Volume 30, Issue 4 (7-2023)
RJMS 2023, 30(4): 275-287 |
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Research code: 01
Ethics code: IR.IAU.K.REC.1402.106
Clinical trials code: 01
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Darouei S, Peymani J, Peyvandi P, Sodagar S. Comparing the Effectiveness of Cognitive-Behavioral Therapy and Mindfulness-Based Therapy on Fear of Recurrence and Body Image in Breast Cancer Patients at Karaj Medical Center. RJMS 2023; 30 (4) :275-287
URL: http://rjms.iums.ac.ir/article-1-8745-en.html
URL: http://rjms.iums.ac.ir/article-1-8745-en.html
Assistant Professor, Department of Psychology, Faculty of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran , Dr.peymani@yahoo.com
Abstract: (152 Views)
Background & Aims: Breast cancer is the most common cancer among women all over the world and at the same time, it is one of the most curable. These two characteristics, i.e. the prevalence and curability of this disease, have caused a large number of patients to be treated, have a long life span, and need support after diagnosis, during, and after treatment. Many women suffer from mental complications such as depression and anxiety after learning about this disease, and performing difficult treatments such as surgery and chemotherapy, each of which has specific side effects, aggravates these mental complications. Fear of cancer recurrence is considered a significant concern for breast cancer survivors. It is acknowledged that there is a connection between the fear of cancer recurrence and the states of anxiety and depression. Fear of recurrence is the fear or worry that the cancer will return or progress in the same organ or in another part of the body. Many patients are afraid of relapse and have to live with uncertainty. Fear of cancer recurrence has a functional impact on the lives of cancer survivors and their families. Fear of relapse is associated with lower quality of life and emotional health, higher mental and physical fatigue, and higher depression and anxiety in cancer survivors. In addition, body image is an important element in the quality of life of cancer patients. Today, due to the high and stable prevalence of cancers especially breast cancer in women, and their relationship with mental and social functioning defects effective and timely prevention and intervention programs for this special group of women. It is very important. In order to reduce stress and damage caused by cancer, both preventive strategies and therapeutic strategies are necessary. But so far, most of the investments have been made in the treatment sector. Since many women have breast cancer, clinical treatments are not able to cover all of them, so planners should invest more in prevention so that fewer women are affected by this traumatic problem. Among the other treatment methods that can be effective in improving the psychological symptoms of people with cancer and have received less attention from researchers, especially in Iran, is cognitive therapy based on mindfulness. This type of psychotherapy is derived from cognitive-behavioral treatments and is considered one of the important components of the third wave of psychological treatment models. Mindfulness is a process of having non-judgmental attention to internal and external events as they arise in the moment. Internal events include thoughts, emotions, perceptions, and bodily sensations, and external events include environmental, situational, and interpersonal experiences, mindfulness means moment-to-moment awareness of existing experiences. Many researchers have investigated the effectiveness of cognitive group therapy based on mindfulness and cognitive-behavioral therapy on psychological disorders resulting from cancer or its consequences. Considering the high prevalence of breast cancer among women and its increasing spread in many countries of the world, including Iran, and the stress that this issue causes people suffering from this disease, it is necessary to identify the factors related to it. Few researches have been conducted on the effectiveness of cognitive-behavioral therapy and mindfulness-based therapy on fear of recurrence and body image in patients with breast cancer in Arak, therefore, considering the high prevalence of this disease among women and its adverse effects. The main question of this study is whether cognitive-behavioral therapy and mindfulness-based therapy affect the fear of recurrence and body image in women with breast cancer.
Methods: The current research design was a quasi-experimental type of unequal control group with pre-test, post-test, and follow-up, which was approved by the code of ethics IR.IAU.K.REC.1402.106 in the Islamic Azad University of Karaj branch. The current research design was a semi-experimental one with pre-test, post-test, and follow-up. The statistical population of the present study was women with breast cancer who were referred to treatment centers, clinics, and hospitals in Karaj city for treatment. The subjects were selected based on the voluntary sampling method in three groups of 15 people, based on the diagnosis and referral of experts according to the entry and exit criteria, which were randomly selected for the physical division of the subjects of each group into three groups. The statistical population of the present study was women with breast cancer who were referred to treatment centers, clinics, and hospitals in Karaj for treatment. Based on the voluntary sampling method, the subjects were matched in three groups: awareness, cognitive-behavioral, and control. To collect data, Kesh et al.'s (1986-1987) self-body multidimensional relationship questionnaire and fear of cancer recurrence were used. The mindfulness and cognitive-behavioral program lasted for 8 sessions and each session lasted for 90 minutes and about two months. To analyze the data, univariate and multivariate analysis of covariance and Ben-Ferroni post hoc test were used.
Results: The results showed that cognitive behavioral therapy and mindfulness-based therapy have an effect on fear of recurrence and body image in women with breast cancer. Also, there is a difference between cognitive behavioral therapy and therapy based on mindfulness of the fear of relapse, and there is no difference between cognitive behavioral therapy and therapy based on mindfulness of body image and disease perception.
Conclusion: In general, it can be said that using cognitive-behavioral therapy and mindfulness methods, it is possible to improve the fear of recurrence and the body image of women with breast cancer. The important limitations of the current research include the use of available sampling methods, the unisex nature of the sample, the large number of items in the questionnaires for women with breast cancer, the lack of examination of the type of treatment received, the use of self-reporting tools, and the limitation of the research community to women with breast cancer. did According to the results of the research, the researchers should use random sampling methods for sampling, conduct this research on men (for example, men with lung cancer), divide the questionnaires into two or more parts to reduce bias as a result of fatigue and examine the results by treatment type. Acceptance by women with breast cancer and the use of interviews to collect data are suggested. Another suggestion is to conduct this research on women with breast cancer in other cities and even other vulnerable groups such as women with obesity, women with diabetes, etc.
Methods: The current research design was a quasi-experimental type of unequal control group with pre-test, post-test, and follow-up, which was approved by the code of ethics IR.IAU.K.REC.1402.106 in the Islamic Azad University of Karaj branch. The current research design was a semi-experimental one with pre-test, post-test, and follow-up. The statistical population of the present study was women with breast cancer who were referred to treatment centers, clinics, and hospitals in Karaj city for treatment. The subjects were selected based on the voluntary sampling method in three groups of 15 people, based on the diagnosis and referral of experts according to the entry and exit criteria, which were randomly selected for the physical division of the subjects of each group into three groups. The statistical population of the present study was women with breast cancer who were referred to treatment centers, clinics, and hospitals in Karaj for treatment. Based on the voluntary sampling method, the subjects were matched in three groups: awareness, cognitive-behavioral, and control. To collect data, Kesh et al.'s (1986-1987) self-body multidimensional relationship questionnaire and fear of cancer recurrence were used. The mindfulness and cognitive-behavioral program lasted for 8 sessions and each session lasted for 90 minutes and about two months. To analyze the data, univariate and multivariate analysis of covariance and Ben-Ferroni post hoc test were used.
Results: The results showed that cognitive behavioral therapy and mindfulness-based therapy have an effect on fear of recurrence and body image in women with breast cancer. Also, there is a difference between cognitive behavioral therapy and therapy based on mindfulness of the fear of relapse, and there is no difference between cognitive behavioral therapy and therapy based on mindfulness of body image and disease perception.
Conclusion: In general, it can be said that using cognitive-behavioral therapy and mindfulness methods, it is possible to improve the fear of recurrence and the body image of women with breast cancer. The important limitations of the current research include the use of available sampling methods, the unisex nature of the sample, the large number of items in the questionnaires for women with breast cancer, the lack of examination of the type of treatment received, the use of self-reporting tools, and the limitation of the research community to women with breast cancer. did According to the results of the research, the researchers should use random sampling methods for sampling, conduct this research on men (for example, men with lung cancer), divide the questionnaires into two or more parts to reduce bias as a result of fatigue and examine the results by treatment type. Acceptance by women with breast cancer and the use of interviews to collect data are suggested. Another suggestion is to conduct this research on women with breast cancer in other cities and even other vulnerable groups such as women with obesity, women with diabetes, etc.
Type of Study: Research |
Subject:
Clinical Psychiatry
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