Features of Psycho-Emotional State and Quality of Life in Women with Postmastectomy Syndrome with Different Types of Attitude to the Disease

The investigation of some features of attitude type to the disease is an integral part of developing of the differentiated application of psychological and physical rehabilitation of patients of different nosology. The most common consequence of breast cancer is postmastektomy syndrome, which includes the manifestation of symptoms such as upper limb lymphostasis, limiting range of motion in the shoulder joint, sensory disturbances, cardiovascular and respiratory systems, deterioration of quality of life, negative psycho-emotional effects. The studies of the most experts clearly show that all of the patients, who underwent radical treatment for breast cancer, extremely needed psychological rehabilitation, which adequate conducting not only contributes to a noticeable improvement in health and physical condition, but also significantly improves the quality of life. The stressful factors are the detecting of malignancy, the presence of public understanding of the absence of the recovery possibility, a high percentage of deaths, possible surgery, radiation and chemotherapy which are closely related to somatic discomfort. One of the features of cancer is the psychopathological changes that occur in most patients because of the specificity of the disease. However, they deeply affect not only somatic but also the mental component. Objective: to determine the peculiarities of the psycho-emotional state and quality of life in women with postmastectomy syndrome with different types of attitude to the disease. 50 women with postmastectomy syndrome on clinical stage of rehabilitation were involved in this study. To determine the type of attitude to the disease we applied the questionnaire, developed in the Laboratory of Clinical Psychology at V.M. Bekhterev Institute which allows defining 12 types of attitudes to the disease: harmonious, erhopaty, anozognozic, anxious, hypochondriac, neurasthenic, melancholic, apathetic, sensitive, self-centered, paranoid, dysphoric. Every type of attitude to the disease consisted of common feelings (wellness, mood, sleep, appetite), perceptions of the patients about their disease, treatment, attitudes toward medical staff, family, environment, work (studying), loneliness, past and future. In generalizing the results, all types of attitude to the disease have been combined into three blocks. The first block (rational attitude) included harmonious, erhopaty, anozognozic types of relationship, indicating the most favorable response of the patient to the disease; second block (intrapsychic attitude) – anxious, hypochondriac, neurasthenic, melancholic, apathetic, indicating intrapsychic orientation of the personal response to the disease in violation of social adaptation of patients; third block (interpsychic attitude) – sensitive, self-centered, paranoid, dysphoric indicating interpsychic orientation of response. Diffuse type of attitude predicted the presence of three or more assessment scales in the diagnostic area, while this type of women after radical mastectomy at inpatient phase was connected with intra-psychological direction It was proved that women with a rational type of attitude to disease show significantly better results of the social/family well-being, functional component of quality of life and fewer symptoms of anxiety compared to interpsychic and intrapsychic.