The Relationship between Quality of Life, Coping Styles and Anxiety of Death among Survivors of Cancer

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1 International Research Journal of Applied and Basic Sciences 2013 Available online at ISSN X / Vol, 7 (3): Science Explorer Publications The Relationship between Quality of Life, Coping Styles and Anxiety of Death among Survivors of Cancer Mohamadehsan Taghizadeh 1,Majid safarzadeh 2,Azadeh abolghasem beyk 3 1. Assistant professor, Department of Psychology, Payamnoor university (PNU) 2. Assistant professor, Department of Psychology, Payamnoor university (PNU) 3. M.A in Clinical Psychology,Department of Psychology, Islamic Azad University, science and research branch saveh Corresponding Author: Mohamadehsantaghi zadeh ABSTRACT: Patients affected by are facing physical, psychological and social problem which may cause disorders in the natural process of life and its quality.therefore, considering that the concept of "quality of life",coping styles and anxiety of death among the patients affected by and survivors of is avital subject for these people, it needs to be studied. Recognizing these factors help patients organize their activities to promote the level of their health and to improve their life. These study is a correlation research in which 3o patients affected by and 3o survivors of were selected from among affected and survivors of in Atieh Hospital and Sepas charity institution in Tehran using availability sampling. The information was collected using 36 question questionnaires (closed form) of life, coping styles of Lazaroos and Folkman and anxiety of death of Templers and their validity and reliability are 0.84, 0.80 and 0.86, respectively. They were analyzed using independent t.test, multi variety regression and logical regression.the finding show that there is significant relationship between quality of life and surviving (P=o/o1). There is significant relationship between surviving and no surviving and problem focused coping styles (P=0/01). Also there is a significant relationship between anxiety of death and surviving and no surviving (P=o/o1). There is a relationship between quality of life and anxiety of death death of patients affected by and survived (P=0/01). There is a significant difference between problem-focused and excitement focused coping styles in patients affected by and survived ( P=0/05). There is relationship between quality of life and coping styles and surviving and none surviving of people affected by (P=0/01). Keyword: quality of life coping styles anxiety of death survivors. INTRODUCTION Cancer is chronic and incident disease which its general incidence has been increased from 1970s. In 2002 in U.S.A, it has been estimated that 1.4 millions new cases of will be diagnosed during the coming year (Barry, 1996). In Iran, has high incidence and is a third agent of death after cardiovascular and pulmonary diseases.statistics of 138o show that the incidence rate of in Iran among men is 20 individuals, among women is 16.6 individuals and in the whole population is 18.3 individuals per one hundred thousand individuals (Sicel, 1999). For the last two decades, quality of life, coping styles and anxiety of death were one of the most important subjectsin clinical researches and has been stressed as one of the effective aspects of nursing care of patients, its research has been studied, regarding recognizing differences between patients, predicting the consequences of disease and evaluating therapeutic interventions(bayat, 2011). World Health Organization (WHO)defines quality of life as follows : It is understanding of an individual of his/her life status considering the culture and value systems in which he / she lives and priorities. This definition has broad concept which is influenced by physical and psychological condition of health, the level of non-affiliation, social relationship and personal believes of an individual (Abolghasemi, 2010). Chronic diseases such as are among disorders which strongly affects health and in turn quality of life op people (Aghayousefi, 2001).

2 Diagnosis of is a very undesirable and unbelievable experience for everybody. Cancer influences economic and social condition and family life of patient regarding mental aspect and sexual performance (Paymani, 2005).The conducted studies on patients affected by show that severity of signs and mental stress influence quality of life coping styles and anxiety of death (Malekiyan, 2007). Physiological changes produced during the period of disease are not the only effective factors in disordering the quality of life of patients affected by, but also affection mental condition, reaction of patient to results of diagnostic tests and prognosis of disease and steps of grief and sorrow and anger all influence the quality of life, coping styles and anxiety of death (Lindeman, 1999). Theoretical concepts Cancer: s are a group of diseases with about one hundred various types which result from malignant growth of body cell. Cell is the smallest unit of body and human body has been created from billions cells. These cells divide to the extent that body requires (Fure, 2007). In s, these cells divide abnormally and uncontrollably without the need of body and normal life of cell are more exposed to danger and attack (Tabari, 2010). Quality of life : It is understanding of an individual of his/her life status considering the culture and value systems in which he/she lives and its relationship with his/ her goals, expectations, standards and priorities. This definition has a broad concept which is influenced by physical and psychological condition of health, the level of non- affiliation, social relationship and personal believe of an individual (Bayat, 2011). Coping styles: Falkman and Lazaroos as authorities in studying the coping styles divided the coping methods problem- focused and excitement focused. Problem focused coping style includes efforts aimed at solving problem (sharf, 1381) or facing with direct demand (White, 2000).Excitement focused coping style occurs when one finds out that nothing can be done directly or return to cognitive process ( Lindeman, 1999). Anxiety of death:anxiety of death (thanatophobia )is defined as a unusual and great fear of death with feeling such as phobia or anxiety when thinking to death process or things will be occurred after death (Felc,1995). RESEARCH METHOD The present study is of correlation type. Thus, this study deals with the relationship between quality of life, coping styles and anxiety of death among survivors of. Testees were selected in complete random design from AtieHospital, Tehran and Kayhan medical center, Koyenasr, and Sepas charity institution. Statistical society of this study are patients affected by and survivors of in Tehran. The testees were selected using availability sampling. 30 feales affected by and 30 females survived were selected from affected and survived patients considering condition of including and excluding from sample. After selecting the testees and inviting the samples who were available in centers, the process of the study were explained. Then, questionnaires were provided to testees simultaneously. The order of questionnaires was1-quality of life, 2- coping styles, 3-anxiety of death. The questionnaires were collected after completing by testees individually. We used descriptive and deductive statistical methods for studying and analyzing the collected data according to hypotheses and purposes of study. In this research the questionnaires of Lazaroos coping styles,whoqol- Bree quality of life and Templers anxiety of death were distributed to patients of affected by and survived. In descriptive study, after collecting the data, the basic data of testees have been shown as tables accompanied by statistical indices (minimum and maximum of score,mean,and standarddeviation). In the deductive study, the obtained information from tests of deductive statistics such as Pearsoniancorrelation test and multi vitiate regression test and logistical regression was used for analyzing the data. Findings Considering the present data and analysis of findings, first, the description of data such as statistical indices (mean and standard deviation )of scores of " quality of life", "coping styles " and "anxiety of death "questionnaires between the patients affected by and survived is performed. Then the data analysis will be accomplished using statistical methods of concurrent regression and logistical regression. 181

3 Statistical index subscale Table 1. Subscale statistical indices of quality of life and anxiety of death. Mean Standard deviation Patients affected Patients survived from Patients affected by By Patients affected by Physical health Mental health Social relations Environmental health Total score of quality of life Anxiety of death The information in the relates es to statistical indices of subscale scores of quality of life in patients affected by and survived. As can be seen, mean score of physical health in affected patients is and in survived patients is Also, mean scores of mental health in patients suffering from and survived are and16.43, respectively.the mean scores of social relations in patients suffering and survived are 6.43 and 8, respectively..the mean scores of environmental health in patients suffering cer and survived are and , respectively.the total scores of quality of life for both suffering and survived patients are and 63.56,respectively.Also, the mean score of anxiety for patients survived is 5.26 and for patients affected by is 12. Figure 1. The comparison between subscale scores of quality of life in patients suffering and survived نمره Statistical indices Option Problem- focused coping styles Excitement focused coping styles Table 2. Subscale statistical indices of coping styles questionnaires. Mean Standard deviation Patients survived Seeking for social supports Responsibility Efficiently solving problem Positive re evaluation Total score of problem focused coping styles Coping-facing Refraining Self - control avoidance Total scores of excitement focused coping styles The information in this table relates to the statistical indices such as mean and standard deviation of subscale of problem- focused and excitement focused coping styles in patients suffering and survived from. 182

4 Figure 2. The comparison between problem focused and excitement focused styles in patients suffering and survive مدبرانه اجتناب دار دوری مجدد حل CONCLUSIONS This study showed that theree is a strong relationship between the coping styles and quality of life of patients affected by and patients survived when tested by separating the methods, and between quality of life and excitement-focused coping style. It means that When the quality of life becomes better,using the excitement focused coping style decreases and considering the other researches and logical reasoning and ideas of Falkman and Lazaroos it is reasonable that when using the excitement- focused coping style decreases using the problem focused coping styles increases. According to findings of this research, this is a desirable event that has appositive effect on quality of life in patients suffering and survived from. As using problem focused coping style makes an individuals purposeful and usually patients uses it when the disease is evaluated and understood as uncontrollable factor and as a result, patient tends to self-. care, decreasing privation and weakening morale and increasing participation in self care Interaction between human beings and their surroundings, depending on their type of thought and their perspective on life can causes both happiness and psychopathology. Unfortunately, in recent years,only the negative aspects of important events of life have been stressed and valuable internal and positive aspects of human beings have received lower attention (Sharf, 1381 ). In order to pay attentionn to positive factors in life and the role of these factors in decreasing negative aspects resulted from critical events of life and considering increasing and rapid growth of many types of diseases such as, in this research the relationship between quality of life, coping styles and anxiety of death among survivors of was studied. It is necessary to note that although is a disease and since it influences all aspects of one's life and can causes important physical disorders, it can be prevented and cured. (Shaban, 2004). Considering that early diagnosing and curing of can uproot the disease of patients, we can fight to this disease and restore our physical and mental health with increasing quality of life, using problem focused coping styles and decreasing anxiety of death (Shirkhani, 2005 ). In summary, this research shows that the mean score of subscales of quality of life in survived patients is higher than affected patients. As the results of this study show,there is a direct and significant relationship between surviving and none surviving. Using problem focused coping style has direct relationship with surviving. Therefore, coping styles are predictive variables which influence surviving as basis variable. But, the findings of this research show that when patientt uses problem focused coping styles, the probability of their surviving increases and patients who uses excitement focused coping styles will not survive. Also, there is a significant and indirect relationship between anxiety of death and surviving and non surviving from death. Also, quality of life can influence surviving and non surviving of patients affected by as a predictive variable. The more the quality of life, the more surviving. Recommendations We recommend to Ministry of Health and public and private hospitals, clinics, therapeutic centers and other medical centers related to : Pay attention to mental healthh and sound and effective social relations of patients. Include decreasing anxiety of death and curing this for increasing probability of surviving. Put increasing quality of life of patients affected by as epigraph of their educational and therapeutic program. Highlight instructing the use of problem focused coping styles in the patients affected by. 183

5 Pay attention to social support of patients suffering and survived. Include forming supporting institutions for patients and introducing them to the patients in their program. REFERENCES Abbaszadeh F, Bagheri A, mehran N Quality of life among pregnant women.hayat 15(1):3-41 Abolghasemi Sh.2010.Examining the effectiveness of conducted visualization and meaningtherapy on level of depression, anxiety and hopefulness in women affected by if Shafa Hospital, Ahvaz,seasonal scientific research journal of Woman and Culture, second year,no.5, p Aghayousephi A The role of personal factors on coping methods and the effect of coping style on personal factors and depression, doctoral dissertation,tarbiatmodarresuviversity, p Barry P.1996.Psychological nursing care of physically ill patients, third edition. Philadelphia.ippinocott company : Bayat M Studying the quality of life in women from Mashhad City,The seasonal journalof leading thoughts of woman and family, fifth year,p Felc D, Peny J.1995.Quality of life : its definition and measurement. Research in developmental disabilities,16 : Fuer N.2004.Cancer psychology, translated by Javaherkalam,Farid.Tehran, Paeez Publication. Lindeman CA, Machatie M Fundemental of contemporary nursing practice. 1th. Edition, Philadelphia WB saunders Company, 9-30 Malekiyan A, Alizade A, Ahmadzade G.2007.Depression and anxiety in patients affected by, the journal of behavioral sciences researches, fifth period. no. 2. P Shaban M, Monjamed Z.2004.The relationship between characteristics and quality of life in patients under chemotherapy, the journal of nursing and tocology faculty, medical sciences University of Tehran,fall 2004,p Sharf.S( 2004 ). Theories of psychotherapy, translated by Firoozbakht, Tehran, Rasa cultural publications. Shirkhani F Examining the reveal of diagnosis in the patients hospitalized in educational and medical centers of ShahidBeheshtiUniversity, doctoral dissertation of general medicine, ShahidBeheshti University, p Sicel R.1999.Blood diseases and, translated by Arjmand, Hosain et.al (1381 ), Tehran,Naslefarda, second edition. Tabary F Exploring the quality of life in early diagnosed patients,the journal of nursing and tocology faculty,medical sciences University of Tehran, 13th period, no.2,p White E Coping with stress.undergraguate Journal of psychology, University of North Carolina Vol