Guided Self-Help for Prevention of Depression and Anxiety in Women with Breast Cancer

Depression and anxiety are prevalent in women with breast cancer. We developed a self-help kit as a self-learning package of necessary preparatory information (basic knowledge on chemotherapy, side effects, and problem-solving skills). We provided an oncology nurse-guided self-help kit with a cognitive behavioral therapy approach to 46 women with breast cancer in the intervention group and usual care to 36 in the control group in outpatient chemotherapy settings. The oncology nurse monitored and facilitated the patient’s progress using the diary during the patient’s chemotherapy. We also provided professional-led support group programs. Depression, anxiety, and quality of life were measured at baseline, 1 week, 3 months, and 6 months. The chi-square test and t were used to examine differences between the two groups, and repeated measures analysis of variance was used to test the effects of the intervention on the measures over time. All depression and anxiety scores were improved in both the intervention and control groups, but there were no significant differences between the two groups. Further studies are needed to evaluate the effectiveness of an oncology nurse-guided self-help approach for cancer patients.

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The Effect of Dialectic Behavioral Counseling on Depression, Anxiety, and Postpartum Hematocrit Level

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0041-1728780 ◽

2021 ◽

Vol 43 (04) ◽

pp. 275-282

Author(s):

Nasrin Pour Amiri ◽

Atefeh Ahmadi ◽

Firoozeh Mirzaee ◽

Moghadameh Mirzai ◽

Nader Shahrokhi

Keyword(s):

Postpartum Depression ◽

Behavioral Therapy ◽

Intervention Group ◽

Anxiety Symptoms ◽

Control Group ◽

P Value ◽

Depression And Anxiety ◽

Hematocrit Level ◽

Negative Experience ◽

Behavioral Counseling

Abstract Objective Childbirth is a biological, psychological, and sociological event that can be a positive or negative experience, and, without support, this period may be potentially damaging. Parturition may distort maternal emotions and lead to short- or long-term disorders such as postpartum depression and anxiety. The present research aims to study the effects of dialectic behavioral therapy-based counseling on depression, anxiety symptoms, and postpartum hematocrit level. Methods The current research is a clinical trial study, and the sample was selected using parturients who were referred to the Health General Center with a diagnosis of postpartum depression and anxiety. The sample size consisted of 116 subjects who agreed to participate in the study. The patients in intervention group underwent group dialectic behavioral counseling (10 sessions/one session per week) and the control group did not receive any type of intervention. The patients were assessed in the first and last sessions as well as 2 months after the end of the sessions, using the Beck depression scale and Spielberg anxiety scale as well as the results of hematocrit tests. Data were analyzed using the IBM SPSS Statistics for Windows, Version 21.0 (IBM Corp., Armonk, NY, USA) Results The results implied the effectiveness of dialectic behavioral therapy on reduction of the depression score, anxiety symptoms (p-value ≤ 0.0001), and hematocrit level (p-value = 0.04). The participants' depression, anxiety, and hematocrit levels decreased in the experiment group compared to the control group, and this decrease has remained until the 2-month follow-up. Conclusion It seems that dialectic behavioral counseling reduces the levels of postpartum depression, anxiety, and hematocrits.

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Breast cancer application protocol: a randomised controlled trial to evaluate a self-management app for breast cancer survivors

BMJ Open ◽

10.1136/bmjopen-2019-034655 ◽

2020 ◽

Vol 10 (7) ◽

pp. e034655

Author(s):

Andy S K Cheng ◽

Xiangyu Liu ◽

Peter H F Ng ◽

Cindy T T Kwok ◽

Yingchun Zeng ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Survivors ◽

Controlled Trial ◽

Intervention Group ◽

Readiness For Change ◽

Self Management ◽

Controlled Study ◽

Control Group ◽

Problem Solving Skills ◽

Randomised Controlled

IntroductionThe eHealth technologies that are being designed for chronic disease constitute a global trend towards health assessment and self-management. However, most of these approaches tend to focus on a single symptom or problem rather than on the multiple problems that are characteristic of many of these chronic illnesses. The aim of this study is to examine the effectiveness of and adherence to a self-management application (app) that identifies multiple problem areas related to surviving breast cancer as the targeted chronic illness.Methods and analysisThis is a randomised controlled study. Eligible participants will be allocated randomly into either an intervention group or a control group at a 1:1 ratio. The intervention group will be assigned to the self-management app (‘Be-with-You’), while the control group will use a general health app (‘Sham’ app). The primary outcomes will include the differences between the two groups in their health literacy, problem-solving skills and self-management skills. The secondary outcomes will include group differences in self-efficacy, readiness for change and health-related quality of life. All of these outcomes will be measured at baseline and at 4 weeks and 12 weeks after intervention. In addition, usability of these two mobile apps will be measured at 4 weeks and 12 weeks after intervention. The planned sample size is 476.Ethics and disseminationThe Human Subjects Ethics Sub-committee of The Hong Kong Polytechnic University approved the study (HSEARS20190922001, 24 September 2019). Dissemination of findings will occur at the local, national and international levels.Trial registration numberChiCTR1900026244.

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Eficacia de una intervención en psicología positiva combinada con terapia cognitivo conductual en estudiantes universitarios

Anales de Psicología ◽

10.6018/analesps.32.3.261661 ◽

2016 ◽

Vol 32 (3) ◽

pp. 728 ◽

Cited By ~ 3

Author(s):

Rosario Josefa Marrero ◽

Mónica Carballeira ◽

Sabrina Martín ◽

Miriam Mejías ◽

Juan Andrés Hernández

Keyword(s):

Cognitive Behavioral Therapy ◽

Repeated Measures ◽

Program Effectiveness ◽

Behavioral Therapy ◽

Intervention Group ◽

Well Being ◽

Waiting List ◽

Cognitive Behavioral ◽

Control Group ◽

Convenience Sample

<p>The aim of this study was to design and implement a positive intervention combined with cognitive-behavioral therapy to enhance subjective and psychological well-being and other positive functioning constructs in a convenience sample. Participants analysed were 48 university students (mean age 22.25),25 assigned nonrandomized to intervention condition and 23 to no-treatment waiting-list control condition. All participants were assessed pre- and post-intervention to test the treatment program effectiveness. Repeated-measures ANCOVAs, controlling baseline differences between the two groups, indicated that the intervention group reported greater social support after the intervention period than the waiting-list control group. Within-group differences were found for happiness, self-acceptance, positive relations with others, optimism, and self-esteem in the intervention group; these differences did not appear in the waiting-list control group. These findings suggest the limited capacity of this intervention program for improving well-being through positive activities combined with cognitive-behavioral therapy. Future research should analyse what kind of activities could be more effective in promoting well-beingdepending on the characteristics of participants.</p>

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Investigation of a Lifestyle Intervention in Women at High Risk of Breast Cancer

Western Journal of Nursing Research ◽

10.1177/0193945917697227 ◽

2017 ◽

Vol 40 (7) ◽

pp. 976-996 ◽

Cited By ~ 2

Author(s):

Claire J. Han ◽

Larissa A. Korde ◽

Scott Reding ◽

Kristen Allott ◽

Matt Van Doren ◽

...

Keyword(s):

Breast Cancer ◽

Body Composition ◽

High Risk ◽

Lifestyle Intervention ◽

Behavioral Therapy ◽

Intervention Group ◽

Group Versus ◽

Control Group ◽

Obese Women ◽

Therapy Program

One fourth of breast cancer can be attributed to sedentary lifestyles and being overweight or obese. This pilot study was conducted to explore whether a 6-month lifestyle intervention affected body composition and obesity-related biomarkers among women at high risk of breast cancer. Overweight/obese women at high risk of breast cancer were randomized to the control group or to the intervention. The intervention was an individually tailored, cognitive-behavioral therapy program that assists women in identifying strategies to improve their nutrition and physical activity habits with the goal of reduced adiposity. We compared changes in body composition and plasma biomarkers from baseline to 6 months. Body weight, adiposity, leptin, insulin resistance, and C-reactive protein were significantly reduced in the intervention group versus controls. No significant differences were observed in adiponectin, insulin, glucose, or interleukin-6. Our findings suggest that this intervention improves the metabolic and inflammatory profiles of overweight/obese women at risk of breast cancer.

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The effect bibliotheraphy on depression and anxiety level of breast cancer patient at Arifin Achmad Regional General Hospital of Riau Province

Jurnal Kesehatan Komunitas ◽

10.25311/keskom.vol5.iss3.466 ◽

2019 ◽

Vol 5 (3) ◽

pp. 248-253

Author(s):

Bayu saputra ◽

Yani Sofiani ◽

Diana Irawati

Keyword(s):

Breast Cancer ◽

Cancer Patient ◽

Breast Cancer Patient ◽

Intervention Group ◽

Depression Scale ◽

Psychological Problem ◽

Future Research ◽

Control Group ◽

Depression And Anxiety ◽

Control Group Design

Patient with breast cancer who get chemotheraphy has an side effect, one of this effect is psychological problem. The psychological problem among breast cancer patient is about depression and anxiety. The implementation of biblioteraphy has a positive effect on psychological condition. The aim of this research was to identify the effect biblioteraphy method on the level of depression and anxiety of breast cancer patient. The method was used quasy experimental pretest-postest with intervention control group design. The sampel was 32 respondents using purposive sampling technique wich divided into 2 groups, the intervention group received biblioteraphy story telling method and pray of Prophet Ayyub Alaihisalam while the control group without intervention.The evaluation of psychological aspect depression and anxiety used Hospital Anxiety Depression Scale (HADS) in bahasa. The analysis of depression and anxiety changes measured using independent t-test. The result: There was a significant relationship between level of depression and anxiety in pre and post on respondents who received intervention and without intervention. Conclusion: the applying of intervention of biblioteraphy method with frequency as much as 5 time and maximum in 45 minutes proved in lowering level of depression and anxiety. It is suggested for applying bibliotheraphy when giving nursing care of breast cancer patient. The future research should investigate other aspect such as education and environment against level of depression and anxiety.

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Efficacy of a Six-Week-Long Therapist-Guided Online Therapy Versus Self-help Internet-Based Therapy for COVID-19–Induced Anxiety and Depression: Open-label, Pragmatic, Randomized Controlled Trial

JMIR Mental Health ◽

10.2196/26683 ◽

2021 ◽

Vol 8 (2) ◽

pp. e26683

Author(s):

Mohammed Al-Alawi ◽

Roopa K McCall ◽

Alya Sultan ◽

Naser Al Balushi ◽

Tamadhir Al-Mahrouqi ◽

...

Keyword(s):

Behavioral Therapy ◽

Controlled Trial ◽

Intervention Group ◽

Anxiety And Depression ◽

Control Group ◽

Online Therapy ◽

Pragmatic Randomized Controlled Trial ◽

Randomized Controlled ◽

Self Help ◽

Acceptance And Commitment

Background The COVID-19 pandemic has led to a notable increase in psychological distress, globally. Oman is no exception to this, with several studies indicating high levels of anxiety and depression among the Omani public. There is a need for adaptive and effective interventions that aim to improve the elevated levels of psychological distress due to the COVID-19 pandemic. Objective This study aimed to comparatively assess the efficacy of therapist-guided online therapy with that of self-help, internet-based therapy focusing on COVID-19–induced symptoms of anxiety and depression among individuals living in Oman during the COVID-19 pandemic. Methods This was a 6-week-long pragmatic randomized controlled trial involving 60 participants who were recruited from a study sample surveyed for symptoms of anxiety or depression among the Omani public amid the COVID-19 pandemic. Participants in the intervention group were allocated to receive 1 online session per week for 6 weeks from certified psychotherapists in Oman; these sessions were conducted in Arabic or English. The psychotherapists utilized cognitive behavioral therapy and acceptance and commitment therapy interventions. Participants in the control group received an automatic weekly newsletter via email containing self-help information and tips to cope with distress associated with COVID-19. The information mainly consisted of behavioral tips revolving around the principles of cognitive behavioral therapy and acceptance and commitment therapy. The primary outcome was measured by comparing the change in the mean scores of Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scale from the baseline to the end of the study (ie, after 6 sessions) between the two groups. The secondary outcome was to compare the proportions of participants with depression and anxiety between the two groups. Results Data from 46 participants were analyzed (intervention group n=22, control group n=24). There was no statistical difference in the baseline characteristics between both groups. Analysis of covariance indicated a significant reduction in the GAD-7 scores (F1,43=7.307; P=.01) between the two groups after adjusting for baseline scores. GAD-7 scores of participants in the intervention group were considerably more reduced than those of participants in the control group (β=−3.27; P=.01). Moreover, a greater reduction in mean PHQ-9 scores was observed among participants in the intervention group (F1,43=8.298; P=.006) than those in the control group (β=−4.311; P=.006). Although the levels of anxiety and depression reduced in both study groups, the reduction was higher in the intervention group (P=.049) than in the control group (P=.02). Conclusions This study provides preliminary evidence to support the efficacy of online therapy for improving the symptoms of anxiety and depression during the COVID-19 crisis in Oman. Therapist-guided online therapy was found to be superior to self-help, internet-based therapy; however, both therapies could be considered as viable options. Trial Registration ClinicalTrials.gov NCT04378257; https://clinicaltrials.gov/ct2/show/NCT04378257

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Investigating the Effect of Cognitive-behavioral Stress Management on Occupational Performance among Women with Breast Cancer

Current Women s Health Reviews ◽

10.2174/1573404816666191220095123 ◽

2020 ◽

Vol 16 (2) ◽

pp. 152-159

Author(s):

Arezoo Shayan ◽

Mansoureh Refaei ◽

Farkhondeh Jamshidi

Keyword(s):

Breast Cancer ◽

Stress Management ◽

Repeated Measures ◽

Intervention Group ◽

Performance Measure ◽

Cognitive Behavioral ◽

Occupational Performance ◽

Cognitive Behavioral Stress Management ◽

Behavioral Stress ◽

Significant Difference

Background: Treatment of breast cancer can be accompanied by long-term consequences affecting women’s participation in many tasks. Objective: This study aimed to assess the effect of cognitive behavioral stress management (CBSM) program on occupational performance of women with breast cancer. Methods: In this randomized clinical trial, conducted between Feb 3 and Oct 26, 2016, 104 women with breast cancer who had referred to Imam Khomeini clinic in Hamadan, and who fulfilled the inclusion criteria (20-60 years old, married, suffering from grade 1-3 breast cancer with a history of recent surgery) were enrolled. They were randomly divided into two groups of 52 using a permuted block size of four. The intervention group took part in four 60-minute sessions of CBSM over four weeks. The study data were collected using a demographic information form and the Canadian Occupational Performance Measure. The statistical analyst was masked to intervention allocation. The data were analyzed using descriptive statistics, paired t-test, and repeated measures ANOVA. Results: A significant difference was observed between the two groups regarding the mean scores of occupational performance (p=0.02) and satisfaction (p=0.005) after the intervention. Each variable was measured at three time points (before the intervention, immediately and 2 weeks after intervention). A significant difference was observed in the two groups’ mean scores of performance (p=0.026) and satisfaction (p=0.01), irrespective of the time of assessment. Conclusion: The CBSM program promoted the occupational performance immediately and two weeks after the intervention in women with breast cancer. This technique can be used as a complementary method alongside medical therapies in oncology centers.

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The Impact of the Theory-Based Training on Beliefs of Women towards Breast Cancer Screening Behaviors

Current Women s Health Reviews ◽

10.2174/1573404816999200402120836 ◽

2020 ◽

Vol 16 (3) ◽

pp. 229-235

Author(s):

Alireza Didarloo ◽

Leila Mokhtary ◽

Hamid-Reza Khalkhali ◽

Soheila Ahangarzadeh-Rezaei

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Health Beliefs ◽

Educational Intervention ◽

Intervention Group ◽

Health Belief ◽

Control Group ◽

Belief Model ◽

Screening Behaviors

Background: Breast cancer is the most prevalent type of cancer among women that is fatal if not diagnosed and treated in due time. Health beliefs play an important role in people's willingness to engage in health-promoting behaviors. Objective: The aim of the study was to examine the effects of the health belief model (HBM)-based training intervention on women’s health beliefs towards breast cancer screening behaviors. Methods: The study of educational intervention was conducted on women referred to healthcare centers. The sample was selected by convenient sampling and randomly assigned to control and intervention groups of 50 subjects. The intervention group received the theory-based training intervention, but the control group received only the routine care. Champion’s Health Belief Model Scale (CHBMS) was used for collecting the study data. Data analysis was performed using independent t-test, paired t-test, Chi-squared test, and correlation coefficient in SPSS software version 16.00. Results: The mean age of the subjects for control and intervention groups was 39.06±9.78, 38.32±8.27, respectively. Overall, 38%, 12% and 13%of the subjects reported breast selfexamination behavior, mammography and clinical breast examinations, respectively. Before the intervention program, the overall mean score of health beliefs in groups of control and intervention was 160.82±23.28, and 159.14±20.61, respectively. After educational intervention, the overall mean score of beliefs in the intervention group changed from 159.14±20.61 to 195.26±24.42, and it was statistically significant (p<0.001). In the control group, after the intervention, no significant changes were observed in the mean score of total health beliefs and were not statistically significant (p>0.05). Among the variables of the HBM, women's perceived self-efficacy toward breast selfexamination experienced the most positive change after an educational intervention. Conclusion: Our results indicated that HBM-based training significantly improved women’s beliefs toward breast cancer screening behaviors. It is suggested that trainers in the healthcare system use these educational approaches to promote people’s beliefs toward breast cancer and its screening methods.

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Effect of Raja Yoga Meditation on the Distress and Anxiety Levels of Women with Breast Cancer

Religions ◽

10.3390/rel12080590 ◽

2021 ◽

Vol 12 (8) ◽

pp. 590

Author(s):

Raquel Vilanova Araújo ◽

Ana Fátima Carvalho Fernandes ◽

Regina Célia Vilanova Campelo ◽

Renan Alves Silva ◽

Inez Sampaio Nery

Keyword(s):

Breast Cancer ◽

Intervention Group ◽

Vital Signs ◽

Educational Activity ◽

Control Group ◽

Controlled Clinical Trial ◽

Specialized Center ◽

Care Practices ◽

Anxiety Depression ◽

Yoga Meditation

Objective: To evaluate the effect of Raja yoga meditation on the level of distress and anxiety in women with breast cancer. Method: A randomized, controlled, clinical trial was carried out in a specialized center between February and December 2019. The patients in the intervention group (n = 25) participated in four group meditation sessions for one month, and the participants in the control group (n = 25) were exposed to an educational activity for the same period and frequency. Cohen’s d was used to evaluate the effect size. Results: A significant reduction in the level of distress and anxiety was found in the intervention group (p < 0.001). The effect of meditation was average in reducing distress, anxiety, depression, and vital signs. There was also an average effect on the increase in saturation of peripheral oxygen (SPO2). Conclusion: The practice of meditation reduced distress and anxiety more effectively than the usual care practices.

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Effects of exercise in breast cancer patients: implications of the trials within cohorts (TwiCs) design in the UMBRELLA Fit trial

Breast Cancer Research and Treatment ◽

10.1007/s10549-021-06363-9 ◽

2021 ◽

Author(s):

Roxanne Gal ◽

Evelyn M. Monninkhof ◽

Carla H. van Gils ◽

Rolf H. H. Groenwold ◽

Sjoerd G. Elias ◽

...

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Beneficial Effect ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Exercise Intervention ◽

Intervention Group ◽

Control Group ◽

Physical Fatigue ◽

Trials Within Cohorts

Abstract Purpose The Trials within Cohorts (TwiCs) design aims to overcome problems faced in conventional RCTs. We evaluated the TwiCs design when estimating the effect of exercise on quality of life (QoL) and fatigue in inactive breast cancer survivors. Methods UMBRELLA Fit was conducted within the prospective UMBRELLA breast cancer cohort. Patients provided consent for future randomization at cohort entry. We randomized inactive patients 12–18 months after cohort enrollment. The intervention group (n = 130) was offered a 12-week supervised exercise intervention. The control group (n = 130) was not informed and received usual care. Six-month exercise effects on QoL and fatigue as measured in the cohort were analyzed with intention-to-treat (ITT), instrumental variable (IV), and propensity scores (PS) analyses. Results Fifty-two percent (n = 68) of inactive patients accepted the intervention. Physical activity increased in patients in the intervention group, but not in the control group. We found no benefit of exercise for dimensions of QoL (ITT difference global QoL: 0.8, 95% CI = − 2.2; 3.8) and fatigue, except for a small beneficial effect on physical fatigue (ITT difference: − 1.1, 95% CI = − 1.8; − 0.3; IV: − 1.9, 95% CI = − 3.3; − 0.5, PS: − 1.2, 95% CI = − 2.3; − 0.2). Conclusion TwiCs gave insight into exercise intervention acceptance: about half of inactive breast cancer survivors accepted the offer and increased physical activity levels. The offer resulted in no improvement on QoL, and a small beneficial effect on physical fatigue. Trial registration Netherlands Trial Register (NTR5482/NL.52062.041.15), date of registration: December 07, 2015.

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