Group positive psychotherapy was found to be effective in reducing depression and increasing happiness in breast cancer patients based on a randomized controlled trial. 42 breast cancer patients were randomly assigned to a positive psychotherapy group or control group. The positive psychotherapy group received 10 weekly 1.5 hour group sessions, while the control group only received usual care. Depression was measured using the Beck Depression Inventory and happiness was measured using the Oxford Happiness Inventory before and after the intervention. The results showed that the positive psychotherapy group had a significant reduction in depression and a significant increase in happiness compared to the control group. Positive psychotherapy is a promising low-cost intervention that can improve psychological health in breast cancer patients.
Rethinking, rebuilding psychosocial care for cancer patientsJames Coyne
Presented as the 8th Trevor Anderson Psycho-Oncology Lecture, September 8, 2014, Melbourne, Australia.
Discusses how psychosocial care for cancer patients needs to be reorganized so that a broader range of cancer patients are served. Routine screening for distress is unlikely to be an efficient means of countering tendencies of cancer care more generally becoming more organized around time efficiency and billable procedures. Psychosocial care for many cancer patients involves discussions, negotiations, and care coordination they cannot be well fit into the idea of a counseling session. The unsung heroes of providing such care are underappreciated social workers and oncology nurses.
Anna Ratzliff, MD, PhD, Associate Director for Education, Division of Integrated Care & Public Health Department of Psychiatry & Behavioral Sciences, University of Washington
Latino Health Forum 2014
Penny George™ Institute for Health and Healing: Meeting Patients Where They AreAllina Health
By Courtney Baechler, MD. A discussion about the Penny George Institute and its goal to empower patients using the mind-body-spirit approach to health, encouraging a philosophy of wellness at any stage of care. The Penny George Institute has become a national leader in holistic health care and is an important component of Allina Health efforts to achieve health care transformation through the Triple Aim.
Self-management support return on investment webinar, Wednesday 7 January.
Led by Renata Drinkwater, CEO Self-Management UK and Beverley Matthews, LTC Programme Lead, NHS Improving Quality.
A thorough research was conducted among the individuals to understand the perspective of individuals towards self-medication. Self medication was even started for chronic diseases. The result was very surprising and new which we got to know.
Structured psychotherapies are treatments for mental health disorders that are recommended by international good practice guidelines. Their positive impact on the costs to healthcare funding bodies has been widely demonstrated. Nevertheless, in France today, psychotherapies delivered in private practice settings are not reimbursed to patients by health cover systems.
A financial evaluation of covering the cost of psychotherapies was performed using the methodology of the British programme Improving Access for Psychological Therapies (2005). The cost of a session was estimated at 41€, the reimbursement rate by the compulsory health insurance system at 70% and 60% for the care of individuals aged 18 to 75 presenting common, chronic and/or severe mental disorders.
The yearly cost for the cover of psychotherapeutic care was 514 million euros (between 308M and 347M€ for the compulsory systems) to treat 1.033M individuals in France, or 2.3% of the population.
In terms of the cost-benefit ratio, 1€ invested in psychotherapeutic treatment could, depending on patient profile, save from 1.14€ to 1.95€.
France has the 14 300 professionals qualified to deliver the psychotherapies required to treat this population.
With a view to providing appropriate care for patients, inter-professional collaboration among GPs and mental health professionals, and between clinical psychiatrists and psychologists, appears essential. These recommendations should be defined in national good practice guidelines.
Protective factors against suicidal acts in major depression:Reasons for living, Journal Club Presentation in the Dept of Psychiatric Nursing, Kothamangalam
MedicalResearch.com: Exclusive Interviews with Medical Research and Health Care Researchers from Major and Specialty Medical Research Journals and Meetings
Rethinking, rebuilding psychosocial care for cancer patientsJames Coyne
Presented as the 8th Trevor Anderson Psycho-Oncology Lecture, September 8, 2014, Melbourne, Australia.
Discusses how psychosocial care for cancer patients needs to be reorganized so that a broader range of cancer patients are served. Routine screening for distress is unlikely to be an efficient means of countering tendencies of cancer care more generally becoming more organized around time efficiency and billable procedures. Psychosocial care for many cancer patients involves discussions, negotiations, and care coordination they cannot be well fit into the idea of a counseling session. The unsung heroes of providing such care are underappreciated social workers and oncology nurses.
Anna Ratzliff, MD, PhD, Associate Director for Education, Division of Integrated Care & Public Health Department of Psychiatry & Behavioral Sciences, University of Washington
Latino Health Forum 2014
Penny George™ Institute for Health and Healing: Meeting Patients Where They AreAllina Health
By Courtney Baechler, MD. A discussion about the Penny George Institute and its goal to empower patients using the mind-body-spirit approach to health, encouraging a philosophy of wellness at any stage of care. The Penny George Institute has become a national leader in holistic health care and is an important component of Allina Health efforts to achieve health care transformation through the Triple Aim.
Self-management support return on investment webinar, Wednesday 7 January.
Led by Renata Drinkwater, CEO Self-Management UK and Beverley Matthews, LTC Programme Lead, NHS Improving Quality.
A thorough research was conducted among the individuals to understand the perspective of individuals towards self-medication. Self medication was even started for chronic diseases. The result was very surprising and new which we got to know.
Structured psychotherapies are treatments for mental health disorders that are recommended by international good practice guidelines. Their positive impact on the costs to healthcare funding bodies has been widely demonstrated. Nevertheless, in France today, psychotherapies delivered in private practice settings are not reimbursed to patients by health cover systems.
A financial evaluation of covering the cost of psychotherapies was performed using the methodology of the British programme Improving Access for Psychological Therapies (2005). The cost of a session was estimated at 41€, the reimbursement rate by the compulsory health insurance system at 70% and 60% for the care of individuals aged 18 to 75 presenting common, chronic and/or severe mental disorders.
The yearly cost for the cover of psychotherapeutic care was 514 million euros (between 308M and 347M€ for the compulsory systems) to treat 1.033M individuals in France, or 2.3% of the population.
In terms of the cost-benefit ratio, 1€ invested in psychotherapeutic treatment could, depending on patient profile, save from 1.14€ to 1.95€.
France has the 14 300 professionals qualified to deliver the psychotherapies required to treat this population.
With a view to providing appropriate care for patients, inter-professional collaboration among GPs and mental health professionals, and between clinical psychiatrists and psychologists, appears essential. These recommendations should be defined in national good practice guidelines.
Protective factors against suicidal acts in major depression:Reasons for living, Journal Club Presentation in the Dept of Psychiatric Nursing, Kothamangalam
MedicalResearch.com: Exclusive Interviews with Medical Research and Health Care Researchers from Major and Specialty Medical Research Journals and Meetings
ΑΠΟΛΟΓΙΣΜΟΙ ΕΤΑΙΡΙΚΗΣ ΚΟΙΝΩΝΙΚΗΣ ΕΥΘΥΝΗΣ Ε Τ Η Σ Ι Α Ε Ι Δ Ι Κ Η Ε Κ Δ Ο Σ Η
Στρατηγική Υπευθυνότητας
Η έκδοση που κρατάτε στα χέρια σας είναι μια
ακόμη προσπάθεια της Direction Εκδοτικός Ορ-
γανισμός να αναδείξει τις εταιρείες που έχουν
ενσωματώσει την υπευθυνότητα στη συνολική
τους στρατηγική και στην καθημερινή λειτουργία
τους, έχοντας συνειδητοποιήσει και αναγνωρίσει
το ανταγωνιστικό πλεονέκτημα και τα οφέλη που
μπορεί να προσφέρει η Λογοδοσία Αειφορίας. Η
4η Ετήσια Ειδική Έκδοση CSR Reports έρχεται
σε συνέχεια των τριών προηγούμενων επιτυ-
χημένων εκδόσεων και με τίτλο «Στρατηγική
Υπευθυνότητας» έχει σκοπό τη συνοπτική πα-
ρουσίαση των Απολογισμών Αειφορίας που δη-
μοσιεύθηκαν στην Ελλάδα για το έτος 2012. Πρό-
κειται για μια έκδοση που αποτελεί απαραίτητο
εργαλείο δουλειάς για όλους τους επαγγελματίες
του χώρου της Εταιρικής Κοινωνικής Ευθύνης,
ενώ παράλληλα απευθύνεται σε όλους τους
stakeholders που ενδιαφέρονται για το υπεύθυνο
προφίλ των εταιρειών που δραστηριοποιούνται
στην Ελλάδα και με βάση αυτό διαμορφώνουν
τις επενδυτικές, καταναλωτικές και οικονομικές
προτιμήσεις τους (εταιρείες, δημόσιοι και ιδιω-
τικοί φορείς, ΜΚΟ, ΜΜΕ κ.λπ.). Στις επόμενες
σελίδες παρουσιάζονται Κοινωνικοί Απολογισμοί
σημαντικών εταιρειών που ακολουθούν τις επι-
ταγές του Υπεύθυνου Επιχειρείν, άρθρα Ελλήνων
ακαδημαϊκών και διεθνούς φήμης ειδικών σε
θέματα ΕΚΕ και εταιρικής υπευθυνότητας και
ερευνητικά δεδομένα για τους Απολογισμούς
Αειφορίας σε Ελλάδα και εξωτερικό, καθώς και
βασικά στοιχεία για πρότυπα και αρχές που ακο-
λουθούνται κατά τη Λογοδοσία Αειφορίας. Επί-
σης, υπάρχει αναλυτική καταγραφή των Απολο-
γισμών Ετ
News from the Coal Face: There’s light at the end of the tunnel. Presented by Dr Andrew Miller, General Practitioner, at HINZ 2014, 11 November 2014, 4.30pm, Marlborough Room
AssignmentRead a selection of your colleagues responses..docxnormanibarber20063
Assignment:
Read
a selection of your colleagues' responses.
Respond
to at least
two
of your colleagues by comparing your assessment tool to theirs. APA Format with at least two references in each responses no more than five years old
Response Post #1
Main Post - Brief Psychiatric Rating Scale
Week 2 Discussion - Assessment and Diagnosis in Psychotherapy
Main Post
Assessment Tools
It is paramount as health care professionals to be skillful in assessing clients to be able to diagnose, plan, and produce optimal care yielding full or partial recovery of the clients. Various assessment and measuring tools are available for mental health providers to help measure illness, diagnose clients, and measure a client’s response to treatment that will help supplement data obtained from the clinical interview. Though assessments usually span the entire treatment cycle, a thoughtfully constructed initial intake meeting can be a great tool to establish and reinforce the required therapeutic alliances between client and therapist, provide reassurance, ease anxiety, and enhance information gathering process required for an accurate diagnosis and suitable treatment plan (Wheeler, 2014).
Brief Psychiatric Rating Scale
The Brief Psychiatric Rating Scale (BPRS) was developed in the sixties. It is still one of the most popular behavioral rating scales/instruments use today by clinicians to quickly gather information about the possible presence and severity of various psychiatric symptoms and to assess changes in symptoms in response to medications (Zanello et al., 2013). Originally, the BPRS was a 16-item scale, it was later extended to the standard 18-item version and currently expanded to a 24-item scale to measure additional aspects of schizophrenia symptoms thereby increasing its sensitivity to psychotic and affective disorders and to be used for patients living in the community (Shafer et al., 2017).
The 18-item BPRS assess the following symptoms: somatic concern, anxiety, emotional withdrawal, conceptual disorganization, guilt feelings, tension, mannerisms and posturing, grandiosity, depressive mood, hostility, suspiciousness, hallucinatory behavior, motor retardation, uncooperativeness, unusual thought content, blunted affect, excitement, and disorientation (Yee et al., 2017). The manual of administration of the 24-item BPRS offers a more detailed semi-structured interview with more probe questions for each symptom, and providing supplementary rules for the rating (e.g., delusions) including a well-defined anchor point (Zanello et al., 2013). The recent analysis of the 24-item BPRS produced a four-factor solution: Negative Symptoms, Positive Symptoms, Manic-hostility, and Anxiety–Depression (Zanello et al., 2013). The current BPRS is rated on a seven-point Likert-type scale. A rating of “1” indicates the absence of symptoms, ratings of “2–3” indicate “very mild” to “mild” symptoms that are considered to have nonpathological inte.
Research Methods in PsychologyThe Effectiveness of Psychodyn.docxronak56
Research Methods in Psychology
The Effectiveness of Psychodynamic Therapy on Childhood Abused Victims.
Annotate Bibliography
Nickel, R., & Egle, U. T. (2005). Influence of childhood adversities and defense styles on the 1-year follow-up of psychosomatic- psychotherapeutic inpatient treatment. Psychotherapy Research, 15(4), 483-494. doi:10.1080/10503300500091660
This study was conducted to examine childhood abused victims' quality of life before treatment, and after treatment. A multimodal psychodynamic group concept was used to treat 138 patients for an average of 80.4 days. In order, to properly develop a comparison, clinical examiners interviewed each patient before the start to their in-patient program to diagnose each individual, and have therapy goals for them. The questionnaires that were used to measure quality of life targeted the patient's social life health, general health, emotional and physical functioning. The patients were all re-assessed after one year had passed by, to examine any changes in their quality of life. It was revealed that the patients' mental quality of life had improved by more than one standard deviation. Their physical quality of life improved just less than one standard deviation.
Baker, V., & Sheldon, H. (2007). 'The Light at the End of the Tunnel': Issues of Hope and Loss in Endings with Survivors Groups. Group Analysis, 40(3), 404-416. doi:10.1177/0533316407081759
In this article, a previous study was mentioned in which childhood abuse survivors were treated for 20 sessions. The authors of this article agreed that 20 sessions of treatment for childhood abuse survivors isn't enough for them to develop a secure attachment to the group. This study explores whether childhood abuse victims can benefit from treatment by being treated for a longer period. Seven group members of ages 23-55 were treated for 52 sessions, over a period of 13 months. All of the members in this group are women, and they had all been sexually abused in their childhood by a family member. They followed a psychodynamic, time-limited closed group therapy, in which they all benefited somewhat. However, many of the members expressed anxiety of leting go, and not being able to move on after the group ended.
Foa, E. (2009). Psychodynamic Therapy for Child Trauma. Retrieved from https://www.istss.org/ISTSS_Main/media/Documents/ISTSS_g12.pdf
The authors of this article discuss the efficacy of pyshcodynamic methods on childhood abuse victims, by presenting the results of five randomized controled trials. The population involved in these randomized controled trials were : preschoolers that were exposed to domestic violance, abused infant and sexually abused girls. Three of these randomized controled trials focused on a child-parent therapy, using a relationship-based intervention. The goal to these three randomzied trials was to strengthen the parent-child relationship to lead to a long term healthy child development. Another randomized ...
Original ArticleDesign and implementation of a randomized.docxgerardkortney
Original Article
Design and implementation of a randomized
trial evaluating systematic care for bipolar
disorder
Abundant evidence demonstrates that treatments
for bipolar disorder can reduce the severity of
mood symptoms and improve daily functioning.
Specific pharmacotherapies have been proven effi-
cacious in the acute management of mania and
depression (1, 2) as well as in the prevention of
recurrence (1). For lithium, more intensive treat-
ment has been shown to improve both long-term
clinical outcomes and psychosocial functioning.
Promising evidence also supports the efficacy of
several disease-specific psychosocial interventions
for bipolar disorder (3, 4).
Unfortunately, treatments provided in everyday
practice fall far short of those proven in clinical
Simon GE, Ludman E, Unützer J, Bauer MS. Design and implementation
of a randomized trial evaluating systematic care for bipolar disorder.
Bipolar Disord 2002: 4: 226–236. ª Blackwell Munksgaard, 2002
Objectives: Everyday care of bipolar disorder typically falls short of
evidence-based practice. This report describes the design and
implementation of a randomized trial evaluating a systematic program to
improve quality and continuity of care for bipolar disorder.
Methods: Computerized records of a large health plan were used to
identify all patients treated for bipolar disorder. Following a baseline
diagnostic assessment, eligible and consenting patients were randomly
assigned to either continued usual care or a multifaceted intervention
program including: development of a collaborative treatment plan,
monthly telephone monitoring by a dedicated nurse care manager,
feedback of monitoring results and algorithm-based medication
recommendations to treating mental health providers, as-needed outreach
and care coordination, and a structured psychoeducational group
program (the Life Goals Program by Bauer and McBride) delivered by the
nurse care manager. Blinded assessments of clinical outcomes, functional
outcomes, and treatment process were conducted every 3 months for
24 months.
Results: A total of 441 patients (64% of those eligible) consented to
participate and 43% of enrolled patients met criteria for current major
depressive episode, manic episode, or hypomanic episode. An additional
39% reported significant subthreshold symptoms, and 18% reported
minimal or no current mood symptoms. Of patients assigned to the
intervention program, 94% participated in telephone monitoring and 70%
attended at least one group session.
Conclusions: In a population-based sample of patients treated for bipolar
disorder, approximately two-thirds agreed to participate in a randomized
trial comparing alternative treatment strategies. Nearly all patients
accepted regular telephone monitoring and over two-thirds joined a
structured group program. Future reports will describe clinical
effectiveness and cost-effectiveness of the intervention program compared
with usual care.
Gregory E Simona, Evette
Lud.
Abstract—Spiritual health is not given its due importance since long time. But nowadays modern medicine is seen in relation to spiritual health. and studies were conducted to find out its effect in various diseases. So this study was conducted on medical students of SMS Medical College, Jaipur (Rajasthan) India. aimed to assess the spiritual health and its association with psycho wellness. A cross-sectional study was conducted on 1st MBBS students present on the day of survey were given spiritual health assessment scale (SHAS) to assess the their spiritual health. Then these students were screened through Modified Mini Scale (MMS) to found out zone of psycho wellness i.e. red and orange zone of psycho-wellness. Association was inferred by Chi-square test and ANOVA with Post-hoc Tukey test. Out of 230 students attend on the day of survey, majority of students i.e.164(71.3%) were having good spiritual health. Likewise only 132 students (57.39%) were in green zone (no disease zone), while 36(15.65%) students were in orange (borderline) and 62 students (26.96%) were in red zone (Psychiatric disease zone) of psycho-wellness. On analysis it was found that Mean scores of spiritual SHAS of green zone was significantly high than mean SHAS scores of other zones. Majority of students were having poor spiritual health and this spiritual health was strongly associated with psycho-wellness of students. Poorer the spiritual health of students leads to poorer the psycho-wellness of students.
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.
Effects of an Intensive 3-Week Yoga Retreat on Sense of Well Being in Cancer ...Yogacharya AB Bhavanani
Introduction: Cancer survivors are often severely affected physically, mentally and emotionally after passing through modern medical treatments. As Yoga conjointly emphasizes body-mind-spirit thus enhancing physical, mental, social and spiritual well-being, Kaivalyadhama Yoga Institute in Lonavla, India initiated a three week residential intensive retreat for cancer survivors to empower them in their journey, “back to health and wellbeing”. The aims and objectives of the present study is to evaluate the effects of this residential program for cancer patients on their psychological well being, and determine if or not these effects were sustained at follow up after three months.
Materials and Methods: The modes of reintegration used in this program were designed to specifically address the multidimensional needs of cancer survivors and incorporated various Yogic techniques including Asana, Pranayama, Mudra, Bandha, relaxation, silent meditation and chanting as well as education given in a group setting. Three standard psychological evaluation tools were used: WHO Quality of Life-BREF (WHOQOL-BREF), Profile of Mood States (POMS) and Hospital Anxiety and Depression Score (HADS). These were administered on first (D1) and last days (D20) of the program and repeated at follow up three months later (3M). Pre and post retreat (D1-D20) data was analyzed for 26 subjects using Students paired t-test while RMANOVA was used to compare pre-post retreat and follow up data of 19 subjects.
Results: Significant improvements were seen in all domains of QOL with significant reduction in all negative psychological states and improvement in vigour and total POMS score. There was significant decrease in anxiety, depression and overall rating on HADS with marked decrease in anxiety compared to depression. In pre-post and follow-up (D1, D20 and 3M) comparisons for 19 subjects, all components showed significant changes except social QOL. Though some of the benefits of the retreat are lost during follow up, none of the values reached level of significance except in anger subscale and even that was still lower than at start of retreat.
Discussion and Conclusion: The present study offers evidence of the beneficial psychological changes occurring after a three week intensive retreat for cancer survivors. This is in tune with previous reports. One of the biggest benefits may actually lie in the empowerment of the participants as they are given tools, which make them feel in control of their health and wellbeing. Changes are maintained in those who continue the practices even at three months follow up but are lost slowly in those who discontinued them. Even then, all parameters at three months follow up are still positive as compared to pre-retreat values. More rigorous and randomized controlled studies are required to validate these results in the future.
Evaluating the Quality of Life and Social Support in Patients with Cervical C...CrimsonpublishersTTEH
Aims: Purposes of this descriptive correlational research were to 1) describe quality of life and social support and 2) look at the correlation of certain factors and quality of life in women with cervical cancer after treatment. Methods: Fifty-three women diagnosed with cervical cancer who were followed up after finished the treatments at the Gynecological outpatient department of a university hospital in 2016.They were asked to fill 3 questionnaires; 1) the general information; 2) Social support; and 3) Functional Assessment of Chronic Illness Therapy (FACT-Cervix). Alpha Cronbach’s coefficients for the social support was .73 and for the FACT-Cervix was .91. Data were analyzed by descriptive statistic and Spearman Rank Test.Result: Results showed that participants’ age was ranged from 30 to 86, mean=55.15 (SD=10.05). Social support was about 29 to 59, mean=48.23 (SD=6.76). Symptom distress was from 0 to 9, mean=3.36 (SD=2.83). For quality of life was diverted from 75 to159, mean=126.02 (SD=21.09). The results discovered that there was no correlation between age and social support with the quality of life, however, there was negative correlation between symptom distress and quality of life with r=-.40 at p=0.003.Conclusion: This study disclosed that social support for this women’s group could not help to improve their quality of life. Their symptom distress seems to have a direct effect on their QOL. Thus, the healthcare team needs to alleviate patients’ distress in order to improve the quality of life in cervical cancer survivors.
Outcomes of Online Mindfulness-Based Cognitive Therapy for Patients With Residual Depressive SymptomsA Randomized Clinical Trial
Zindel V. Segal, PhD1; Sona Dimidjian, PhD2; Arne Beck, PhD3; et alJennifer M. Boggs, PhD3; Rachel Vanderkruik, MA2; Christina A. Metcalf, MA2; Robert Gallop, PhD4; Jennifer N. Felder, PhD5; Joseph Levy, BA2
Author Affiliations
JAMA Psychiatry. Published online January 29, 2020. doi:10.1001/jamapsychiatry.2019.4693
Significance for fasd
the importance of epidemiological studies, important historical research on mental health, techniques and processes, and epidemiological research findings on mental health during covid 19 are included.
Effect of Behavioral Intervention on Reducing Symptom Severity during First C...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
2. http://www.ephysician.ir
Page 2176
1. Introduction
The development of cancer during recent decades and its damaging effects on physical, affective, spiritual, social,
and economic aspects have focused experts’ attention on this disease as well as lay people, and they present cancer
as this century’s major health problem. Twenty-five percent of all cancers in Iranian women are breast cancer as the
last reports of Iran community cancer show. Despite clinical developments, breast cancer is still one of the fatal
malignancies all over the world (1, 2), making up 32% of all cancers among women (3). Although vast
advancements in breast cancer therapy has resulted in better reactions toward therapy and increased longevity of the
patients, most of these therapies have side effects and also cause mental-social problems for the patients (4, 5). The
mental pressures, reduction of physical, affective, and social operations, sexual function disorders and changing
their mental image affect the patients’ quality of life and happiness after diagnosis and breast cancer therapy (6, 7).
The beginning of this current disease is the beginning of a stressful period for women, and neglecting their mental
status causes the loss of a sense of control, resulting in feelings of hopelessness, depression, and anxiety. It is
possible that the psychological complications threaten the patient’s survival by its negative effect on the
continuation of the therapy process and post-treatment follow-up (8-10). Thus, along with medical advancements for
treating breast cancer, intervention seems necessary in order to increase happiness and decrease the mental pressures
of these patients. Many interventions have been presented for improving the mental health of these patients, but
those that are short-lived and economical are better. Positive psychotherapy was presented for the first time by
Seligman in 2000. This theory, unlike Beck’s cognitive behavioral therapy, pays attention to the abilities and
positive emotions. Indeed, positive psychotherapy is an objective study of experiences and positive operations of
each person (11, 12). This method shows great promise for enhancing patients’ well-being by means of positive
psychotherapy intervention (PPIS). Positive psychotherapy interventions are treatment methods for enhancing
positive sentiments, behaviors and cognitions (13, 14). This focus on generating positive emotions decreases mental
disorders and has positive effects on happiness and quality of life. Other advantages of positive psychotherapy are:
1) it is helpful for depressed patients who don’t like using drugs or drugs can’t cure them, 2) it is economical and its
tasks are easy to do, and 3) intervention doesn’t take a long time, and the improvements in the patients’ behaviors
are fast and don’t have lateral complications (15, 16). Several studies have been conducted on the effectiveness of
positive psychotherapy on different disorders. In 2014, Seyedi-Asl et al. (17) studied the effectiveness of group
positive psychotherapy on infertile women’s happiness in Iran. The results showed that there was a greater reduction
of depression in the treatment group than in the control group. In addition, there were greater increases in happiness
in the intervention group than in the control group. Asgharipoor et al. (18) compared the effectiveness of positive
psychotherapy and cognitive-behavioral therapy for depressive disorder patients. They discovered that both
interventions are effective in reducing depression symptoms and increasing the happiness of the patients, while there
were no significant changes in the control group. Another study on the effect of positive psychotherapy was done by
means of the Internet, and it was found that depression symptoms were decreased by positive psychotherapy
practices (16). Since the effectiveness of positive psychotherapy on the psychological status of patients with cancer
has never been studied, we decided to measure the effectiveness of group positive psychotherapy on depression and
happiness to determine new ways of enhancing the patients’ health.
2. Material and Methods
2.1. Trial design
This study was a randomized controlled trial that was conducted from September 10, 2013 to December 25, 2015.
2.2. Participants
This clinical trial was conducted in the Oncology Center in Kermanshah in 2014. The explanation of this research’s
performance methods and its goals were given to women who were referred to the Center to see if they were willing
to participate. Therefore, 103 patients agreed to participate, but only 42 were selected after the interviews. From the
42 participants, 21 were assigned randomly to the positive psychotherapy intervention group, and 21 were assigned
to the control group. While both groups used their drugs, the experimental group benefited from 10 sessions (1.5
hours weekly) of positive psychotherapy, which the control group did not have. At the end, the invalid data of five
members of experimental group and four members of the control group were omitted.
2.3. Instruments
The inventories below were used for gathering data. The patients completed these inventories before the first session
and after the last session:
3. Electronic physician
Page 2177
1) Demographic inventory: This inventory was made for gathering information of women with cancer by
educational level, age, job, illness time, and …
2) Beck’s depression inventory (BDI-II): This inventory is used to measure depression in adults and in
teenagers who have had this problem for at least two weeks (19). This inventory has 21 items, and each
item is one graded from 0 to 13, and each individual’s score is from 0 to 63. Four groups were established
based on the ranges of scores as 0-13: minimum score, 14-19: mild depression, 20-28: moderate
depression, and 29-63: intense depression (20). The alpha coefficient of 0.87 and the test-retest reliability
of 0.74 were obtained in the Iranian prescription of this inventory.
3) Oxford happiness inventory (OHI): The Oxford happiness inventory was developed by Hills and Argyle
(21). At first, this inventory had 21 items that were derived from converting the depression inventory, and,
later, eight additional items were added. Thus, it has 29 items each of which has four choices that are
graded from 0 to 3, and the final score is between 0 and 87. Getting a higher score on the happiness
inventory shows that there is more happiness in that person’s life. A Cronbach’s alpha of 0.92 and the test-
retest reliability of 0.73 were obtained in the Iranian prescription of this inventory.
2.4. Selection criteria
The final criteria for choosing individuals were: 1) gaining equivalent score of mild to moderate depression (14-28
in BDI-II), 2) being 25-50 years old, and 3) having had breast cancer for at least 3 months. Also, the exclusion
criteria were: 1) intense depression score or lack of depression and 2) receiving simultaneous psychiatry therapy or
other psychotherapies.
2.5. Interventions
Positive psychotherapy is task-oriented. Each session of group positive psychotherapy has two parts; the first is
reviewing previous tasks, and the second is discussing the next task. Each weekly session takes one and a half hours.
Welcome and presentation are done at the first session, after which a positive introduction is presented, and the rules
are explained (Table 1).
Table 1. Method of group positive psychotherapy
Session 1 Using abilities
Sessions 2, 3 Gratitude visit
Sessions 4, 5 Active replying
Sessions 6, 7 Counting gifts
Sessions 8, 9 Taste with relish / Biography
Session 10 Completion and preserving treatment’s effects, giving some easy tasks to be done.
2.6. Outcomes
The primary outcomes of our analysis were the rate of depression and happiness in patients with breast cancer. Also,
the secondary outcome from the analysis was the effectiveness of positive psychotherapy on depression and
happiness in the patients.
2.7. Statistical methods
SPSS-16 was used to analyze the data. The Kolmogorov-Smirnov (K-S) test was used to measure the normalization
of the quantitative data, and the results showed that all variables had normal distributions. Also, chi-squared and
multivariate analyses of covariance (MANCOVA) were used in this research.
2.8. Research ethics
This study was approved by the Moral Committee at Kermanshah University of Medicine Science with the number
of 5392 and was recorded in the Iranian Registry of Clinical Trials by the code of IRCT2013101410063N4. Written
testimonials were provided by all patients, and all of the data were coded and kept in a safe place.
3. Results
Five members of the experimental group and four members of the control group did not participate in posttest, so
their results were omitted. The mean age of the 33 participants was 36.63 ± 5.53 years. The mean and standard
deviation of the experimental group were 36.6 ± 6.4 years, and they were 37.23 ± 4.7 years for the control group.
Chi-squared was used to evaluate the consistency of the qualitative data (demographic features), and the results
showed that there was no significant difference between the two groups in age, educational level, and jobs, so it was
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concluded that these two groups were the same in demographic variables (Table 2). The covariance results on the
experimental group’s posttest showed reduction in depression compared to the pretest; the mean scores of
depression of the control group were the same in the pretest and posttest. Also, there were greater levels of
happiness in the experimental group posttest than in the pretest or the posttest of the control group. The results
showed that there was a significant difference between experimental and control groups for the dependent variables
at the level of p < 0.001. Thus, there was a significant difference at least in one of the dependent variables
(depression, happiness) in both groups. Multivariable covariance analysis of MANCOVA on the dependent variable
was done to study the difference, and the results were presented. Table 3 shows the results of the MANCOVA
analysis to compare the means of both dependent variables (depression, happiness) by controlling pretests. Thus,
Table 3 shows that the MANCOVA analysis was significant in the depression variable (p < 0.001, F = 22.4) and the
happiness variable (p < 0.001, F = 39.93). Thus, the research hypotheses about the effectiveness of group positive
psychotherapy in reducing depression and enhancing happiness among breast cancer patients were confirmed.
Table 2. Demographic comparison of the experimental and control groups by means of chi-squared (n = 33)
Variable Classification Experimental
Group
Control Group Total p-value
n % n % n %
Age (year) 24-32 6 37.5 4 23.5 10 30.3 >0.482
33-41 7 43.8 11 64.7 18 54.5
42-50 3 18.8 2 11.8 5 15.2
Educational
level
Under High school 7 43.8 7 41.2 14 42.4 >0.700
High school diploma 7 43.8 6 35.3 13 39.4
College 2 12.6 4 23.5 6 18.2
Job Housewife 9 56.3 8 47.1 17 51.5 >0.706
Self-employed 5 31.3 5 29.4 10 30.3
Employee 2 12.4 4 23.5 6 18.2
Table 3. Mean results of MANCOVA on depression and happiness in the experimental and control groups
Variables Experimental Group a
Control Group a
Mean
Squares
F Sig.
Pretest b
Posttest b
Pretest b
Posttest b
Depression 20.93 ± 6.25 14.18 ± 5.47 19.23 ± 4.7 20.11 ± 5.08 227.5 22.4 <0.001
Happiness 30.56 ± 10.9 41.12 ± 11.53 25.3 ± 4.45 25.17 ± 4.45 624.4 39.93 <0.001
a: number of participants: experimental group (n = 16), control group (n = 17), b: standard deviation ± mean
4. Discussion
The results showed a significant reduction in depression among the breast cancer patients, but this enhancement was
not significant in comparison to the control group. These results were in agreement with those of Seligman et al.
(12) and Seyedi-Asl et al. (17). For example, Senf and Liau (22) showed reduced depression among 122 participants
by the use of positive psychotherapy intervention in their research. Seligman designed positive psychotherapy
assignments to decrease depression. For example, his ‘three good things’ assignment neutralized the obsessive
rumination of depressed patients about negative events. Gratitude visits can change patients’ minds about aspects of
their negative past relationships, allowing them to enjoy the good things their families had done for them (12).
Despite cognitive, behavioral, and interpersonal approaches that focus on decreasing depression, positive approaches
accomplish this by increasing positive emotions indirectly (14, 16). The results showed that group positive
psychotherapy caused significant enhancement of happiness among breast cancer patients, and the same was true for
the control group. The results on happiness were in agreement with those of Asgharipoor et al. (18) and Senf and
Liau (22). Also Ruini et al. (23) and Wing, Schutte, and Byrne (24) obtained the same results in their study about the
effectiveness of positive psychotherapy intervention on life satisfaction and mental well-being (23, 24). Happiness
has three items, i.e., positive emotion, engagement, and meaningfulness in Seligman’s opinion. Several ways exists
for gaining happiness, and the first one is positive emotion, which exists at three times for each person, as described
below:
1) The past positive emotion: Gratitude and Mercifulness
2) The present positive emotion: Tasting, Enjoying, and Mindfulness
3) The future positive emotion: Hopefulness and Optimism
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The second way for gaining happiness is doing joyful activities, and the last part of happiness is having goals that
cause enthusiasm toward life. Indeed, positive psychotherapy has designed some related assignments to increase
happiness. There were several limitations in the present study that should be noted and taken into consideration
when interpreting the results, as well as to provide direction for future study, such as:
1) Extension limitation because of research’s sample group limitation
2) Lack of control group for controlling therapy’s unspecified factors
3) Treatment carried out for just a short time (10 weeks)
5. Conclusions
In some recent studies, the effectiveness of positive psychotherapy on depression and happiness was measured, but
this study just surveyed the effectiveness of positive psychotherapy intervention on breast cancer patients. The
results showed the effectiveness of this therapy in reducing depression and enhancing the mental status of breast
cancer patients. Since positive psychotherapy, irrespective of other psychotherapies, pays attention to both the
negative and positive aspects of emotions, the quality of the treatment is better than other approaches. This therapy
is very affordable for patients. Also, this therapy can be used in oncology centers to enhance physical and mental
status of patients.
Acknowledgments:
This paper was extracted from Mr. Dowlatabadi’s postgraduate thesis. It was done employees of Kermanshah
University of Medical Sciences and Imam Reza Hospital. The authors gratefully acknowledge the supporters and
patients with cancer who helped with the compilation of some of the data.
Trial registration:
The trial is registered at the Iranian Registry of Clinical Trial (IRST) with the identification number
IRCT2013101410063N4.
Funding:
The authors received financial support for the research from Kermanshah University of Medical Sciences.
Conflict of Interest:
There is no conflict of interest to be declared.
Authors' contributions:
All authors contributed to this project and article equally. All authors read and approved the final manuscript.
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