consciousness and responsibility», «Socially maladjusted personality») on the generalized factors of quality of life («Life activity», «Optimal quality of life in the conditions of disease», as well as the factor «Gastrointestinal problems», reflecting the somatization of psychological problems in the situation of the disease). The results of the study show that the integrated study of the mechanisms of psychological adaptation and characteristics of the quality of life in the conditions of the disease opens up new ways of psychological care and social rehabilitation of cancer patients, as it allows to take into account in each case the influence of «the profile of personality» on individual domains of quality of life.

psychological adjustment to the disease, quality of life, profile of personality, bone tumor, psychological support, rehabilitation

1. Wasserman L.I., Ababkov VA., Trifonova E.A. Sovla- danie so stressom: teoriia i psikhodiagnostika [Coping theory and psychological testing]. St. Petersburg, Rech’ Publ., 2010. 192 p. (In Russ.).

2. Lazarus R.S. Stress and the coping: An anthology. - 2 ed.

3. N.Y.: Columbia Univ. Press, 1985. 437 p. DOI: 10.1007/978- 94-015-7129-6_24.

4. Davis S.K. Emotional intelligence and attentional bias for threat-related emotion under stress // Scand J Psychol. 2018. V 22 . P. 1-10. DOI: 10.1m/sjop.12439.

5. Grafe LA., Eacret D., Dobkin J., Bhatnagar S. Reduced Orexin System Function Contributes to Resilience to Repeat¬ed Social Stress. eNeuro. 2018. V 16; 5(2). P. 1-13. DOI: 10.1523/eneuro.0273-17.2018.

6. Berezin F.B. Psihicheskaya i psyhofiziologicheskaya adaptaziya cheloveka. [Mental and psychophysiological adap¬tation of a person]. Leningrad. Nauka. 1988. 267 p. (In Russ.).

7. Aleksandrovskiy Yu. A. Pogranichnyye psikhicheskiye rasstroystva: Uchebnoye posobiye. [Borderline mental dis¬orders: Textbook]. 3-th edition. Moscow. Medicina. 2000. 495p. (In Russ.).

8. Berebin M.A., Wasserman L.I. Sistemnyy podkhod i teoriya funktsional’nykh sistem v izuchenii psikhicheskoy adaptatsii kak mediko-psikhologicheskoy problem. [The system approach and the theory of functional systems in the study mental adaptation as a medical and psychologi-cal problem]. Meditsinskaya psikhologiya v prakticheskom zdravookhranenii. [Medicine psychology in practical health care]. Saint Petersburg. 2003: 29-34. (In Russ.).

9. de Wolff M, Ersb0ll AS, Hegaard H, Johansen M, Gustaf¬sson F, Damm P, Midtgaard J. Psychological adaptation after peripartum cardiomyopathy: A qualitative study // Midwifery. 2018. V 52 P. 52-60. DOI: 10.1016/j.midw.2018.03.012.

10. Kotsyubinskiy A.P., Skorik A.I., Aksenova I.O. et al. Shizofreniya: uyazvimost’ - diatez - stress - zabolevaniye. [Schizophrenia: Vulnerability - Diathesis - Stress - Disease]. Saint Petersburg: Hippocrate +, 2004. 336 p. (In Russ.).

11. Isaeva E.R. Koping-povedeniye i psikhologicheskaya zashchita lichnosti v usloviyakh zdorov’ya i bolezni. [Coping behavior: analysis of age and gender differences on the exam¬ple of Russia’s population]. Vestnik Tomskogo gosudarstven- nogo pedagogicheskogo universiteta - TSPU Bulletin, 2009, no. 11 (89): 144-147. (In Russ.).

12. Klinicheskaya psikhologiya i psikhoterapiya. [Clinical psychology and psychotherapy]. 3-th eddition / Eddited by M. Pierre, U. Baumann. Saint Petersburg: Piter, 2012. 944 p. (In Russ.).

13. Mikhaylichenko T.G., Shchelkova O.YU. Metodologi- ya izucheniya psikhologicheskoy adaptatsii patsiyentov s au- toimmunnymi zabolevaniyami pecheni v period ozhidaniya transplantatsii organa. [Methodology of studying psycholog¬ical adaptation of patients with autoimmune liver diseases while waiting for transplantation]. Bulletin of the South Ural State University. Ser. Psychology. 2017, vol. 10, no. 1: 121¬138. (in Russ.) DOI: 10.14529/psyl70112.

14. Luriya R.A. Vnutrennyaya kartina bolezni i trogennyye zabolevaniya. [Internal image of disease and trogenic diseases]. 4-th eddition. Moscow: Medicina, 1977. 112 p. (In Russ.).

15. Nikolaeva V V. Vnutrennyaya kartina bolezni kak fe- nomen telesnosti [Internal image of disease as a phenomenon of body reality]. Psikhosomatika: telesnost’ i kul’tura [Psy- chosomatics: corporeality and culture] / Eddited by V V Ni¬kolaeva. Part 3. Moscow: Akademicheskiy Proyekt, 2009: 101-174. (in Russ.).

16. Vasilenko T.D. Zhiznennyy put’ lichnosti: vremya i smysl chelovecheskogo bytiya v norme i pri somaticheskoy patologii. [Life Path of Person: Time and Meaning of Human Being in Normal and Somatic Pathology]. Kursk, 2011.572 p. (in Russ.).

17. Tkhostov A.SH. Psikhologiya telesnosti. [Psychology of corporeality]. Moscow: Smysl, 2002. 288 p. (In Russ.).

18. Myasishchev VN. Lichnost’ i nevrozy. [Personality and Neuroses]. Leningrad: Leningrad University publ., 1960. 224 p. (In Russ.).

19. Iovlev B.V., Karpova E.B. Psikhologiya otnosheniy. Kontseptsiya VN. Myasishcheva i meditsinskaya psikhologi¬ya. [Psychology of relations. The concept of VN. Myasish¬cheva and medical psychology]. Saint-Petersburg: Sensor, 1999. 76 p. (In Russ.).

20. Vasserman L.I., Trifonova Ye.A. Metodologiya issle- dovaniya svyazannogo so zdorov’yem kachestva zhizni. [Methodology for the study of health-related quality of life]. Psikhologicheskaya diagnostika rasstroystv emotsional’noy sfery i lichnosti. [Psychological Diagnostics of Emotion¬al and Personality Disorders]. Eddited by L.I. Vasserman,

21. O. Yu. Shchelkova. Saint-Petersburg: Skifiya-print, 2014: 30-43. (In Russ.).

22. Pestereva Ye.V, Chulkova V.A., Karitskiy A.P., Semi- glazova T.YU. K issledovaniyu kachestva zhizni onkolog- icheskikh bol’nykh [Study of quality of life in oncological patients]. Voprosy onkologii. [Problems in oncology]. 2012. 36, № 3: 217-223. (In Russ.).

23. Sirota N.A., Moskovchenko D.V., Yaltonskiy V.M. et al. Bespokoystvo o progressirovanii onkologicheskogo zabolevaniya: sovremennyye teoreticheskiye kontseptsii i podkhody [Anxiety about the progression of cancer: modern theoretical concepts and approaches]. Medicinskaa psihologia v Rossii. [Medicine psychology in Russia]. 2016. Vol. 6 (41). URL: http://mprj.ru (30.04.2018). (In Russ.).

24. Geue K., Brähler E., Faller H., Härter M., Schulz H., Weis J., Koch U., Wittchen HU, Mehnert A. Prevalence of mental disorders and psychosocial distress in German adoles¬cent and young adult cancer patients (AYA). Psychooncology. 2018: 70-83. DOI: 10.1002/pon.4730.

25. Schelkova O.Yu., Usmanova E.B. Kachestvo zhizni i psikhologicheskiye kharakteristiki bol’nykh s opukholevym porazheniyem kostey. [Quality of life and psychological char¬acteristics in patients with bone tumor]. Vestnik of Saint-Pe¬tersburg University. 2015. Vol. 12, № 3: 64-76. (In Russ.)

26. Paredes T., Pereira M., Moreira H., Simöes M.R., Ca- navarro M.C. Quality of life of sarcoma patients from diag¬nosis to treatments: predictors and longitudinal trajectories. Europe Journal of Oncological Nurses. 2011. Vol. 15 (5): 492-499. DOI: 10.1016/j.ejon.2011.01.001.

27. Mason G.E., Aung L., Gall S. Quality of life follow-ing amputation or limb preservation in patients with lower extremity bone sarcoma. Front Oncology. 2013. Vol. 14 (3): 210-216. DOI: doi.org/10.3389/fonc.2013.00210.

28. Shchelkova O.Yu., Usmanova E.B. Quality of life and relation to disease in patients with bone sarcoma. Psychology in Russia: State of the Art. 2015. № 8(1): 22-31. DOI: doi. org/10.11621/pir. 2015.0103.

29. Karnofsky D.A., Burchenal J.H. The Clinical Evalua¬tion of Chemotherapeutic Agents in Cancer // Evaluation of Chemotherapeutic Agents / MacLeod C.M. (Ed). Columbia Univ Press, 1949. 196 p. DOI: 10.3322/canjclin.18.2.72.

30. Wasserman L.I., Trifonova E.A., Shchelkova O.Yu. Psik- hologicheskaia diagnostika i korrektsiia v somaticheskoi klinike: nauchno-prakticheskoe rukovodstvo [Psychological diagnostics and correction in somatic clinic: scientific and practical guid¬ance]. St. Petersburg: Rech’ Publ., 2011. 271 p. (In Russ.).

31. Ware J.E., Snow K. K., Kosinski M., Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston, MA: New England Medical Center, The Health Institute. 1993. DOI: 10.1097/00007632-200012150-00008.

32. Aaronson N.K., Ahmedzai S., Bergman B. The Eu-ropean Organisation for Research and Treatment of Cancer QLQ-C30: A quality of life instrument for use in interna-tional clinical trials in oncology. Journal of National Can-cer Institute. 1993. Vol. 85: 365-375. DOI: 10.1016/0959- 8049(94)90535-5.

33. Fayers P., Aaronson N., Bjordal K., Sullivan M. QLQ C-30 Scoring Manual / EORTC Study Group on Quality of Life. Brussels, 1995. 50 p. DOI: 10.1002/0470846283.ch7.

34. Pervin L., John O. Personality: Theory and Research. Moscow: Aspect-Press, 2001. 607 p.

35. Yanichev D.P. Kognitivnyye aspekty samovospriyat- iya lichnostnykh chert u patsiyentov s nevroticheskoy i nev- rozopodobnoy simptomatikoy: Ph.D.: 19.00.04. [Cognitive aspects of self-perception of personality traits in patients with neurotic and neurosis symptoms]. Saint Petersburg: Saint Pe¬tersburg State University, 2006. 156 p. (In Russ.).

36. Leont’yev D.A. Test smyslozhiznennykh oriyentat- siy. [Test of meaningful orientations]. 2-th edition. Moscow: Smysl, 2006. 15 p. (In Russ.).

37. Wasserman L.I., Iovlev B. V, Karpov E.B., Vuks A.Y Psikhologicheskaia diagnostika otnosheniia k bolezni [Psy¬chological diagnostics of attitude to the disease]. St. Peters¬burg, NIPNI im. VM.Bekhtereva Publ., 2005. 32 p. (In Russ.).

38. Shchelkova O.Yu., Usmanova E.B. Kachestvo zhizni i otnosheniye k bolezni pri raznykh formakh opukholevo- go porazheniya kostey [Quality of Life and the Attitude to the Disease among Patients with the Different Bone Tumor Types]. Peterburgskiypsikhologicheskiyzhurnal. [Petersburg Psychological Journal]. 2017. № 19: 1-38. (In Russ.).

39. Shchelkova O.Yu., Usmanova E.B. Vliyaniye otnos- heniya k bolezni na kachestvo zhizni patsiyentov s opuk- holevym porazheniyem kostey. [Influence of attitude to disease on quality of life of patients with bone tumor]. Vo¬prosy onkologii. [Problems in oncology]. 2017. Vol. 63, № 1: 115-121. (In Russ.).

40. Onkopsikhologiya dlya vrachey-onkologov i meditsin- skikh psikhologov. Rukovodstvo [Oncopsychology for oncol¬ogists and medical psychologists. Textbook]. A.M. Belyaev et al. / Edited by A.M. Belyaev, V.A. Chulkova, T. Yu. Semi- glazova, M.V. Rogachev. Saint Petersburg: Lyubavich, 2017. 352 p. (In Russ.)

41. Semiglazova T.YU. et al. Kachestvo zhizni - vazhney- shiy kriteriy effektivnosti lecheniya i reabilitatsii onkologich- eskikh bol’nykh [Quality of life as the most important criterion of treatment efficiency and rehabilitation in oncological pa¬tients]. Oncopsychology. Textbook / Edited by A.M. Belyaev, VA. Chulkova, T.Yu. Semiglazova, M.V Rogachev. Chapter 1. Saint-Petersburg: Lyubavich, 2017. pp. 10-32. (In Russ.)

42. Usmanova E.B., Sushentsov E.A., Shchelkova O.Yu. Kachestvo zhizni patsiyentov s opukholyami kostey. [Quality of life in patients with bone tumors]. Bone and soft tissue sarcomas, tumors of the skin. 2015. № 1: 55-61. (In Russ.).

43. Volovik VM. O funktsional’noy diagnostike psikhich- eskikh zabolevaniy [About functional diagnostics of mental diseases]. Novoye v teorii i praktike reabilitatsii psikhicheski bol’nykh. [New in the theory and practice of rehabilitation in patients with mental diseases]. St. Petersburg, NIPNI im. V M. Bekhtereva Publ., 1985: 26-32. (In Russ.).

44. Kabanov M.M. Reabilitatsiya psikhicheski bol’nykh - povysheniye kachestva ikh zhizni (teoretiko-metodolog- icheskiye aspekty) [Rehabilitation in patients with mental diseases - improving the quality of life (theoretical and methodological aspects). Psikhosotsial’naya reabilitatsiya i kachestvo zhizni. [Psychosocial rehabilitation and quality of life]. St. Petersburg: NIPNI im. VM.Bekhtereva Publ., 2001: 24-28. (In Russ.).