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sdeedi K, Atashpour H. The Effectiveness of Dialectical Behavior Therapy on Life Expectancy, Self-Care and Depression of Breast Cancer Patients. TB 2025; 24 (1) :31-47
URL: http://tbj.ssu.ac.ir/article-1-3752-en.html
URL: http://tbj.ssu.ac.ir/article-1-3752-en.html
Department of Psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran , hamidatashpour@gmail.com
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The Effectiveness of Dialectical Behavior Therapy on Life Expectancy, Self-Care and Depression of Breast Cancer Patients
Nilofar Saeedi(M.A.)1, Hamid Atashpour(Ph.D.)2
1.Master's student in clinical psychology, Department of Psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
2.Corresponding Aouther:Associate Professor Department of Psychology, Department of Psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
Email:hamidatashpour@gmail.com Tel:09131068707
Abstract
Introduction: People with breast cancer face psychological challenges such as depression, reduced life expectancy and deficiencies self-care. The present study was conducted with the aim of investigating the effectiveness of dialectical behavior therapy on life expectancy, self-care and depression of cancer patients in Isfahan city.
Methods: The current research method was quantitative and of the type of semi-experimental studies with a pre-test-post-test design and a control group. The statistical population of the current study included people with breast cancer in Isfahan city who had referred to health centers in Isfahan city in 2024. In this study, 30 women with breast cancer who were diagnosed with this disease by a doctor were selected by convenience sampling method and were randomly assigned to two experimental and control groups. The people in the control and experimental groups completed life expectancy, self-care and depression questionnaires in two stages of pre-test and post-test. Multivariate covariance test and spss-24 software were used for data analysis.
Results: The results showed that dialectical behavior therapy significantly increased the mean life expectancy and self-care scores of participants in the experimental group in the post-test phase compared to the pre-test phase of the control group. On the other hand, in the experimental group, the mean depression score in the post-test phase was significantly lower than the pre-test phase compared to the control group (p<0/05).
Conclusion: From the findings of the present study, it can be concluded that psychologists and psychiatrists can use dialectical behavior therapy and its techniques to increase life expectancy, self-care and reduce depression in women with breast cancer.
Keywords: Dialectical Behavior Therapy, Depression, Life Expectancy, Self-Care, Cancer Patients
Conflict of interest: The authors declared no conflict of interest.
References
1-Barrios CH. Global challenges in breast cancer detection and treatment. The Breast 2022; 62: 1-6.
2-Houghton SC, Hankinson SE. Cancer progress and priorities: Breast cancer, cancer epidemiol. Biomark. Prev. 2021; 30: 822–844.
3-Basudan AM. Breast Cancer Incidence Patterns in the Saudi Female Population: A 17-Year Retrospective Analysis. Medicina. 2022; 58, 1-11.
4-Sung H, Ferlay J, Siegel RL & et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J. Clin. 2021; 71, 209–249.
5-Soqia J, Al-shafie M, Yakoub L & et al. Depression, anxiety and related factors among Syrian breast cancer patients: a cross-sectional study. BMC Psychiatry. 2022; 22: 1-7.
6-Chin CH, Tseng LM, Chao TC & et al. Self-care as a mediator between symptom-management self-efficacy and quality of life in women with breastcancer. PLoS ONE. 2021; 16(2):1-10.
7-Brokaar EJ, van den Bos F, Visser LE & et al. Deprescribing in Older Adults With Cancer and Limited Life Expectancy: An Integrative Review. American Journal of Hospice and Palliative Medicine. 2022;39(1):86-100.
8-Colonio C, Lecman L, Pinto J & et al. Life expectancy and cancer survival in Oncosalud: outcomes over a 15-year period in a Peruvian private institution. ecancer, 2021; 15, 1-15.
9-Mursyidah NI, Ashariati A, Kusumastuti E & et al. Comparison of Breast Cancer 3-years Survival Rate Based on the Pathological Stages. Journal of Aesculap Medical Science. 2019; 8(1): 38-44.
10-Gimenez G, Gil-Lacruz AI, Gil-Lacruz M. Is Happiness Linked to Subjective Life Expectancy? A Study of Chilean Senior Citizens. Mathematics, 2021; 9: 1-12.
11-Sagna A, Kemp M, DiNitto D & et al. Impact of Suicide Mortality on Life Expectancy in the United States, Age and Sex Decomposition, in: Public Health, 2020; 179(1): 76 - 83.
12-Mohamadzade M, Jahandari P. The Relationship of Resilience and Emotional Regulation with Life Expectancy among Soldiers. Military Caring Sciences. 2019; 6 (3). 198-206.[Persian]
13-Amin F, Ostadebrahim H, Kamiab Z & et al. Correlation between health literacy and self-care behaviors in patients with COVID- 19. Journal of Health Literacy. 2022; 3(7): 82-90.
14-Wang Z¸Yin G, Jia R. Impacts of self-care education on adverse events and mental health related quality of life in breast cancer patients under chemotherapy. Complement Ther Med. 2019; 43: 165–169.
15-Abdollahi A, Alsaikhan F, Nikolenko D & et al. Self-care behaviors mediates the relationship between resilience and quality of life in breast cancer patients. BMC Psychiatry. 2022; 22: 1-6.
16-Hernandez Silv E, Lawler S & Langbecker D. The effectiveness of mHealth for self-management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review. J Cancer Surviv. 2019; 13(1), 97-107.
17-Davis LE, Bubis LD, Mahar AL & et al. Patient-reported symptoms after breast cancer diagnosis and treatment: A retrospective cohort study. Eur J Cancer. 2018; 101: 1-11.
18-Turdaliyeva B, Karibayeva I, Bagiyarova F & et al. Prevalence and Associated Factors of Depression Symptoms in Women Newly Diagnosed with Breast Cancer in Kazakhstan. Asian Pacific Journal of Cancer Preventio. 2021; 23: 2483- 2490.
19-Alshaya DS. Genetic and epigenetic factors associated with depression: An updated overview. Saudi Journal of Biological Sciences. 2022; 29: 1-11.
20-Wulandari P, Livana PH. Factors that Influence the Incidence of Depression in Breast Cancer Patients. Open Access Maced J Med Sci. 2022; 10(3): 393-399.
21-Christensen H, Marck D. The efficacy of mindfulness based stress reduction (MBSR) for decreasing anxiety and depression among breast cancer survivors. Sch Physician Assist Stud. 2017; 16:61- 73.
22-Mikhael VS, Hamady MM, Mohammed A & et al. Study of Depression, Quality of Life and Breast Cancer Benha Journal of Applied Sciences. 2021; 6(2): 95-100.
23-Liang Sh, Liu C, Rotaru K & et al. The relations between emotion regulation, depression and anxiety among medical staff during the late stage of COVID-19 pandemic: a network analysis, Psychiatry Research. 2022; 317: 1-7.
24-Hevani AN. The relationship between well-being and depression on a state and trait level: a experience sampling study. University of Twente. 2021.
25-Kim S. Son HG. Lee S & et al. Study on the Relationship between Depression Change Types and Suicide Ideation before and after COVID-19. Healthcare. 2022; 10, 1-9.
26-Rafiei M, Azizi Borujeni A, Seif Hosseini A & et al. Comparison of the effectiveness of dialectical behavior therapy, Fluvoxamine and their combination on depression in women with breast cancer. Adv Pharmacol Ther J. 2022; 1(2): 69-76.
27-Linehan, M.L. DBT skills training manual. Second Edition.Guilford Press. 2015.
28-Gottlieb AL, Klinger Ch, Sampaio D. Introduction to Dialectical Behavior Therapy for Psychiatrists and Psychiatry Residents. Advances in Psychiatry and Behavioral Health. 2022; 2, 241–251.
29-Rabiee N, Nazari A, Keramat A & et al. The Effectiveness of Dialectica Behavioral Therapy on the Success of Breast Feeding in Traumatic Childbirth: A Randomized Controlled Trial. Iran J Psychiatry. 2022; 17: 118-126.
30-Saito E, Tebbett-Mock A, McGee M. Dialectical Behavior Therapy Decreases Depressive Symptoms Among Adolescents in an Acute-Care Inpatient Unit. Journal of Child and Adolescent Psychopharmacology. 2020; 30(4), 1-14.
31-Barani H, Fooladchang M. The Efficacy of Teaching Dialectical Behavior Therapy Skills on Anxiety and Depression Symptoms in Students. Journal of Applied Psychological Research, 2022, 13(1), 287-304 .[Persian]
32-Esnaasharan S, Yazdkhasti F, Orayzi H. The Effect of Dialectical Behavior Therapy (DBT) on Emotional Regulation and Distress Tolerance of addicted women leaving: The mediating role of Mindfulness, Effective Communication and Emotional Cognitive Regulation Strategie. Knowledge & Research in Applied Psychology. 2021; 22(2): 1-12.[Persian]
33-Rahimi E, Maredpo A. The effect of dialectical behavior therapy on negative automatic thoughts, suicidal ideation and life expectancy in female students of Yasooj university of medical sciences. Int J Health Stud. 2021; 7(4):6-11.
34-Torbati A, Eshaghzadeh M, Imeni M & et al. The Effects of Educational Intervention ba- sed on Dialectical Behavior Therapy on Emotional Regulation and Self-control after Discharge in Pati- ents with COVID-19. Health Educ- ation and Health Promotion. 2022; 10(3): 525-530.
35-Tavakoli F, Kazemi-Zahrani H, Sadeghi M. The effectiveness of dialectica behavior therapy on adherence to treatment and self-caring behavior in patients with coronary heart disease. ARYA Atheroscler. 2019; 15(6): 281-7.
36-Miller JF, Powers MJ. Development of an instrument to measure hope. Nursing Research. 1988; 37(1):6-10.
37-Abdi N, Asady Lari M. Standardization of three Hope scale, as possible measures at the end of life. Iranian Journal of Cancer Prevention 2011;2:71-7.
38-Galiana L, Oliver A, Sansó N & Benito E. Validation of a new instrument for self-care in Spanish palliative care professionals nationwide. Spanish Journal of Psychology. 2015; 18(1), 1-15.
39-Raofi N. The effectiveness of compassion-based therapy on distress tolerance, self-care, empathy and compassion fatigue in mothers with children with cancer. [MD thesis], Isfahan Islamic Azad University. 2018.
40-Beck AT, Steer RA & Brown GK. Manual for the BDI-II. San Antonio: The Psychological Corporation. 1996.
41-Rahimi G. Application of Beck depression questionnaire in Iranian students. Clinical Psy. & Personality / Shahed University. 2014; 10: 1-16
42-Martinez R, Marraccini M, Knotek S & et al. Effects of-Dialectical Behaviora Therapy Skills Training for-Emotional Problem Solving for-Adolescents (DBT STEPS-A) Program of-Rural Ninth-Grade Students. School Mental Health. 2021; 9: 1-15.
43-Pouy S, Attari Peikani F, Nourmohammadi H & et al. Investigating the Effect of Mindfulness-Based Training on Psychological Status and Quality of Life in Patients with Breast Cancer. Asian Pac J Cancer Prev. 2018; 19(7):1993-1998.
44-Butler LD, Mercer KA, McClain-Meeder K & et al. Six domains of self-care: Attending to the whole person. Journal of human behavior in the social environment. 2019;29(1):107-24.
45-Mohamadiheris V, Shakerdolag AL, Khademi AL & et al. The effectiveness of emotion regulation training on chronic pain, resilience and self-care in patients with coronary artery occlusion. Nursing and Midwifery Journal 2021; 19 (8) :610-620.
46-Zheng M, Guo X, Chen Z & et al. Association between interpersona relations and anxiety, depression symptoms, and suicidal ideation among middle school students. Front. Public Health. 2023; 11: 1-14.
47-Mehlum L. Mechanisms of change in dialectical behaviour therapy for people with borderline personality disorder. Current Opinion in Psychology. 2021; 37: 1-5.
Nilofar Saeedi(M.A.)1, Hamid Atashpour(Ph.D.)2
1.Master's student in clinical psychology, Department of Psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
2.Corresponding Aouther:Associate Professor Department of Psychology, Department of Psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
Email:hamidatashpour@gmail.com Tel:09131068707
Abstract
Introduction: People with breast cancer face psychological challenges such as depression, reduced life expectancy and deficiencies self-care. The present study was conducted with the aim of investigating the effectiveness of dialectical behavior therapy on life expectancy, self-care and depression of cancer patients in Isfahan city.
Methods: The current research method was quantitative and of the type of semi-experimental studies with a pre-test-post-test design and a control group. The statistical population of the current study included people with breast cancer in Isfahan city who had referred to health centers in Isfahan city in 2024. In this study, 30 women with breast cancer who were diagnosed with this disease by a doctor were selected by convenience sampling method and were randomly assigned to two experimental and control groups. The people in the control and experimental groups completed life expectancy, self-care and depression questionnaires in two stages of pre-test and post-test. Multivariate covariance test and spss-24 software were used for data analysis.
Results: The results showed that dialectical behavior therapy significantly increased the mean life expectancy and self-care scores of participants in the experimental group in the post-test phase compared to the pre-test phase of the control group. On the other hand, in the experimental group, the mean depression score in the post-test phase was significantly lower than the pre-test phase compared to the control group (p<0/05).
Conclusion: From the findings of the present study, it can be concluded that psychologists and psychiatrists can use dialectical behavior therapy and its techniques to increase life expectancy, self-care and reduce depression in women with breast cancer.
Keywords: Dialectical Behavior Therapy, Depression, Life Expectancy, Self-Care, Cancer Patients
Conflict of interest: The authors declared no conflict of interest.
References
1-Barrios CH. Global challenges in breast cancer detection and treatment. The Breast 2022; 62: 1-6.
2-Houghton SC, Hankinson SE. Cancer progress and priorities: Breast cancer, cancer epidemiol. Biomark. Prev. 2021; 30: 822–844.
3-Basudan AM. Breast Cancer Incidence Patterns in the Saudi Female Population: A 17-Year Retrospective Analysis. Medicina. 2022; 58, 1-11.
4-Sung H, Ferlay J, Siegel RL & et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J. Clin. 2021; 71, 209–249.
5-Soqia J, Al-shafie M, Yakoub L & et al. Depression, anxiety and related factors among Syrian breast cancer patients: a cross-sectional study. BMC Psychiatry. 2022; 22: 1-7.
6-Chin CH, Tseng LM, Chao TC & et al. Self-care as a mediator between symptom-management self-efficacy and quality of life in women with breastcancer. PLoS ONE. 2021; 16(2):1-10.
7-Brokaar EJ, van den Bos F, Visser LE & et al. Deprescribing in Older Adults With Cancer and Limited Life Expectancy: An Integrative Review. American Journal of Hospice and Palliative Medicine. 2022;39(1):86-100.
8-Colonio C, Lecman L, Pinto J & et al. Life expectancy and cancer survival in Oncosalud: outcomes over a 15-year period in a Peruvian private institution. ecancer, 2021; 15, 1-15.
9-Mursyidah NI, Ashariati A, Kusumastuti E & et al. Comparison of Breast Cancer 3-years Survival Rate Based on the Pathological Stages. Journal of Aesculap Medical Science. 2019; 8(1): 38-44.
10-Gimenez G, Gil-Lacruz AI, Gil-Lacruz M. Is Happiness Linked to Subjective Life Expectancy? A Study of Chilean Senior Citizens. Mathematics, 2021; 9: 1-12.
11-Sagna A, Kemp M, DiNitto D & et al. Impact of Suicide Mortality on Life Expectancy in the United States, Age and Sex Decomposition, in: Public Health, 2020; 179(1): 76 - 83.
12-Mohamadzade M, Jahandari P. The Relationship of Resilience and Emotional Regulation with Life Expectancy among Soldiers. Military Caring Sciences. 2019; 6 (3). 198-206.[Persian]
13-Amin F, Ostadebrahim H, Kamiab Z & et al. Correlation between health literacy and self-care behaviors in patients with COVID- 19. Journal of Health Literacy. 2022; 3(7): 82-90.
14-Wang Z¸Yin G, Jia R. Impacts of self-care education on adverse events and mental health related quality of life in breast cancer patients under chemotherapy. Complement Ther Med. 2019; 43: 165–169.
15-Abdollahi A, Alsaikhan F, Nikolenko D & et al. Self-care behaviors mediates the relationship between resilience and quality of life in breast cancer patients. BMC Psychiatry. 2022; 22: 1-6.
16-Hernandez Silv E, Lawler S & Langbecker D. The effectiveness of mHealth for self-management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review. J Cancer Surviv. 2019; 13(1), 97-107.
17-Davis LE, Bubis LD, Mahar AL & et al. Patient-reported symptoms after breast cancer diagnosis and treatment: A retrospective cohort study. Eur J Cancer. 2018; 101: 1-11.
18-Turdaliyeva B, Karibayeva I, Bagiyarova F & et al. Prevalence and Associated Factors of Depression Symptoms in Women Newly Diagnosed with Breast Cancer in Kazakhstan. Asian Pacific Journal of Cancer Preventio. 2021; 23: 2483- 2490.
19-Alshaya DS. Genetic and epigenetic factors associated with depression: An updated overview. Saudi Journal of Biological Sciences. 2022; 29: 1-11.
20-Wulandari P, Livana PH. Factors that Influence the Incidence of Depression in Breast Cancer Patients. Open Access Maced J Med Sci. 2022; 10(3): 393-399.
21-Christensen H, Marck D. The efficacy of mindfulness based stress reduction (MBSR) for decreasing anxiety and depression among breast cancer survivors. Sch Physician Assist Stud. 2017; 16:61- 73.
22-Mikhael VS, Hamady MM, Mohammed A & et al. Study of Depression, Quality of Life and Breast Cancer Benha Journal of Applied Sciences. 2021; 6(2): 95-100.
23-Liang Sh, Liu C, Rotaru K & et al. The relations between emotion regulation, depression and anxiety among medical staff during the late stage of COVID-19 pandemic: a network analysis, Psychiatry Research. 2022; 317: 1-7.
24-Hevani AN. The relationship between well-being and depression on a state and trait level: a experience sampling study. University of Twente. 2021.
25-Kim S. Son HG. Lee S & et al. Study on the Relationship between Depression Change Types and Suicide Ideation before and after COVID-19. Healthcare. 2022; 10, 1-9.
26-Rafiei M, Azizi Borujeni A, Seif Hosseini A & et al. Comparison of the effectiveness of dialectical behavior therapy, Fluvoxamine and their combination on depression in women with breast cancer. Adv Pharmacol Ther J. 2022; 1(2): 69-76.
27-Linehan, M.L. DBT skills training manual. Second Edition.Guilford Press. 2015.
28-Gottlieb AL, Klinger Ch, Sampaio D. Introduction to Dialectical Behavior Therapy for Psychiatrists and Psychiatry Residents. Advances in Psychiatry and Behavioral Health. 2022; 2, 241–251.
29-Rabiee N, Nazari A, Keramat A & et al. The Effectiveness of Dialectica Behavioral Therapy on the Success of Breast Feeding in Traumatic Childbirth: A Randomized Controlled Trial. Iran J Psychiatry. 2022; 17: 118-126.
30-Saito E, Tebbett-Mock A, McGee M. Dialectical Behavior Therapy Decreases Depressive Symptoms Among Adolescents in an Acute-Care Inpatient Unit. Journal of Child and Adolescent Psychopharmacology. 2020; 30(4), 1-14.
31-Barani H, Fooladchang M. The Efficacy of Teaching Dialectical Behavior Therapy Skills on Anxiety and Depression Symptoms in Students. Journal of Applied Psychological Research, 2022, 13(1), 287-304 .[Persian]
32-Esnaasharan S, Yazdkhasti F, Orayzi H. The Effect of Dialectical Behavior Therapy (DBT) on Emotional Regulation and Distress Tolerance of addicted women leaving: The mediating role of Mindfulness, Effective Communication and Emotional Cognitive Regulation Strategie. Knowledge & Research in Applied Psychology. 2021; 22(2): 1-12.[Persian]
33-Rahimi E, Maredpo A. The effect of dialectical behavior therapy on negative automatic thoughts, suicidal ideation and life expectancy in female students of Yasooj university of medical sciences. Int J Health Stud. 2021; 7(4):6-11.
34-Torbati A, Eshaghzadeh M, Imeni M & et al. The Effects of Educational Intervention ba- sed on Dialectical Behavior Therapy on Emotional Regulation and Self-control after Discharge in Pati- ents with COVID-19. Health Educ- ation and Health Promotion. 2022; 10(3): 525-530.
35-Tavakoli F, Kazemi-Zahrani H, Sadeghi M. The effectiveness of dialectica behavior therapy on adherence to treatment and self-caring behavior in patients with coronary heart disease. ARYA Atheroscler. 2019; 15(6): 281-7.
36-Miller JF, Powers MJ. Development of an instrument to measure hope. Nursing Research. 1988; 37(1):6-10.
37-Abdi N, Asady Lari M. Standardization of three Hope scale, as possible measures at the end of life. Iranian Journal of Cancer Prevention 2011;2:71-7.
38-Galiana L, Oliver A, Sansó N & Benito E. Validation of a new instrument for self-care in Spanish palliative care professionals nationwide. Spanish Journal of Psychology. 2015; 18(1), 1-15.
39-Raofi N. The effectiveness of compassion-based therapy on distress tolerance, self-care, empathy and compassion fatigue in mothers with children with cancer. [MD thesis], Isfahan Islamic Azad University. 2018.
40-Beck AT, Steer RA & Brown GK. Manual for the BDI-II. San Antonio: The Psychological Corporation. 1996.
41-Rahimi G. Application of Beck depression questionnaire in Iranian students. Clinical Psy. & Personality / Shahed University. 2014; 10: 1-16
42-Martinez R, Marraccini M, Knotek S & et al. Effects of-Dialectical Behaviora Therapy Skills Training for-Emotional Problem Solving for-Adolescents (DBT STEPS-A) Program of-Rural Ninth-Grade Students. School Mental Health. 2021; 9: 1-15.
43-Pouy S, Attari Peikani F, Nourmohammadi H & et al. Investigating the Effect of Mindfulness-Based Training on Psychological Status and Quality of Life in Patients with Breast Cancer. Asian Pac J Cancer Prev. 2018; 19(7):1993-1998.
44-Butler LD, Mercer KA, McClain-Meeder K & et al. Six domains of self-care: Attending to the whole person. Journal of human behavior in the social environment. 2019;29(1):107-24.
45-Mohamadiheris V, Shakerdolag AL, Khademi AL & et al. The effectiveness of emotion regulation training on chronic pain, resilience and self-care in patients with coronary artery occlusion. Nursing and Midwifery Journal 2021; 19 (8) :610-620.
46-Zheng M, Guo X, Chen Z & et al. Association between interpersona relations and anxiety, depression symptoms, and suicidal ideation among middle school students. Front. Public Health. 2023; 11: 1-14.
47-Mehlum L. Mechanisms of change in dialectical behaviour therapy for people with borderline personality disorder. Current Opinion in Psychology. 2021; 37: 1-5.
Type of Study: Research |
Subject:
Psychology
Received: 2025/01/8 | Accepted: 2025/03/12 | Published: 2025/05/19
Received: 2025/01/8 | Accepted: 2025/03/12 | Published: 2025/05/19
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