Effect of Psycho-educational Program on Depressive Symptoms, Anxiety and Stress Coping Strategies among Women with Breast Cancer

Document Type : Original Article


1 Lecturer of psychiatric/ Mental Health Nursing, Faculty of Nursing, Ain Shams University

2 Assistant Professor of Psychiatric Mental Health Nursing, Faculty of Nursing-Ain Shams university.


Background Women with breast cancer are commonly suffers from anxiety and depression
due to disturbed body image and low self-esteem that negatively impairs their coping strategies and
recovery process. So, implementation of psycho-educational program to improve the patient’s
coping skills was highly needed. Aim: This study aimed to examine the effect of the psycho-
educational program on depressive symptoms, anxiety, generalized anxiety disorder and stress
coping strategies among women with breast cancer. Research design: A quasi-experimental
research (one group pre/posttest) design was used in this study. Subjects. The study subjects
consisted of (113) women with breast cancer. Setting: This study was conducted in the breast clinics,
oncology center at Ain shams University Hospital. Sample: A purposive sample was obtained from
all available patients with breast cancer during the study period, and approved to participate in the
program for six successive months. Tools for data collection; the data was collected using; 1)
Women’s Interview Questionnaire; to assess what the socio-demographic characteristics and medical
history of women understudy. 2) Mini-Mental Adjustment Scale for Cancer Patients (Mini-MAC),
and 3) Hospital Anxiety and Depression Scale (HADS). Results: This study showed a highly
statistically significant difference regarding minimizing the total anxiety & depression, generalized
anxiety disorder in the post program phase (p<0.01) as compared to the pre-program phase. This
study also revealed that there was a highly statistically significant improvement in positive stress
coping strategies in the post-program implementation phase (p<0.01) compared to the pre-program
phase, includes; fighting spirit, self-control & emotional control, and seeking social support
representing 88%, 86%, 77% respectively. Moreover, the current study showed that negative coping
strategies have been minimized in the post program implementation phase compared to the pre-
program phase includes anxiety & anxious preoccupation, in-active stotic acceptance, distancing &
escaping, and denial representing 37%34%, 38%, and 53% respectively. Conclusions: Women with
breast cancer reported minimized symptoms of depression, anxiety, and generalized anxiety disorder
post program implementation compared to the pre-program level. Also, this study revealed that
women understudy reported improvement in utilization of positive stress coping strategies and
minimized utilization of negative coping strategies post program implementation compared to the
pre-program level. Recommendations: This study recommends establishment of a counseling clinic
to provide psycho-educational training about stress coping strategies for women with breast cancer
and their partners or family caregivers to enhance their recovery, and well-being.