تجربه زیسته بیماران مبتلا به کرونا ویروس (کووید-19): یک مطالعه پدیدارشناسی

نویسندگان
پروین رحمتی نژاد 1
مجید یزدی 2
زهره خسروی 3
فاطمه شاهی صدرآبادی 4
1 دانشگاه علوم پزشکی قم
2 دانشگاه یزد
3 دانشگاه الزهرا (س)
4 دانشگاه فرهنگیان یزد، پردیس فاطمه الزهرا (س). یزد . ایران
10.52547/rph.14.1.71
چکیده
ابتلا به بیماری جدید و ناشناخته کووید 19 علاوه بر مخاطرات سلامت جسمانی به دلیل ماهیت و ویژگی‌های خاص بیماری منجر به تجربه‌های روانی دشوار و متفاوتی نیز می‌گردد. بیماران علاوه بر علائم جسمانی، واکنش­های روان­شناختی مختلفی دارند که می‌تواند به عنوان مانعی در فرایند سیر و بهبودی بیماری عمل کرده و بر رنج آنان در دوران بیماری بیفزاید. بنابراین پژوهش حاضر با هدف فهم تجربه زیسته این افراد جهت کمک به کاهش رنج این بیماران صورت گرفته است. روش مطالعه به صورت کیفی با رویکرد پدیدارشناختی بود. تعداد شرکت‌کنندگان 15 نفر و با روش نمونه‌گیری هدفمند انتخاب شدند. برای گردآوری اطلاعات از مصاحبه نیمه‌ساختاریافته استفاده شد. تحلیل داده‌ها نیز از طریق روش کلایزری صورت گرفت. برای اطمینان و اعتبار یافته‌ها نیز از روش بازنگری و نظارت شرکت‌کنندگان، خودبازبینی پژوهشگر در فرآیند جمع‌آوری و تحلیل داده و ثبت تمامی پیش‌فرض‌های ذهنی خود از قبل و در نظر نگرفتن آن‌ها در فرآیند تحلیل و بازنگری و کدگذاری مجدد مصاحبه‌ها توسط دو پژوهشگر دیگر استفاده شد. یافته‌های پژوهش شامل 278 کد اولیه بوده که با توجه به هدف و سوال پژوهش 6 مضمون اصلی و 24 زیرمضمون استخراج شد. اضطراب مرگ، تجربه انگ بیماری، تجربه ابهام، تجربه‌های هیجانی مثبت، هیجان‌های تجربه شده در رابطه با اعضای خانواده و هیجان‌های ناشی از قرنطینگی مضمون‌های اصلی بودند. تجارب هیجانی دردناک در این بیماران می‌تواند منجر به تاخیر و دشواری در روند بهبودی این افراد گردیده و علاوه بر درد بیماری، رنج روانی را نیز تحمیل نماید. کسب آگاهی بیشتر درباره این بیماری برای کاستن تجربه ابهام، راهبردهای روانشناختی برای کنترل اضطراب مرگ و انگ اجتماعی و راهکار برای مدیریت رفتار و هیجان اعضای خانواده می‌تواند در مداخلات روان­شناختی ویژه این بیماران در نظر گرفته شده و منجر به کاهش هیجان‌های منفی و امکان مقابله بهتر با بیماری و رنج روانی ناشی از آن گردد.
کلیدواژه‌ها
تجربه زیسته
بیماران
کووید 19
پدیدارشناسی

عنوان مقاله English

Lived Experience of Patients with Coronavirus (Covid-19): A Phenomenological Study

نویسندگان English

Parvin Rahmatinejad 1
Majid Yazdi 2
Zohreh Khosravi 3
Fatemeh Shahisadrabadi 4
2 Yazd University
3 Department of Faculty of Education and Psychology, Alzahra University, Tehran, Iran
4 Department of Consulting, Yazd Farhangian University, Branch Fatemeh Alzahra, Yazd, Iran.
چکیده English

Getting a new disease and unknown Covid 19 In addition to the risks to physical health leads to difficult and different psychological experiences due to the specific nature and characteristics of the disease. In addition to physical symptoms patients have a variety of psychological reactions that can act as a barrier to the healing process and increase their suffering during illness. Therefore the present study aims to discover the lived experience of these people to help reduce the suffering of these patients. The study method was qualitative with a phenomenological approach. The number of participants was 15 and they were selected by purposeful sampling method. A semi-structured interview was used to gather information. Data analysis was also performed by Colaizzi method. To Trustworthiness and validate the findings were used participants' review and monitoring methods, the researcher's self-observation in the data collection and analysis process and the recording of all their mental presuppositions in advance and their non-consideration in the analysis and review process and recoding of interviews by two other researchers. The research findings included 278 initial codes, which were extracted 6 main themes and 24 sub-themes according to the purpose and question of the research. Death anxiety, the experience of stigma, the experience of ambiguity, the positive emotional experiences, the emotions experienced in relation to family members and the emotions caused by quarantine were the main themes. Painful emotional experiences in these patients can lead to delays and difficulties in the recovery process of these people and in addition to the pain of the disease, it can also impose psychological suffering. Awareness of the disease to reduce the experience of ambiguity, psychological strategies to control death anxiety and social stigma, and strategies to manage the behavior and excitement of family members can be considered in the specific psychological interventions of these patients and reduce negative emotions and possibility better deal with the disease and psychological suffering caused by it.

کلیدواژه‌ها English

Living Experience
Coronavirus (COVID-19)
Phenomenology
World Health Organization. (2020). WHO statement regarding cluster of pneumonia cases in Wuhan, China. Beijing; WHO: 9 Jan 2020.‌
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China. The New England Journal of Medicin. 2020; 382(8): 727-733.‌
Dong XY, Wang L, Tao YX, Suo XL, Li YC, Liu F, Zaho Y, Zhang Q. Psychometric properties of the Anxiety Inventory for Respiratory Disease in patients with COPD in China. International journal of chronic obstructive pulmonary disease. 2017; 12: 49-58. ‌
Ryu S, Chun BC. An interim review of the epidemiological characteristics of 2019 novel coronavirus. Epidemiology and health. 2020; 42.‌
Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet. 2020; 395 (10223): 514-523.
Seyyed Tabaei R, Rahmatinejad P, Sehat R. (2015). The Prevalence of Behavioral Symptoms of Psychological Disorders in Cancer Patients. Journal of Thought & Behavior in Clinical Psychology, 9(36): 27-36. [Persian].
Sherman DW, Norman R & Mc Sherry CB. A comparison of death anxiety and quality of life of patients with advanced cancer or AIDS and their family caregivers. Journal of the Association of Nurses in AIDS Care, 2010; 21: 99–112.
Kelly DL, Yang GS, Starkweather AR, Siangphoe U, Alexander-Delpech P, Lyon DE. Relationships among fatigue, anxiety, depression, and pain and health-promoting lifestyle behaviors in women with early-stage breast cancer. Cancer nursing. 2020; 43(2):134-46.
Teixeira PJ, Porto L, Kristensen CH, Santos AH, Menna-Barreto SS, Prado-Lima PA. Post-traumatic stress symptoms and exacerbations in COPD patients. Journal of Chronic Obstructive Pulmonary Disease. 2015; 12(1):90-5.
Pooler A, Beech R. Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: a systematic review. International journal of chronic obstructive pulmonary disease. 2014; 9: 315-330.
Borrayo EA, Scott KL, Drennen A, Bendriss TM, Kilbourn KM, Valverde P. Treatment challenges and support needs of underserved Hispanic patients diagnosed with lung cancer and head-and-neck cancer. Journal of Psychosocial Oncology. 2020; 9:1-4.
Hurst JR, Skolnik N, Hansen GJ, Anzueto A, Donaldson GC, Dransfield MT, Varghese P. Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life. European Journal of Internal Medicine. 2020; 73: 1-6.
Makovski TT, Schmitz S, Zeegers MP, Stranges S, van den Akker M. Multimorbidity and quality of life: systematic literature review and meta-analysis. Ageing research reviews. 2019; 53.
Agarwal K, Fortune L, Heintzman JC, Kelly LL. Spiritual Experiences of Long-Term Meditation Practitioners Diagnosed with Breast Cancer: An Interpretative Phenomenological Analysis Pilot Study. Journal of Religion and Health. 2020; 34: 15:1-7.
Rudaz M, Ledermann T, Grzywacz JG. The influence of daily spiritual experiences and gender on subjective well-being over time in cancer survivors. Archive for the Psychology of Religion. 2019; 41(2):159-71.
SeyedTabaee R, Rahmatinejad P, Mohammadi D, Etemad A. (2017). The role of coping strategies and cognitive emotion regulation in well-being of patients with cancer. J Qazvin University Medical Science. 21 (2): 41-49. [Persian].
Smith J A. Qualitative psychology: a practical guide to research methods. London; Sage Publications. 1996.
Uribe-Rodríguez AF, Valderrama L, Durán Vallejo DM , Galeano-Monrroy C, Gamboa K. Developmental Differences In Attitudes Toward Death Between Young And Older Adults. Acta Colomb Psicol. 2008; 11(1):119-126.
Lehto H, Stein KF. Death anxiety: an analysis of an evolving concept. Res Theory Nurs Pract. 2009; 23(1):23-41.
Gonen G, Kaymak SU, Cankurtaran ES, Karslioglu EH, Ozalp E, Soygur H. The factors contributing to death anxiety in cancer patients. J Psychosocial Oncology. 2012; 30(3):347-58.
Yalom, ID. Staring at the sun: Overcoming the terror of death. San Francisco: Jossey-Bass. 2008.
Barrera I & Spiegel D. Review of psychotherapeutic interventions on depression in cancer patients and their impact on disease progression. International Review of Psychiatry. 2014; 26, 31–43.
Lagerdahl AS K, Moynihan M & Stollery B. An exploration of the existential experiences of patients following curative treatment for cancer: Reflections from a UK sample. Journal of Psychosocial Oncology, 2014; 35 (5); 555- 75.
Royal KD & Elahi F. Psychometric properties of the Death Anxiety Scale (DAS) among terminally ill cancer patients. Journal of Psychosocial Oncology. 2011; 29: 359–371.
Engelmann D, Scheffold K, Friedrich M, Hartung TJ, Schulz-Kindermann F, Lordick F, Mehnert A. Death-related anxiety in patients with advanced cancer: validation of the German version of the death and dying distress scale. Journal of pain and symptom management, 2016; 52 (4): 582-587.
Clarke DM, Cook KE, Coleman KJ & Smith GC. A qualitative examination of the experience of depression in hospitalized medically ill patients. Psychopathology. 2006; 39: 303-312.
Henoch I, Bergman B, Gustafsson M, Gaston-Johansson F, Danielson E. The impact of symptoms, coping capacity, and social support on quality of life experience over time in patients with lung cancer. J Pain Symptom Manage. 2007;34 (4): 370-379.
Broberger E, Tishelman C, Von Essen L, Doukkali E, Sprangers MAG. Spontaneous reports of most distressing concerns in patients with inoperable lung cancer: at present, in retrospect and in comparison with EORTC-QLQ-C30+LC13. Qual Life Res. 2007; 16(10): 1635-1645.
Thygesen KH, Esbensen BA. A rehabilitation trajectory for patients with lung cancer: part ii. Klinisk Sygeplege. 2008; 22(2): 64 -77.
Imanzadeh A, Sharifi F. (2019). Lived Experiences of Cancer Patients from Death Anxiety Based on Jaspers Borderline Situations. Iranian Journal of Psychiatric Nursing. 6 (6): 36-41. [Persian].
Steinhauser K, Alexander S, Byock I, George L, Tulsky J. Seriously ill patients; discussions of preparation and life completion: an intervention to assist with transition at the end of life. Palliative and Supportive Care. 2009; 7: 393-404.
Yalom ID, Existential Psychotherapy, Trans: Sepideh Habib. Tehran, Ney publication. 2011. [Persian].
Lo C, Hales S, Jung J, Chiu A, Panday T, Rydall A, et al. Managing Cancer and Living Meaningfully (CALM): Phase 2 trial of a brief individual psychotherapy for patients with advanced cancer. Palliative Medicine, 2014; 28 (3): 234- 242.
Spiegel D. Essentials of psychotherapy intervention for cancer patients. Supportive Care in Cancer. 1995; 3: 252–256.
Lo C, Hales S, Zimmermann C, Gagliese L, Rydall A, Rodin G. Measuring death-related anxiety in advanced cancer: Preliminary psychometrics of the Death and Dying Distress Scale. Journal of Pediatric Hematology and Oncology. 2011; 33: 140-145.
Jones EE, Farina A, Hastorf AH, defrench R S. Social Stigma: The Psychology of Marked Relationships. New York: Freeman WH. 1984.
Goffman E. Stigma: Notes on the Management of Spoiled Identity. Prentice-Hall. USA: Englewood Cliffs.1963.
Colbert AM, Kim KH, Sereika SM, Erlen JA. An examination of the relationships among gender, health status, social support and HIV-related stigma. Journal of the Association of Nurses in AIDS Care. 2010; 21(4): 302-313.
Fife BL, Wright ER. The dimensionality of stigma: a comparison of its impact on the self of persons with HIV/AIDS and cancer. Journal of Health and Social Behavior. 2000; 41: 50-67.
Tod AM, Craven J, Allmark P. Diagnostic delay in lung cancer: a qualitative study. Journal of Advanced Nursing. 2008; 61: 336–343.
Naji SA, Abedi HA, Sasani L. 2014. The experience of social stigma in AIDS patients: a phenomenological study. Quarterly Journal of Sabzevar University of Medical Sciences. 20 (4): 487-495. [Persian].
Raleigh ZT. A biopsychosocial perspective on the experience of lung cancer. Journal of Psychosocial Oncology. 2010; 28: 116–125.
Kuo TT, Ma F C. Symptom distresses and coping strategies in patients with non-small cell lung cancer. Cancer Nursing. 2002; 25: 309–317.
Threader j, McCormack L. Cancer‐related trauma, stigma and growth: the lived experience of head and neck cancer. European Journal of Cancer Care. 2015; 25(1): 157-169.
Leventhal H, Diefenbach M. The active side of illness cognition. In: Skelton JA, Croyle RT, eds. Mental Representation in Health and Illness. New York: Springer Verlag. 1991; 247–72.
Lin H, Bauer-Wu SM. Psycho-spiritual well-being in patients with advanced cancer: An integrative review of the literature. Journal of Advanced Nursing. 2003; 44:69–80.
Harmon-Jones E, Simon L, Greenberg J, Pyszczynski T, Solomon S, McGregor H. Terror management theory and self-esteem: Evidence that increased self-esteem reduced mortality salience effects. Journal Personality and Social Psychology. 1997; 72(1): 24-36.
Cumberland-Li A, Eisenberg N, Champion C, Gershoff E, Fabes RA. The relation of parental emotionality and related dispositional traits to parental expression of emotion and children’s social functioning. Motivation and Emotion. 2003; 27: 27–56.
Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review. 2010; 30(2): 217-237.
Gross JJ. The emerging field of emotion regulation: An integrative review. Review of general psychology. 1998; 2(3): 271-299.
Aldao A. The Future of Emotion Regulation Research: Capturing Context. Perspectives on Psychological Science. 2013; 8(2): 155-172.
Goldin P R, McRae K, Ramel W, Gross JJ. The neural bases of emotion regulation: reappraisal and suppression of negative emotion. Biological Psychiatry. 2008; 63(6): 577-586.
Taylor SE, Stanton AL. Coping resources, coping processes, and mental health. Annual Review of Clinical Psychology. 2007; 3: 377-401.
Cohen S, Wills T A. Stress, social support and the buffering hypothesis. Psychological Bulletin. 1985; 98(2): 310-357.
Tan M, Karabulutlu E .Social support and hopelessness in Turkish patients with cancer. Cancer Nursing. 2005; 28: 236-240.
Cobb S. Social support as a moderator of life stress. Psychosomatic Medicine. 1976; 38: 300-314.
Deci EL, Ryan RM. Intrinsic motivation and self-determination in human behavior. New York: Plenum. 1985.
Ryan RM, Deci EL. Overview of self-determination theory: an organismic dialectical perspective. Handbook of self-determination research. NewYork: university of Rochester. 2002.
Dugas MJ, Buhr K, Ladouceur R. The Role of Intolerance of Uncertainty in Etiology and Maintenance, In: R.G. Heimberg, C.L. Turk, & D.S. Mennin (Eds.), Generalized Anxiety Disorder: Advances in Research and Practice. New York: Guilford. 2004: 143-163.