DEPRESSÃO, DESESPERANÇA E PROCESSO DE ENFRENTAMENTO EM PACIENTES COM CÂNCER DE PÊNIS.

Abstract

The objective of this research was to investigate the occurrence of depression, hopelessness and the coping process in patients with penile cancer. The methodological design is characterized by its objective as a descriptive and correlational research. The sample consisted of 21 participants who were already penectomized. The following instruments were used: Sociodemographic Questionnaire, Beck Depression Inventory (BDI), Beck Holpelessness Scale (BHS), Coping Strategies Inventory - I.E.C (Folkman and Lazarus, 1985) and the Semistructured Interview script. The quantitative data were analyzed using STATA software version 14, in which the percentage frequencies, the mean scores (total and partial, when applicable) and standard deviations of each of the instruments were calculated, and the Spearman's Correlation Coefficient, at the 5% level of significance, among the IEC strategies scores. For the qualitative exam, he used the content analysis of Bardin (2011). The results showed that the participants' average age was 47 years, 85% married, 72% had up to two sons and 39% had incomplete elementary education, 81% worked, 72% lived with up to one minimum wage. About medical history and medical treatment 81% previously tried alternative treatments, 23% took more than a year to start medical treatment and 81% were penectomized. It is added that 14 participants understood the treatment as a set of medical procedures performed and considered beneficial. On the psychosocial aspects, the presence of psychological aspects such as: fears, fantasies, sadness, low self-esteem, psychological crisis, suicidal ideation, secondary gains and two other categories of experiences of blame for illness and treatment and difficulties and sexual dysfunctions. About BDI, 47.62% of the sample had minimal symptoms of depression (M = 12.4 and Dp = 3.6). About BHS 42.86% of the participants experienced symptoms of minimal hopelessness (M = 9.7 and Dp = 2.1). The most used coping strategy was positive reassessment (M = 2.18 and Dp = 0.30), followed by social support (M = 2.09 and Dp = 0.46). Regarding the correlations between the strategies some showed to be significant, being they between the strategy of self-control and strategies of positive re-evaluation and problem solving, with Spearman correlation coefficients of 0.45. Regarding the correlations between IE, BDI and BHS, at 5% significance level, no evidence of this correlation was observed. The study concluded that the experience of penile cancer is a stressful, challenging circumstance that demands different forms of coping and does not end after treatment. This points to the importance of psychological assistance in the various moments of the process of coping with penile cancer, facilitating social reintegration and enhancing the use of more adjusted coping strategies as a way to guarantee quality of life and mental health. Finally, the study understands that the improvement of general health is directly related to a more mature and adaptive mode of psychological functioning and that the reduction of psychopathological conditions seems to occur concomitantly with favorable treatment evolution.