The Effectiveness of Psychoeducational Group Intervention on Post-Traumatic Growth: A Randomized Clinical Trial

Document Type: Original article

Authors

1 Tabriz University of Medical Sciences, Tabriz, Iran

2 Department of Health Psychology, Research Center of Spiritual Health, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran

3 - Faculty of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences (IUMS), Tehran, Iran - Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran

4 Breast Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Breast cancer is a chronic disease that leads to many psychological problems that are involved in treatment and adherence to treatment. The aim of this study was to evaluate the effect of psychoeducational group intervention on psychological factors that help the patients in the treatment process.
Methods: In this study, 80 patients were selected by using convenience sampling at Imam Khomeini Hospital. They were randomly allocated either to the intervention group or to the control group. All participants completed the questionnaires of post-traumatic growth, quality of life, subjective well-being, adherence to treatment and social support. The results were analyzed by SPSS-18 software using univariate and multivariate analysis.
Results: According to the results, the applied intervention had a significant effect on post-traumatic growth as a primary outcome, and also on subjective well-being and adherence to treatment as secondary outcomes.
Conclusion: Psychoeducational group intervention in women with breast cancer can affect the treatment and provide better response to treatment through the improvement of post-traumatic growth, subjective well-being and adherence to treatment.

Keywords


1. Heidarzadeh M, Rassouli M, Brant JM, Mohammadi-Shahbolaghi F, Alavi-Majd H. Dimensions of Posttraumatic Growth in Patients with Cancer: A Mixed-Method Study. Cancer Nurs 2018;41(6):441-9.
2. Norouzi H, Rahimian-Boogar I, Talepasand S. Effectiveness of mindfulness-based cognitive therapy on posttraumatic growth,self-management, and functional disability among patients with breast cancer. Nursing Practice Today 2017;4(4):190-202.
3. Barthakur MS, Sharma MP, Chaturvedi SK, Manjunath SK. Posttraumatic growth in women survivors of breast cancer. Indian J Palliative Care 2016;22(2):157-62.
4. Akbari M, Lotfi Kashani F, Vaziri S. The efficacy of four-factor psychotherapy on increasing sexual self-esteem in breast cancer survivors. Iranian J of Breast Disease. 2017;10(1):48-60.
5. Lim SM, Kim HC, Lee S. Psychosocial impact of cancer patients on their family members. Cancer Res Treat 2013;45(3):226.
6. Wu X, Kaminga AC, Dai W, Deng J, Wang Z, Pan X, et al. The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis. J Affect Disord 2019 Jan 15;243:408-15.
7. Al-Sulaiman RJ, Bener A, Doodson L, Al Bader SB, Ghuloum S, Lemaux A, et al. Exploring the effectiveness of crisis counseling and psychoeducation in relation to improving mental well-being, quality of life and treatment compliance of breast cancer patients in Qatar. Int J Womens Health 2018;10:285-96.
8. Keyes CL, Shapiro AD. Social well-being in the United States: A descriptive epidemiology. How healthy are we?   In: Brim OG, Ryff CD, Kessler RC, (Eds.). The John D. and Catherine T. MacArthur foundation series on mental health and development. Studies on successful midlife development. How healthy are we?: A national study of well-being at midlife. USA: University of Chicago Press; 2004.P.350-72.
9.Rizalar S, Ozbas A, Akyolcu N, Gungor B. Effect of perceived social support on psychosocial adjustment of Turkish patients with breast cancer. Asian Pac J Cancer Prev 2014;15(8):3429-34.
10. Cobb S. Social support as a moderator of life stress. Psychosomatic Medicine 1976;38(5):300-14.
11. Flannery Jr RB. Social support and psychological trauma: A methodological review. J Traumatic Stress 1990;3(4):593-611.
12. Regehr C, Hill J, Knott T, Sault B. Social support, self‐efficacy and trauma in new recruits and experienced firefighters. Stress and Health 2003;19(4):189-93.
13. Prati G, Pietrantoni L. Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. J Loss and Trauma 2009;14(5):364-88.
14. Shorey S, Chan SWC, Chong YS, He HG. A randomized controlled trial of the effectiveness of a postnatal psychoeducation program on self‐efficacy, social support and postnatal depression among primiparas. J Adv Nurs 2015;71(6):1260-73.
15. Brand EF, Lakey B, Berman S. A preventive, psychoeducational approach to increase perceived social support. Am J Community Psychol 1995;23(1):117-35.
16. Scrignaro M, Barni S, Magrin ME. The combined contribution of social support and coping strategies in predicting post‐traumatic growth: a longitudinal study on cancer patients. Psycho‐Oncology 2011;20(8):823-31.
17. Schroevers MJ, Helgeson VS, Sanderman R, Ranchor AV. Type of social support matters for prediction of posttraumatic growth among cancer survivors. Psycho‐Oncology 2010;19(1):46-53.
18. Bozo Ö, Gündoğdu E, Büyükaşik-Çolak C. The moderating role of different sources of perceived social support on the dispositional optimism-posttraumatic growth relationship in postoperative breast cancer patients. J Health Psychol 2009;14(7):1009-20.
19. Tedeschi RG, Calhoun LG. The posttraumatic growth inventory: Measuring the positive legacy of trauma. J Trauma Stress 1996;9(3):455-71.
20. Matsuda A, Yamaoka K, Tango T, Matsuda T, Nishimoto H. Effectiveness of psychoeducational support on quality of life in early-stage breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Qual Life Res 2014;23(1):21-30.
21. Diener E. Subjective well-being. Psychological Bulletin 1984;95(3):542-75.
22. Marashi T, Taherianfar Z, Etemad K, Rakhsha A. [Survey of quality of life of patients with breast cancer among women at Shahid Beheshti University of Medical science and Health service 2017]. Journal Health in the Field 2018;6(1):1-8. Persian.
23. Esfandiar B, Kazemi M, Amanpour E, Tizfahm T. The relationship between religion, spiritual, health, hope, and quality of life in cancer patients. BCCR 2014;6(4):28-36.
24.Shobeiri F, Nikravesh A, Masoumi SZ, Heidari Moghaddam R, Karami M, Badafreh M. [The effect of exercise counseling on functional measures of quality of life in women with breast cancer]. J Education and Community Health 2015;2(1):1-9. Persian.
25-Moharamzad Y, Saadat H, Shahraki BN, Rai A, Saadat Z, Aerab-Sheibani H, et al. Validation of the Persian version of the 8-item Morisky Medication Adherence Scale (MMAS-8) in Iranian hypertensive patients. Glob J Health Sci 2015;7(4):173.
26. Fawzy FI, Fawzy NW. A structured psychoeducational intervention for cancer patients. Gen Hosp Psychiatry 1994 May;16(3):149-92.
27. Aggarwal B, Liao M, Allegrante JP, Mosca L. Low social support level is associated with non-adherence to diet at one year in the Family Intervention Trial for Heart Health (FIT Heart). J Nutrition Education and Behavior 2010;42(6):380-8.
28. Shorey S, Chan SWC, Chong YS, He HG. A randomized controlled trial of the effectiveness of a postnatal psychoeducation program on self‐efficacy, social support and postnatal depression among primiparas. J Adv Nurs 2015;71(6):1260-73.
29.Hashemian K, Pourshahriari MS, Bani Jamali MAS, Golestanie Bakht T. Investigating the relationship between demographic characteristics and subjective biodiversity and happiness in Tehran population.  J Educational Psychology Studies 2007;3(3):139-63.
30. Pat‐Horenczyk R, Perry S, Hamama‐Raz Y, Ziv Y, Schramm‐Yavin S, Stemmer SM. Posttraumatic growth in breast cancer survivors: Constructive and illusory aspects. J Trauma Stress 2015;28(3):214-22.
31. Garlan RW, Butler LD, Siegel ERA, Spiegel D. Perceived benefits and psychosocial outcomes of a brief existential family intervention for cancer patients/survivors. Omega-Journal of Death and Dying 2011;62(3):243-68.
32. Lelorain S, Bonnaud-Antignac A, Florin A. Long term posttraumatic growth after breast cancer: prevalence, predictors, and relationships with psychological health. J Clin Psychol Med Settings 2010;17(1):14-22.
33. Matsuda A, Yamaoka K, Tango T, Matsuda T, Nishimoto H. Effectiveness of psychoeducational support on quality of life in early-stage breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Qual Life Res 2014;23(1):21-30.
34. Dow Meneses K, McNees P, Loerzel VW, Su X, Zhang Y, Hassey LA, editors. Transition from treatment to survivorship: effects of a psychoeducational intervention on quality of life in breast cancer survivors. Oncol Nurs Forum 2007;34(5):1007‐16. 
35. Ram S, Narayanasamy R, Barua A. Effectiveness of group psycho-education on well-being and depression among breast cancer survivors of Melaka, Malaysia. Indian J Palliat Care 2013;19(1):34.
36. Bloom JR, Stewart SL, Johnston M, Banks P, Fobair P. Sources of support and the physical and mental well-being of young women with breast cancer. Soc Sci Med 2001;53(11):1513-24.
37. Jeffries SA, Robinson JW, Craighead PS, Keats MR. An effective group psychoeducational intervention for improving compliance with vaginal dilation: a randomized controlled trial. Int J Radiat Oncol Biol Phys 2006;65(2):404-11.
38. Myers RE, Chodak GW, Wolf TA, Burgh DY, McGrory GT, Marcus SM, et al. Adherence by African American men to prostate cancer education and early detection. Cancer 1999;86(1):88-104.
39. Rolnick SJ, Pawloski PA, Hedblom BD, Asche SE, Bruzek RJ. Patient characteristics associated with medication adherence. Clin Med Res 2013;11(2):54-65.
40. Baglama B, Atak IE. Posttraumatic growth and related factors among postoperative breast cancer patients. Procedia-Social and Behavioral Sciences 2015;190:448-54.
41. Sears SR, Stanton AL, Danoff-Burg S. The yellow brick road and the emerald city: benefit finding, positive reappraisal coping, and posttraumatic growth in women with early-stage breast cancer. Health Psychol 2003;22(5):487-97.
42. Ginzburg K, Ein-Dor T. Posttraumatic stress syndromes and health-related quality of life following myocardial infarction: 8-year follow-up. Gen Hosp Psychiatry 2011;33(6):565-71.