Journal of Patient Safety & Quality Improvement

Journal of Patient Safety & Quality Improvement

Comparing the Effectiveness of Spiritual Therapy and Religious Coping Strategies Training on Anxiety and Depression in Women with Breast Cancer

Document Type : Original Article

Authors
Mona Mobayyeni 1
Neda Fatahi 2
Seyedeh Mansoureh Zekri 3
Ebrahim Abdoli 4
Mahbubeh pourjafari 5
1 Department of counseling, Islamic Azad University, Tehran west Branch, Tehran, Iran.
2 Department of Psychology, Islamic Azad University, Kermanshah Branch, Kermanshah. Iran
3 Department of Psychology, Islamic Azad University, Arak Branch, Iran.
4 Department of Psychology, Islamic Azad University, Boushehr Branch, Boushehr. Iran.
5 Department of Health Governance, Faculty of Governance, University of Tehran, Tehran, Iran.
10.22038/psj.2025.87719.1469
Abstract
Introduction:
Cancer disease and issues related to its treatment have been introduced as the most important stressors in breast cancer patients, which can cause psychological disorders in these patients. The purpose of this research was to compare the effectiveness of spiritual therapy and teaching religious coping strategies to reduce symptoms of anxiety and depression in women with breast cancer.
 
 Materials and Methods:
The current research was semi-experimental based on pre-test-post-test and follow-up (3 months later) design with control group. The statistical population comprised women diagnosed with breast cancer who attended Khatam Al-Anbia Cancer Hospital in Tehran from July to October 2023. A total of 45 patients were selected from this population using purposive sampling. The participants in the spiritual therapy experimental group participated in eight sessions of one 60-minute session per week, and the participants in the religious confrontation training group participated in ten sessions of one 60-90-minute session per week. Research tools included Beck Depression Inventory (BDI-II) and Zang Anxiety Inventory (SAS). The obtained data were statistically analyzed using covariance analysis with repeated measurements in SPSS version 27 software.
Results:
The results of this study indicated that there was no significant difference in depression scores between the spiritual therapy and religious coping groups (p = 1.000). However, both the spiritual therapy and religious coping groups showed significant improvements in depression compared to the control group (p < 0.01). Additionally, there was a significant difference in anxiety scores between the religious coping and spiritual therapy groups during the follow-up phase, as well as between these groups and the control group at follow-up (p < 0.001). Conversely, no significant difference was observed in anxiety levels between the spiritual therapy and religious coping groups (p > 0.05).
Conclusion:
The results of this study indicated the effectiveness of spiritual therapy and religious coping strategies in reducing anxiety and depression symptoms in women with breast cancer. By improving effective coping mechanisms in people, spirituality-based interventions can help patients to face and deal with anxiety and depression caused by the disease and its consequences in a positive and effective way.
Keywords
Spiritual therapy
Religious coping methods
Anxiety
Depression
Breast cancer
Subjects
  1. Valizadeh Otaghsara SM, Ghorbanzadeh V, Esmaeil Lashgarian H, Hashemzadeh H. Molecular insight in breast cancer metastasis. Yafeh. 2020;22(2).
  2. Aghili M, Asghari A, Yaftian S, Namazi M. The effectiveness of meaning therapy on pain and life expectancy among women with breast cancer. Journal of Islamic Psychology. 2023 Jan 21; 8(17): 95-110.
  3. Wang X, Wang N, Zhong L, Wang S, Zheng Y, Yang B, Zhang J, Lin Y, Wang Z. Prognostic value of depression and anxiety on breast cancer recurrence and mortality: a systematic review and meta-analysis of 282,203 patients. Molecular psychiatry. 2020 Dec;25(12):3186-97.
  4. Muzzatti B, Bomben F, Flaiban C, Piccinin M, Annunziata MA. Quality of life and psychological distress during cancer: a prospective observational study involving young breast cancer female patients. BMC cancer. 2020 Aug 13; 20(1):758.
  5. Fervaha G, Izard JP, Tripp DA, Rajan S, Leong DP, Siemens DR. Depression and prostate cancer: A focused review for the clinician. InUrologic Oncology: Seminars and Original Investigations 2019 37(4): 282-288.
  6. Pasyar S, Baghooli H, Barzegar M, Sohrabi N. Comparing the effectiveness of acceptance and commitment therapy and mindfulness-based stress reduction program on negative feedback, health anxiety, psychological well-being, and body image in women undergoing mastectomy. Psychological Achievements. 2023 Mar 21; 30(1): 285-314.
  7. Ahmadi SA, Vaziri S, Ahi G, Akbari ME. Comparison of acceptance and commitment therapy and spiritual therapy in reducing fear of relapse among patients with breast cancer. Journal of Community Health. 2021 Jan 1;8: 413-26.
  8. Alagizy HA, Soltan MR, Soliman SS, Hegazy NN, Gohar SF. Anxiety, depression and perceived stress among breast cancer patients: single institute experience. Middle East Current Psychiatry. 2020 Dec; 27:1-0.
  9. Esfahani A, Zeinali S, Kiani R. Effect of acceptance and commitment therapy on pain-related anxiety and cognitive emotion regulation in breast cancer patients: A clinical trail. Journal of Arak University of Medical Sciences. 2020 May 10;23(2):138-49.
  10. Shahbeik S, Moazedian A, Sabahi P, Otaghsara AK. A Structural Model of Depression Based on Early Maladaptive Schemas, Resilience and Perceived Social Support with the Mediating Role of Self-Compassion and Hope in men and women with cancer. Applied Family Therapy Journal (AFTJ). 2022 Dec 1;3(4):284-308.
  11. Aligohari B, Abolmaali H Kh, Dortaj F, Jamhari F. The Effectiveness of Spiritual Therapy and Religious Coping Strategies Instruction on Reducing the Symptoms of Secondary PTSD Among Veterans' Children with PTSD. IRANIAN JOURNAL OF ISLAMIC STUDIES IN HEALTH 2022;6(2):53-66.
  12. Pourmohseni Koluri F, Shojaee A, Jafari I, Mowlaie M. Comparison of personality profiles, tolerance for ambiguity and religious coping in leukemia patients and healthy people. Health Psychology. 2020 Apr 20;9(33):45-60.
  13. Rastkhane F, Amirpour B. Comparison of dimensions of Islamic faith and forgiveness in marital relationship based on religious coping styles of women in Qom city. Journal of Islamic Psychology. 2022 Jul 23;8(16):146-33.
  14. Tabatabaei T, Ghobadi Z, Birjand I. The Role of Optimism and Religious Coping in Predicting Nurses' Burnout. J Islam Life Style Centeredon Health. 2023;7(3):58-64.
  15. Einy S, Hashemi Z. The role of religious coping, spiritual intelligence, and spiritual well-being in predicting the perceived stress of patients with cancer. Shefaye Khatam. 2020 Jun 10; 8(3): 70-9.
  16. Gall TL, Bilodeau C. The role of positive and negative religious/spiritual coping in women’s adjustment to breast cancer: A longitudinal study. Journal of Psychosocial Oncology. 2020 Jan 2;38(1):103-17.
  17. Esmaeili R, Mohammadi M, Madadi M, Fani M. Correlation of religious coping strategy with quality of life of the elderly with colorectal cancer referred to colorectal clinics of Shahid Beheshti University of Medical Sciences. Advances in Nursing & Midwifery. 2022;31(1):22-8.10. 22037. jnm. v31i1.38233
  18. Heydarzadeh M, Ghahramanzadeh M. A survey on posttraumatic growth on the basis of demoralization syndrome and religious coping among cancer patients referring to Reza radiotherapy and oncology center in Mashhad in 2018: A descriptive study. Journal of Rafsanjan University of Medical Sciences. 2019 Aug 10; 18(6): 557-72.
  19. Haddadi Kuhsar AA, Moradi A, Ghobari Bonab B, Imani F. Comparing the effectiveness of spiritual therapy based on Iranian culture with mindfulness based on reduction stress (MBSR) in reducing depression, anxiety and stress in patients with chronic pain. Clinical Psychology Studies. 2018 Jul 23;8(31):1-30.
  20. Ghorbani A, Ghezelbash S, Alizadeh Mirashrafi H, Khosravi M. Effect of spiritual group therapy on depression, anxiety and stress of the mothers of children with cancer. Complementary Medicine Journal. 2021 Dec 10;11(3):196-209.
  21. Bakhshi A, Normiq KN, Hossein Zahi H, Zare Tajabadi M. The Effectiveness of Spiritual therapy on psychological Hardiness and psychological Distress of Students. Islamic Lifestyle Centered on Health. 2023 Jan 1;7(2): 359-66.
  22. Fardi D, Lotfi Kashani F. Spiritual therapy and breast cancer: a scoping review of the Persian biomedical literature. Payesh (Health Monitor). 2023 Aug 15;22(4):423-32.
  23. Moin ZZ, Abolmaali Alhoseini K, Seirafi MR. A comparison of effectiveness of spiritual therapy and acceptance and commitment therapy (ACT) on reducing existential anxiety in women with breast Cancer. Counseling Culture and Psycotherapy. 2023 Dec 22;14(56):39-66.
  24. Sajadian A, Zahrakar K, Asadpour E. Effectiveness of transpersonal therapy (Spiritual Therapy, Yoga-Meditation) in reducing fear of cancer recurrence in breast cancer survivors: A randomized controlled trial. Iranian Quarterly Journal of Breast Disease. 2021 Aug 10;14(2): 50-63.
  25. Jamshidifar Z, Lotfi Kashani F. Comparison of the effectiveness of spiritual therapy and cognitive-behavior therapy on lowering blood cortisol levels in women with breast cancer. Thoughts and Behavior in Clinical Psychology. 2020 Mar 20;15(55):37-46
  26. Mato S, Saffarinia M, Alipour A. The Effect of Spiritual Therapy on the Fear of Illness Recurrence and Illness Perception of Women with Breast Cancer. MEDICAL ETHICS[Internet]. 2022; 16(47):00-00.
  27. Mohamad KM, SHariatnia K. Effectiveness of spiritual therapy on the life quality of the women with breast cancer in Tehran. Nursing and Midwifery Journal 2017; 15 (2) :107-118
  28. Ghaffari A. The effectiveness of group training coping strategies based on islamic teachings on happiness and life satisfaction of parents of children with learning disabilities. Journal of Learning Disabilities. 2020 Apr 20; 9(3):128-53.
  29. Beck AT, Steer RA, Brown G. Beck depression inventory–II. Psychological assessment. 1996 Jan 1.
  30. Hamidi R, Fekrizadeh Z, Azadbakht M, Garmaroudi G, Taheri Tanjani P, Fathizadeh S, Ghisvandi E. Validity and reliability Beck Depression Inventory-II among the Iranian elderly population. Journal of Sabzevar University of Medical Sciences. 2015 Apr 25;22(1):189-98.
  31. Zung WW. Self-rating anxiety scale. BMC Psychiatry. 1971.

 

 

 

 

 

 

 

 

  1. Hajiarbabi F, Shahhosseini Tazik S, Saffarian Toosi M. The Effectiveness of Film Therapy (Inside-Out Film) on Separation Anxiety of Children Referred to Mashhad Counseling Centers: A Case Report. Pars Journal of Medical Sciences. 2022 Dec 25;18(2):41-8.
  2. Barghi Irani Z, Dehghan Saber L. The comparison of the effectiveness of mindfulness based therapy and spiritual therapy on irrational beliefs and anxiety in the older women. Aging Psychology. 2021 Jan 20;6(4):339-21.
  3. Ahmadinasab M, Malihialzackerini S, Mohaghegh F, Sodagar S, Sabet M. THE effectiveness of meaning-based existential therapy on anxiety and serum levels of tumor necrosis factor TNFα in women with breast cancer. Iranian Journal of Breast Diseases. 2022 Apr 10;15(1):87-102.
  4. Vaziri S, Lotfi Kashani F, Akbari ME. Application of Spiritual Intervention Protocol in Women with Breast Cancer: A Brief Report. Thoughts and Behavior in Clinical Psychology. 2020 Dec 21;15(58):77-88.
  5. Moharer GS, Raisi M, Moghaddam FS. Relationship between religious coping styles and quality of life in HIV-positive patients. JRH 2018; 5 (2) :58-67
  6. Hajizad R, Abdollahzadeh H, Gholami M. The impact of training spiritual/religious coping skills on level of anxiety and stress coping strategies of patients with type II diabetes to provide nursing and caring strategies. Journal of Diabetes Nursing. 2016 Dec 10;4(4):72-83.
  7. Sharif SP, Lehto RH, Nia HS, Goudarzian AH, Haghdoost AA, Yaghoobzadeh A, Tahmasbi B, Nazari R. Religious coping and death depression in Iranian patients with cancer: Relationships to disease stage. Supportive Care in Cancer. 2018 Aug; 26:2571-9.
  8. Hajibabaei M, Kajbaf M, Esmaeili M, Harirchian MH, Montazeri A. Explanation of psychological problems and coping behaviors among women with multiple sclerosis: A qualitative study. Health Psychology. 2020 Nov 21;9(35):7-24.
  9. Mahmoodi M. The effect of spiritual therapy on the life style of hemodialysis patients. Military Caring Sciences. 2021 Nov 10;8(2):193-201.
Journal of Patient Safety & Quality Improvement
Volume 13, Issue 2
Spring 2025
Pages 101-111