Determining the Effectiveness of the Educational Package Based on Adapting to the Disease on the Quality of Life, Reducing Death Anxiety, and Adherence to Treatment Orders in Women with Breast Cancer

Breast cancer is the most common type of cancer in women and is the second cause of death in women aged 33–55. Adaptation to complications caused by breast cancer is very important. Based on the evidence, adaptation to cancer explains the quality of life. Breast cancer is a dreadful event for many women and causes psychological and social challenges, including anxiety and especially death anxiety. Among other related variables, adaptation to the disease and adherence to treatments are very important in chronic diseases where patients must follow the prescribed treatment for a long time. Considering the importance of the quality of life, the seriousness of death anxiety, and adherence to treatments in women with breast cancer, this group needs psychological treatment. So, the present study was conducted to determine the effectiveness of the educational package based on the disease adaptation on the quality of life, reduction of death anxiety, and adherence to treatments in women with breast cancer.

The research method was quasi–experimental with a posttest–pretest design with a control group. The statistical population included all women with breast cancer who were referred to the specialized treatment centers for cancer in Alborz Province, Iran, between October 2021 and April 2022. Among the eligible volunteers, 30 were selected based on the inclusion and exclusion criteria as the research sample. They were selected by the available sampling and were randomly assigned to the experimental and control groups (15 women in each group). The inclusion criteria were as follows: women with cancer with a file focusing on breast cancer, volunteered to participate in the research, age range from 30 to 60 years, being literate in reading and writing, not suffering from psychological disorders and chronic physical diseases, and not participating in other counseling and therapy groups at the same time. The exclusion criteria for the experimental group included an absence of more than two sessions in the treatment protocol and an unwillingness to continue cooperation in the training sessions. The study data were gathered in pretest and posttest for two groups via the Quality of Life Questionnaire (QLQ) for Cancer Patients (Aaronson et al., 1993), the Death Anxiety Scale (Templer, 1972), and the Questionnaire of Adherence to Treatment with Chronic Diseases (Modanloo, 2013). The experimental group underwent twelve 75–minute sessions (2 sessions per week) of an educational package based on adaptation to the disease, but the control group did not receive any intervention. Data analysis was done by descriptive and inferential statistics in SPSS software version 23. The descriptive statistics section included frequency, mean, and standard deviation. The inferential statistics section included the independent t test, Chi–square test, and covariance analysis. The significance level of the tests was considered 0.05.

Findings showed a significant difference between the experimental group and the control group in the variables of quality of life (p<0.001), death anxiety (p<0.001), and adherence to treatments (p<0.001). The impact rate of intervention was 0.627 in the quality of life, 0.394 in the death anxiety, and 0.519 in the adherence to treatments.

Based on the research results, the educational package based on adapting to the disease improves the quality of life and adherence to treatments and reduces death anxiety in women with breast cancer.