Journal List > J Korean Acad Nurs > v.39(2) > 1002514

TOOLS
Yoo, Lee, and Yoon: Effects of a Cognitive-Behavioral Nursing Intervention on Anxiety and Depression in Women with Breast Cancer undergoing Radiotherapy
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2009; 39(2): 157-165.

Published online: 28 April 2009

DOI: https://doi.org/10.4040/jkan.2009.39.2.157

Effects of a Cognitive-Behavioral Nursing Intervention on Anxiety and Depression in Women with Breast Cancer undergoing Radiotherapy

Myung-Sook Yoo1, Haejung Lee2, Jung-A Yoon1

1Nurse, Pusan National University Hospital, Busan, Korea.

2Associate Professor, College of Nursing, Pusan National University, Yangsan, Korea.

Address reprint requests to: Lee, Haejung. College of Nursing, Pusan National University, Beomeo-ri, Mulgeum-eup, Yangsan 626-770, Korea. Tel: 82-51-510-8344, Fax: 82-51-510-8308, haejung@pusan.ac.kr

Received 26 August 2008       Accepted 11 February 2009

Copyright © 2009 Korean Society of Nursing Science

Abstract

Purpose

The purpose of this study was to analyze the effects of a cognitive-behavioral nursing intervention on anxiety and depression of patients with breast cancer undergoing radiotherapy.

Methods

A nonequivalent control group design was used for the study. The research participants were patients with breast cancer (N=71; experimental group=35, comparison group=36) who received radiotherapy at P university hospital. The experimental group received a 6-week cognitive-behavioral nursing intervention (2 hr/week), which included nursing counseling, education about treatment choices for breast cancer and possible side effects and management strategies during radiotherapy, and rehabilitation exercise.

Results

Following the intervention, the experimental group showed significantly lower levels of anxiety (Experimental group=34.60±6.35, Comparison group=44.63±9.93, t=3.552, p<.001) and depression (Experimental group=10.20±6.61, Comparison group=17.81±10.85, t=3.542, p<.001) than the comparison group.

Conclusion

The findings from this study showed that cognitive-behavioral counseling applied by nurses is very effective to reduce anxiety and depression among patients with breast cancer. Therefore, providing nursing counseling to broader spectrum of patients with cancer should be considered. Further research would warrant future clinical application of nursing counseling.

Keywords: Cognitive herapy, Radiotherapy, Breast neoplasms, Anxiety, Depression

Figures and Tables

Figure 1
Theoretical framework modified from Lazarus and Folkman's stress model.
jkan-39-157-g001
Table 1
Contents and Organization of Cognitive Behavior-Nursing Counseling
jkan-39-157-i001

*Rehabilitation exercise consists of progressive relaxation therapy (10 min) and upper body flexibility exercise (30 min).

Table 2
General Characteristics of the Participants
jkan-39-157-i002

Exp=experimental group; Com=comparison group.

Table 3
Disease related Characteristics of the Participants
jkan-39-157-i003

Exp=experimental group; Com=comparison group.

Table 4
Effects of Cognitive-Behavioral Nursing Counseling on Study Variables (N=71)
jkan-39-157-i004

Exp=experimental group; Com=comparison group; Pre=pretest; Post=posttest.

References

1. Chae YR. Effect of treadmill walking exercise on quality of life in patients with breast cancer. Daebul University Bulletin. 2002. 8:193–206.
2. Chung BY. Adjustment process of women with breast cancer. 1991. Seoul: Yonsei University;Unpublished doctoral dissertation.
3. Ellis A. Reason and emotion in psychotherapy. 1962. Secaucus, NJ: Citadel.
4. Hahn HM, Yum TH, Shin YW, Dim KH, Yoon KJ, Chung KJ. A standardization study of Beck Depression Inventory in Korea. Journal of The Korean Neuropsychiatric Association. 1986. 25:487–500.
5. Kim HJ. Effects of foot-reflex-massage on anxiety and fatigue of cancer patients undergoing radiation therapy. 2004. Busan: Kosin University;Unpublished master's thesis.
6. Kim JM. The effect of hand massage on the anxiety of the hysterectomy patients in immediately prior to surgery. Journal of Korean Academy of Nursing. 2000. 30:476–487.
7. Kim JN. The efficacy of an integrated group psychotherapy for breast cancer patients on the quality of life and immune function. The Korean Journal of Clinical Psychology. 2005. 25:639–655.
8. Kim JT, Shin DK. A study based on the standardization of the STAI for Korea. The New Medical Journal. 1978. 21:69–75.
9. Kim KB. The effect of auricular acupressure therapy on anxiety of cancer patient. Journal of Korean Academy of Nursing. 2002. 32:888–896.
10. Kim MJ. A survey on changes in quality of life of patients who received radiation therapy after surgery for breast cancer. Journal of Korean Academy of Nursing. 1994. 24:652–665.
11. Kim SH. Effects of hand massage on the anxiety, sleeping satisfaction and pain of hysterectomy patients. 2003. Seoul: Ewha Womans University;Unpublished master's thesis.
12. Kim TH. Effect of foot-reflex-massage on preoperative anxiety, depression and sleep satisfaction of the patients with breast tumor. 2004. Daejeon: Chungnam National University;Unpublished master's thesis.
13. Kim YS. Effect of the information education of I131 treatment on the anxiety and immune response of thyroid cancer patients. 2006. Busan: Pusan National University;Unpublished doctoral dissertation.
14. Kim YW, Yang CK, Choe BM, Hahn HM. A study of depression in cancer patients on radiotherapy. Journal of Korean Neuropsychiatric Association. 1996. 35:260–267.
15. Koh KB, Kim ST. Coping strategy of cancer patients. Journal of Korean Neuropsychiatric Association. 1988. 27:140–148.
16. Lazarus RS, Folkman S. Stress, appraisal and coping. 1984. New York, NY: Springer Publish Company.
17. Lee CY, Oh DW. Level of anxiety and depression of the hospitalized cancer patients. Journal of Korean Neuropsychiatric Association. 1990. 29:178–188.
18. Lee JH. Counseling psychology. 2006. Seoul: Pakyoungsa.
19. Lee WM. A study of the depression and the quality of life in patients with breast cancer. 2006. Iksan: Wonkwang University;Unpublished master's thesis.
20. Korean cancer statistics. National Cancer Center. 2008. 11. 13. Retrieved December 1, 2008. from http://www.cancer.go.kr/cms/statics/incidence/index.html.
21. Oberst MT, Hughes SH, Chang AS, McCubbin MA. Self-care burden, stress appraisal, and mood among persons receiving radiotherapy. Cancer Nursing. 1991. 14:71–78.
22. Oh EH. Effect of guided imagery program on patients depression and anxiety receiving cancer chemotherapy. 2003. Daegu: Keimyung University;Unpublished master's thesis.
23. Park KA. Rational emotive behavior therapy. 1997. Seoul: Hakjisa.
24. Peck A, Boland J. Emotional reactions to radiation treatment. Cancer. 1977. 40:180–184.
25. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement. 1977. 1:385–401.
26. Rehse B, Pukrop R. Effects of psychosocial interventions on quality of life in adult cancer patients: Meta-analysis of 37 published controlled outcome studies. Patient Education and Counseling. 2003. 50:179–186.
27. Spielberger CD. Anxiety: Current trends in theory and research. 1972. New York, NY: Academic Press.
28. Yang YH. Trajectory of fatigue, quality of life and physical symptoms in cancer patients receiving radiotherapy. Journal of Korean Academy of Nursing. 2003. 33:562–569.
29. Yeo KE, Chung YS. Cognitive-behavior modification: An integrative approach. 1995. Seoul: Yangseowon.
TOOLS
Similar articles