Volume 24, Issue 3 (12-2025)
TB 2025, 24(3): 47-62 |
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Mohamad Reza Khodabakhsh M R K. Improving Quality of Life and Stress Management in Cancer Patients and Survivors: The Role of Cognitive Behavioral Therapy. TB 2025; 24 (3) :47-62
URL: http://tbj.ssu.ac.ir/article-1-3772-en.html
URL: http://tbj.ssu.ac.ir/article-1-3772-en.html
Department of psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran , khodabakhsh@ut.ac.ir
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Improving Quality of Life and Stress Management in Cancer Patients and Survivors: The Role of Cognitive Behavioral Therapy
Mohammadreza khodabakhsh(Ph.D.)1
1.Corresponding Aouther: Assistant Professor, Department of Psychology, Ne, C., Neyshabur Branch, Islamic Azad University, Neyshabur, Iran. Email:Khodabakhsh@iau.ac.ir Tel:09365861050
Abstract
Introduction: Psychosocial cancer care can alleviate pain, and improve function and overall quality of life at every stage of survival. This study aimed to investigate the effectiveness of cognitive behavioral therapy on quality of life and symptoms of post-traumatic stress in cancer patients and survivors
Methods: The present study was a quasi-experimental study of pre-test, post-test with control group and follow-up. The statistical population included patients and survivors of cancer who had visited Neyshabur hospitals from December 2023 to October 2024. 30 people were selected using the available sampling method and were matched in the experimental and control groups. The subjects of the two groups completed the World Health Organization Quality of Life (WHO-QOL-BREF) and Post-Traumatic Stress Disorder questionnaires in three stages. Statistical data were evaluated with SPSS version 26 software and analysis of variance with two-way repeated measures.
Results: The results of the study showed that cognitive behavioral therapy had a significant effect (p<0/05) on the quality of life and symptoms of posttraumatic stress in patients with and recovered from cancer, and the level of posttraumatic stress symptoms in the intervention group decreased compared to the control group, and the quality of life increased, and this result was repeated in the two-month follow-up.
Conclusion: The results showed that cognitive behavioral therapy can be an important step in reducing symptoms of posttraumatic stress in people with or recovering from cancer and improves their quality of life. Therefore, the use of this therapeutic intervention is recommended.
Keywords: Cognitive Behavioral Therapy, Quality of Life, Posttraumatic Stress, Cancer.
Conflict of interest: The authors declared no conflict of interest.
References
1-Pradhan P, Sharman AR, Palme CE & et al. Survivorship Needs in Patients with Head and Neck Cancer in Regional, Rural and Remote Areas: A Systematic Review. Psycho‐Oncology. 2024;33(9): e9311.
2-Ghiasi M, Nikbakht HA, Tajik A & et al. Economic burden and quality of life caused by non-hodgkin lymphoma cancer in Iran. Journal of Health, Population and Nutrition. 2025; 44(1): 280.
3-López-Salas M, Yanes-Roldán A, Fernández A & et al. End-of-life care needs in cancer patients: a qualitative study of patient and family experiences. BMC palliative care. 2024; 23(1): 157.
4-Roshandel G, Ferlay J, Ghanbari‐Motlagh A & et al. Cancer in Iran 2008 to 2025: recent incidence trends and short‐term predictions of the future burden. International journal of cancer. 2021;149(3): 594-605.
5-National Cancer Institute. Cancer Treatment and Survivorship Statistics [Internet]. 2023. Available from: https://www.cancer.gov
6-Leske M, Galanis C, Koczwara B. A meta-analysis of healthy lifestyle interventions addressing quality of life of cancer survivors in the post treatment phase. Journal of Cancer Survivorship. 2025; 19(3): 940-956.
7-Joshy G, Thandrayen J, Koczwara B & et al. Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer. BMC medicine. 2020; 18(1): 372.
8-Lavretsky H, Jeste DV, Eyre HA. The economic burden of poor quality of life in cancer survivorship: a national cost analysis in the United States. Health Econ Rev. 2022;12(1):45.
9-Soong RY, Low CE, Ong V & et al. Exercise interventions for depression, anxiety, and quality of life in older adults with cancer: A systematic review and meta-analysis. JAMA network open. 2025; 8(2): e2457859-e2457859.
10-Smith JR. Prevalence and predictors of PTSD symptoms in breast cancer survivors. JAMA Oncol. 2022; 8(4):567-74.
11-Alaloul F, Polivka B, Warraich SJ. Experiences of Muslim Cancer Survivors Living in the United States. In Oncology Nursing Forum. 2021; 48(5).
12-Capaldi JM, Shabanian J, Finster LB. Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions. Health psychology review. 2024; 18(1): 41-74.
13-Ennis N, Sijercic I, Monson CM. Trauma-focused cognitive-behavioral therapies for posttraumatic stress disorder under ongoing threat: A systematic review. Clinical Psychology Review. 2021; 88: 102049.
14-Blumenstein KG, Brose A, Kemp C & et al, A. Effectiveness of cognitive behavioral therapy in improving functional health in cancer survivors: A systematic review and meta-analysis. Critical reviews in oncology/hematology. 2022; 175: 103709.
15-Habibi Kilak A, Khodabakhsh M & Bagherzadeh Golmakani Z. Comparing the efficacy of cognitive behavioral therapy and emotional focused therapy on psychological distress in caregivers of cancer patients. Journal of Psychological Science. 2025; 24(148): 245-265.
16-Sutanto YS, Ibrahim D, Septiawan D & et al. Effect of cognitive behavioral therapy on improving anxiety, depression, and quality of life in pre-diagnosed lung cancer patients. Asian Pacific journal of cancer prevention: APJCP. 2021; 22(11): 3455.
17-Fan M, Wei X. The Impact of Cognitive-Behavioral Intervention (CBI) on Enhancing Mental Health and Quality of Life in Lung Cancer Patients Undergoing Chemotherapy Nursing. Journal of Multidisciplinary Healthcare. 2025: 3299-3309.
18-Gui H, Chen X, Li L. Psychological distress influences lung cancer: advances and perspectives on the immune system and immunotherapy. International Immunopharmacology. 2023; 1(121):110251.
19-Johnson KE, Lee MJ. Cognitive behavioral therapy for cancer-related trauma: a meta-analysis. J Clin Oncol. 2023;41(15):2800-10.
20-Brown RF. Limitations of (Cognitive Behavioral Therapy) in advanced cancer populations. Lancet Psychiatry. 2022; 9(7):543-51.
21-Dils AT, O'Keefe K, Dakka N & et al. The efficacy of cognitive behavioral therapy for mental health and quality of life among individuals diagnosed with cancer: A systematic review and meta‐analysis. Cancer medicine. 2024; 13(16): e70063.
22-Najafi S, Mohammadkhah F, Salemi SA. The impact of educational intervention based on the theory of planned behavior on preventive behaviors for gastric cancer in obese and smoking individuals. BMC cancer. 2025; 25(1): 129.
23-Fathi S, Poyamanesh J, Ghamari M & et al. Comparison of the effectiveness of an emotion-based therapy and a treatment based on acceptance and commitment on the quality of life of women with chronic headache. Feyz Medical Sciences Journal. 2020; 24(3): 302-311.
24- Razavi SM, Alizadeh KH, Amirfakhraei A. Psychometric Evaluation of the Persian Version of the Post-Traumatic Symptom Scale: Exploratory and Confirmatory Factor Analysis. IJ Psychiatry and Behavioral Sciences. 2024; 18(2).
25-Ilić I, Šipetić-Grujičić S, Grujičić J. Psychometric properties of the world health organization’s quality of life (WHOQOL-BREF) questionnaire in medical students. Medicina. 2019; 55(12): 772.
26-Rezaeipandari H, Morowatisharifabad MA, Mohammadpoorasl A. Cross-cultural adaptation and psychometric validation of the World Health Organization quality of life-old module (WHOQOL-OLD) for Persian-speaking populations. Health and quality of life outcomes. 2020; 18(1): 67.
27-Park JH, Kim SY, Lee YJ. Behavioral activation and avoidance reduction in cancer survivors: a randomized controlled trial. Psycho-Oncology. 2023;32(5):678-92.
28-Xia, S. Effect of cognitive behavioral stress management on anxiety, depression, and quality of life in colorectal cancer patients post tumor resection: a randomized, controlled study. Irish Journal of Medical Science. 2023; 192(4): 1637-1644.
29-Antoni MH, Moreno PI, Penedo FJ. Stress management interventions to facilitate psychological and physiological adaptation and optimal health outcomes in cancer patients and survivors. Annual review of psychology. 2023; 74(1): 423-455.
30-Wang L, Duan H, Zuo H & et al. Cognitive-behavioral stress management relieves anxiety, depression, and post-traumatic stress disorder in parents of pediatric acute myeloid leukemia patients: a randomized, controlled study. Hematology. 2024; 29(1): 2293498.
31-Williams RB. Neurobiological effects of (Cognitive behavioral Therapy). Nat Ment Health. 2023.
Mohammadreza khodabakhsh(Ph.D.)1
1.Corresponding Aouther: Assistant Professor, Department of Psychology, Ne, C., Neyshabur Branch, Islamic Azad University, Neyshabur, Iran. Email:Khodabakhsh@iau.ac.ir Tel:09365861050
Abstract
Introduction: Psychosocial cancer care can alleviate pain, and improve function and overall quality of life at every stage of survival. This study aimed to investigate the effectiveness of cognitive behavioral therapy on quality of life and symptoms of post-traumatic stress in cancer patients and survivors
Methods: The present study was a quasi-experimental study of pre-test, post-test with control group and follow-up. The statistical population included patients and survivors of cancer who had visited Neyshabur hospitals from December 2023 to October 2024. 30 people were selected using the available sampling method and were matched in the experimental and control groups. The subjects of the two groups completed the World Health Organization Quality of Life (WHO-QOL-BREF) and Post-Traumatic Stress Disorder questionnaires in three stages. Statistical data were evaluated with SPSS version 26 software and analysis of variance with two-way repeated measures.
Results: The results of the study showed that cognitive behavioral therapy had a significant effect (p<0/05) on the quality of life and symptoms of posttraumatic stress in patients with and recovered from cancer, and the level of posttraumatic stress symptoms in the intervention group decreased compared to the control group, and the quality of life increased, and this result was repeated in the two-month follow-up.
Conclusion: The results showed that cognitive behavioral therapy can be an important step in reducing symptoms of posttraumatic stress in people with or recovering from cancer and improves their quality of life. Therefore, the use of this therapeutic intervention is recommended.
Keywords: Cognitive Behavioral Therapy, Quality of Life, Posttraumatic Stress, Cancer.
Conflict of interest: The authors declared no conflict of interest.
References
1-Pradhan P, Sharman AR, Palme CE & et al. Survivorship Needs in Patients with Head and Neck Cancer in Regional, Rural and Remote Areas: A Systematic Review. Psycho‐Oncology. 2024;33(9): e9311.
2-Ghiasi M, Nikbakht HA, Tajik A & et al. Economic burden and quality of life caused by non-hodgkin lymphoma cancer in Iran. Journal of Health, Population and Nutrition. 2025; 44(1): 280.
3-López-Salas M, Yanes-Roldán A, Fernández A & et al. End-of-life care needs in cancer patients: a qualitative study of patient and family experiences. BMC palliative care. 2024; 23(1): 157.
4-Roshandel G, Ferlay J, Ghanbari‐Motlagh A & et al. Cancer in Iran 2008 to 2025: recent incidence trends and short‐term predictions of the future burden. International journal of cancer. 2021;149(3): 594-605.
5-National Cancer Institute. Cancer Treatment and Survivorship Statistics [Internet]. 2023. Available from: https://www.cancer.gov
6-Leske M, Galanis C, Koczwara B. A meta-analysis of healthy lifestyle interventions addressing quality of life of cancer survivors in the post treatment phase. Journal of Cancer Survivorship. 2025; 19(3): 940-956.
7-Joshy G, Thandrayen J, Koczwara B & et al. Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer. BMC medicine. 2020; 18(1): 372.
8-Lavretsky H, Jeste DV, Eyre HA. The economic burden of poor quality of life in cancer survivorship: a national cost analysis in the United States. Health Econ Rev. 2022;12(1):45.
9-Soong RY, Low CE, Ong V & et al. Exercise interventions for depression, anxiety, and quality of life in older adults with cancer: A systematic review and meta-analysis. JAMA network open. 2025; 8(2): e2457859-e2457859.
10-Smith JR. Prevalence and predictors of PTSD symptoms in breast cancer survivors. JAMA Oncol. 2022; 8(4):567-74.
11-Alaloul F, Polivka B, Warraich SJ. Experiences of Muslim Cancer Survivors Living in the United States. In Oncology Nursing Forum. 2021; 48(5).
12-Capaldi JM, Shabanian J, Finster LB. Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions. Health psychology review. 2024; 18(1): 41-74.
13-Ennis N, Sijercic I, Monson CM. Trauma-focused cognitive-behavioral therapies for posttraumatic stress disorder under ongoing threat: A systematic review. Clinical Psychology Review. 2021; 88: 102049.
14-Blumenstein KG, Brose A, Kemp C & et al, A. Effectiveness of cognitive behavioral therapy in improving functional health in cancer survivors: A systematic review and meta-analysis. Critical reviews in oncology/hematology. 2022; 175: 103709.
15-Habibi Kilak A, Khodabakhsh M & Bagherzadeh Golmakani Z. Comparing the efficacy of cognitive behavioral therapy and emotional focused therapy on psychological distress in caregivers of cancer patients. Journal of Psychological Science. 2025; 24(148): 245-265.
16-Sutanto YS, Ibrahim D, Septiawan D & et al. Effect of cognitive behavioral therapy on improving anxiety, depression, and quality of life in pre-diagnosed lung cancer patients. Asian Pacific journal of cancer prevention: APJCP. 2021; 22(11): 3455.
17-Fan M, Wei X. The Impact of Cognitive-Behavioral Intervention (CBI) on Enhancing Mental Health and Quality of Life in Lung Cancer Patients Undergoing Chemotherapy Nursing. Journal of Multidisciplinary Healthcare. 2025: 3299-3309.
18-Gui H, Chen X, Li L. Psychological distress influences lung cancer: advances and perspectives on the immune system and immunotherapy. International Immunopharmacology. 2023; 1(121):110251.
19-Johnson KE, Lee MJ. Cognitive behavioral therapy for cancer-related trauma: a meta-analysis. J Clin Oncol. 2023;41(15):2800-10.
20-Brown RF. Limitations of (Cognitive Behavioral Therapy) in advanced cancer populations. Lancet Psychiatry. 2022; 9(7):543-51.
21-Dils AT, O'Keefe K, Dakka N & et al. The efficacy of cognitive behavioral therapy for mental health and quality of life among individuals diagnosed with cancer: A systematic review and meta‐analysis. Cancer medicine. 2024; 13(16): e70063.
22-Najafi S, Mohammadkhah F, Salemi SA. The impact of educational intervention based on the theory of planned behavior on preventive behaviors for gastric cancer in obese and smoking individuals. BMC cancer. 2025; 25(1): 129.
23-Fathi S, Poyamanesh J, Ghamari M & et al. Comparison of the effectiveness of an emotion-based therapy and a treatment based on acceptance and commitment on the quality of life of women with chronic headache. Feyz Medical Sciences Journal. 2020; 24(3): 302-311.
24- Razavi SM, Alizadeh KH, Amirfakhraei A. Psychometric Evaluation of the Persian Version of the Post-Traumatic Symptom Scale: Exploratory and Confirmatory Factor Analysis. IJ Psychiatry and Behavioral Sciences. 2024; 18(2).
25-Ilić I, Šipetić-Grujičić S, Grujičić J. Psychometric properties of the world health organization’s quality of life (WHOQOL-BREF) questionnaire in medical students. Medicina. 2019; 55(12): 772.
26-Rezaeipandari H, Morowatisharifabad MA, Mohammadpoorasl A. Cross-cultural adaptation and psychometric validation of the World Health Organization quality of life-old module (WHOQOL-OLD) for Persian-speaking populations. Health and quality of life outcomes. 2020; 18(1): 67.
27-Park JH, Kim SY, Lee YJ. Behavioral activation and avoidance reduction in cancer survivors: a randomized controlled trial. Psycho-Oncology. 2023;32(5):678-92.
28-Xia, S. Effect of cognitive behavioral stress management on anxiety, depression, and quality of life in colorectal cancer patients post tumor resection: a randomized, controlled study. Irish Journal of Medical Science. 2023; 192(4): 1637-1644.
29-Antoni MH, Moreno PI, Penedo FJ. Stress management interventions to facilitate psychological and physiological adaptation and optimal health outcomes in cancer patients and survivors. Annual review of psychology. 2023; 74(1): 423-455.
30-Wang L, Duan H, Zuo H & et al. Cognitive-behavioral stress management relieves anxiety, depression, and post-traumatic stress disorder in parents of pediatric acute myeloid leukemia patients: a randomized, controlled study. Hematology. 2024; 29(1): 2293498.
31-Williams RB. Neurobiological effects of (Cognitive behavioral Therapy). Nat Ment Health. 2023.
Type of Study: Applicable |
Subject:
Psychology
Received: 2025/05/19 | Accepted: 2025/08/12 | Published: 2025/09/22
Received: 2025/05/19 | Accepted: 2025/08/12 | Published: 2025/09/22
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