Volume 27, Issue 5 (7-2020)                   RJMS 2020, 27(5): 49-61 | Back to browse issues page

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Shakoorseffet Sedighi Z, Sharifi-Daeamadi P. Effectiveness of an educational package to overcome learned helplessness (LH) on mental health in women with breast cancer. RJMS 2020; 27 (5) :49-61
URL: http://rjms.iums.ac.ir/article-1-5746-en.html
Allame-tabatabei University, Tehran, Iran , pr-sharifidaramadi@yahoo.com
Abstract:   (2591 Views)
Background: Patients with breast cancer feel helpless due to the type of disease and the treatment process and show a sharp decline in mental health.
The purpose of the study was to develop an educational package to overcome learned helplessness (LH) and its effectiveness on mental health in women with breast cancer.
Breast cancer is one of the most common types of cancer in women, which has more severe psychological and emotional effects than other types of cancer.  Breast cancer accounts for about 30 percent of cancers in women which this number will increase to 11 million in 2030. There are many challenges during the treatment period include changes in medical care, fear of relapse, changing life roles, long-term effects of treatment (can be physical or psychological), loss of supports, lack of family and friends emotional support, can all be one of the main reasons for the decline in mental health in these patients. Diagnosing breast cancer is a very unpleasant and unbelievable experience for any person that can disrupt family life. Fear of death, severe stress and financial anxiety lead to the onset and increase in the severity of disorders such as depression. And physical health directly affects mental health status and overall quality of life. In this regard, identify and investigate the causes of mental health decline to provide therapeutic intervention not only affects the quality of life of individuals but also effects on their survival rate and increases their ability to fight disease. Examination of mental health factors in these patients shows that learned helplessness is an important factor that can weak the protection of a person’s mental system against severe stress. Learned helplessness is an important and fundamental factor that makes people with cancer feel incapable of this problem and cannot properly use strategies and support resources.
Methods: The purpose was to develop a training package to overcome helplessness of women with breast cancer in two stages.
This study was a Simi-experimental pretest - posttest with control group. The study sample was selected by purposive sampling method and consist of 30 women with breast cancer who randomly assigned to experimental (15 subjects) and control (15 subjects) groups. Then, the participants in the experimental group participated in 12 sessions of 90 min of educational package to overcome learned helplessness. Then, the data were analyzed using statistical tests such as MANCOVA and ANCOVA.
 In the qualitative part of the study, the population of the experienced experts in sciences, managers and experts in the field of psychological intervention is positive. In the quantitative section, the population of the present study was the woman with breast cancer admitted to the Cancer Research Center and patients of Vali Aasr Clinic in Imam Khomeini Hospital. In the qualitative section of sampling method, the number of interviews, in other words, the sample size, depends on the theoretical saturation of the questions in question, so that if the investigator concludes that the answers given or the interviews conducted, they are closely resembled with informed individuals, leading to duplication of responses or interviews, and there are no new data, the interviews are enough and thus stop. In the quantitative section, 30 people were selected based on inclusion (age of the participants should be 20 to 50 years, being literate, lack of participation in other psychological periods in the past and present, at least 2 months past from the diagnosis and  lack of disability or physical and mental illness preventing the presence of the patients) and exclusion criteria (absence of more than 2 sessions of participation in the sessions, any incapacity associated with the attendance of participants, and lack of willingness to continue receiving interventions) were selected purposefully.
Instruments for gathering data were General Health Questionnaire (GHQ-28). This questionnaire has been developed to identify non-psychiatric disorders. It is used to diagnose mild mental disorders and to screen for non-psychotic psychological disorders in different societies and different situation, The text of the questionnaire is about boredom, discomfort and general health. This questionnaire with emphasis on psychological, physical and social issues at the present time and in this way, the person’s symptoms and health conditions are evaluated.
Results: The results of MANCOVA indicated that training to overcome learned helplessness improved mental health (F=56.191, p=0.000) in women with breast cancer. In addition, the results showed that the study intervention have significant impact on the components of mental health such as, physical function (F=6.906, p=0.000), anxiety (F=10.307, p=0.004), disruption in social functioning (F=11.678, p=0.002) and major depression (F=32.378, p=0.000).
Conclusion: Based on research findings, using of educational package to overcome learned helplessness could have important role in improving the mental health of women with breast cancer. By concerning the explanation of effectiveness of the skills of overcoming learned helplessness and effectiveness on helplessness in women with breast cancer could reduce physical function and anxiety and disruption in social functioning and major depression. In deed by practicing on this skills, these kind of people will not have an inferiority style of depression that will activated when dealing with a negative life event and will not believe that the result is a negative event, and they will not do anything to change it. Since these patients are tired of the treatment process and the disease progresses more, they could learn how they will get out of feeling afraid.  These studies often carried out in the context of positive psychotherapy, all show the effect and effectiveness of this approach on reducing helplessness and increasing mental health in a variety of ways. In general, despite the limitations of the study, the results showed that if the patients are helped to learn for accepting their feelings at the beginning of the illness and also learn to be aware of their mental awareness and thoughts and behavior in the present moment , and be able to separate himself from mental experiences (mind reading, catastrophizing, extreme generalization) and recognize their values and adopt an adaptive attributional style, they will be very resilient against the stresses of cancer in the way of improving mental health
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Type of Study: Research | Subject: Clinical Psychiatry

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