Effectiveness of group supportive psychotherapy on life expectancy and psychological adjustment of mothers of children with cancer

Dissertation for Master's Degree (M.A)

Tension: Clinical Psychology

Abstract

The present study was conducted with the aim of investigating the effect of group supportive psychotherapy on the life expectancy and psychological adjustment of mothers of children with cancer. The design of the current research was quasi-experimental and pre-test-post-test with a control group. The statistical population included all mothers with children with cancer referring to Dr. Sheikh Children's Superspeciality Hospital in Mashhad. From this number, 30 people were selected as a sample using available sampling method. Bell's compatibility questionnaire (adult form) and Schneider's hope scale were used to collect information. The results showed that group supportive psychotherapy was effective in increasing the hope of mothers of children with cancer (P?0.01). Also, this treatment has been effective on psychological adaptation and its dimensions, including adaptation at home, social, emotional and health adaptation (P?0.01). However, this treatment did not affect the job adaptation of mothers with cancer children. The results of the present study show that group supportive psychotherapy can be used to promote adaptation and hope of mothers with children with cancer. Keywords: psychological adaptation, hope, supportive psychotherapy, occupational adaptation 1.1 Introduction Cancer is not a modern disease; It has existed in the past; But today, due to the increase in environmental pollution, more people get infected with it and more people go to the doctor than in the past. Cancer is the uncontrollable growth of cells in an area of ??the body; This is the common aspect of all cancers; Regardless of what caused the cancer and what damage was done to the cells. Today, the psychological effects of cancer are not only on the individual, but also on the people around him and the social environment that surrounds him. Keeping and living with a cancer person will be accompanied by difficulties and complications. In addition, the worry and fear of losing the person with cancer affects the mental health of the caregiver. In this chapter, while stating the dimensions of the research problem, its importance and necessity are stated, and then the goals, assumptions and definitions of the research variables are presented. 1.2 Statement of the problem Cancer is a disease of cells, the characteristic factor of which is the unlimited and uncontrollable proliferation of cells that form a malignant neoplasm (Mirzaei, 2005; Fallah et al. 2013). This disease is the third cause of death in Iran and more than 30,000 Iranians die of cancer every year (Najafi and Emami, 2019). Also, cancer accounts for about 4% of deaths in children under 5 years of age and 13% of children aged 5 to 15 years in the Iranian population (Mehran Far and others, 2012). Cancer in children is somehow different from cancer in adults, which means that most children's cancers can be controlled if diagnosed in time (Biraghi et al., 2009). The effect that a child's cancer has on the psychological conditions and quality of life of his caregivers is no less than the effect on him (Heckler[2] and others, 2008). Bowman and Wijenberg believe that parents of children with cancer, in addition to physical illnesses, suffer severe psychological distress, so that this distress increases over time. This distress appears in the form of a high level of anger and rage, sleepiness, annoyance, depression, withdrawal from society and lack of self-control (Wan [3], 1986).  Therefore, supportive care through various methods of counseling and psychotherapy is an integral part of the treatment of cancer patients and their families and should not be neglected (Fekri et al., 2018).

Researches show that resilience and psychological toughness are effective on the psychological well-being of mothers of children with cancer (Dehghani Neishabouri and Maqsoodi, 2019). Also, group therapy and spiritual intervention in mothers with children with cancer increases their quality of life and reduces their distress (Mousavi et al., 2013; Lotfi Kashani et al., 2014). One of the effective treatment methods in the treatment of physical and mental disorders is psychotherapy and supportive group therapy. Porafkari (1376) defines supportive psychotherapy as follows: "a type of psychotherapy that is used to help patients during crises caused by social issues or physical illness.It is also used in order to resolve discomfort caused by long-term mental and physical illness or physical defects." According to the researchers, supportive group psychotherapy in practice is a meeting of a group of sympathetic people, in regular meetings during which the participants discuss and exchange opinions about the special conditions and difficulties they are in, the problems and issues they face, and their personal experiences regarding the ways to face and solve these issues and problems.

Supportive psychotherapy leads to an increase in The degree of hope and psychological adaptation. Schneider, Harris, and Holleran (1991) consider hope to be a "cognitive set based on a sense of success (goal-oriented decisions) and paths (methods chosen to achieve goals). Therefore, thinking paths are considered to be the underlying elements of hope or goal-oriented thinking." It is its goals and the sources of thinking are the thoughts that people have defined about their abilities and capabilities to go through the chosen paths to reach their goals. Through the combination of resources and paths, goals can be achieved. If each of these two cognitive elements do not exist, it is impossible to achieve the goals. Research findings have shown that there is a relationship between the high level of people's hope and their success in sports activities, the high level of academic progress, better physical and mental health, and the more effective psychotherapy methods used in the treatment of disorders (Schneider, 2002). Also, Novotny [5] (1989), receiving hope is a measurable quality that can be used in the process of investigation and recognition of the nursing process, and after that, interventions are applied to improve it, and without improving hope, there will be no basis for accepting treatment and care training. Dufalt[6] (1985), also showed that the element of hope is a symbol of the client's mental health.

Also, adaptation to new conditions is one of the characteristics of mental health. Godstein and Lanyon [7] (1995) have defined adaptation [8] as a continuous process in which a person's social learning experiences create his psychological needs and also provide the possibility of acquiring abilities and skills through which the needs can be satisfied. Whenever a person's physical and mental balance is disturbed in such a way that he is in an unpleasant state, he needs to use internal forces and external support to create balance. In this case, if he succeeds in using new mechanisms and solves the problem in his favor, then the adaptation process has taken place (Godstein and Lanyon, 1995). The dimensions of adaptation include physical adaptation, psychological adaptation, and social adaptation. The precursor to achieving mental, moral, and physical adaptations is social adaptation (Walipour, 2010). Although the usefulness of spiritual intervention in reducing the distress of mothers with children with cancer has been investigated, the usefulness of supportive treatments and their effectiveness on the level of hope and adaptation have not been considered. Therefore, according to the mentioned cases, the question of the current research is whether group supportive psychotherapy is effective on the life expectancy and psychological adjustment of mothers of children with cancer or not? 1.3 Necessity of conducting research Cancer is not a disease but a type of disease. There are more than 200 different types of cancer, each of which develops in specific ways. What they all have in common is that they all start in a similar way, with a change in the normal structure of a cell. In 2005, 7.6 million people died of cancer in the world. In 2020, 16 million people will be diagnosed with cancer and at the same time, 10 million people will die from this disease every year. In the next 10 years, if no action is taken, 85 million people will die from cancer. More than 70% of cancer deaths occur in low- or middle-income countries. But the real problem of cancer is more than these numbers, because one third of the patients suffer from clinical depression and anxiety, and due to the loss of income and the need to finance the treatment, the family's economic performance is severely damaged. In the latest statistics in our country, cancer is the third cause of death with 9.4% after circulatory system diseases (33.4%) and poisoning and suicide accidents (13.4%).