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Volume 9, Issue 3 (Autumn 2022)                   J Prevent Med 2022, 9(3): 280-291 | Back to browse issues page

Research code: A-10-1916-1
Ethics code: IR.IAU.BOJNOURD.REC


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Solaymani A, Shariatnia K, Akbari H. Comparing the Effects of Cognitive Hypnotherapy and Spiritual Therapy on Death Anxiety in Women With Breast Cancer. J Prevent Med 2022; 9 (3) :280-291
URL: http://jpm.hums.ac.ir/article-1-649-en.html
1- Department of Psychology, Faculty of Humanities, Bojnourd Branch, Islamic Azad University, Bojnourd, Iran.
2- Faculty of Humanities, Azadshahr Branch, Islamic Azad University, Azadshahr Iran.
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Introduction
Breast cancer is the second leading cause of cancer death among women after lung cancer. Having cancer puts a person’s physical and mental health at risk. The biggest problems of these patients are depression, hopelessness, reduced adaptation, and high stress. Most cancer patients suffer from a psychiatric disorder, the most common of which is adjustment disorder associated with death anxiety. This type of anxiety is a continuous, abnormal fear affected by personal beliefs. With the progress of the disease and during the treatment process, psychological symptoms also endanger the quality of life in patients. In addition to physical treatment, cancer patients need psychological treatment. One of the psychological treatment methods to control death anxiety is cognitive hypnotherapy. Considering the importance of reducing death anxiety in cancer patients and the effectiveness of cognitive hypnotherapy (CH) and spiritual therapy (ST) methods, this study aims to compare the effects of CH and ST on the death anxiety of women with breast cancer.
Methods
This is a quasi-experimental study with a pre-test/post-test design using a control group. The study population consists of all women with breast cancer referred to Mirdamad medical center in Gorgan, Iran. Of these, 30 patients were selected by a convenience sampling method and their disease was diagnosed by a specialist. Then, they were divided into two intervention groups of CH (n=10) and ST (n=10) and one control group (n=10). The inclusion criteria were signing the consent form, reading and writing literacy, diagnosis of disease since the past 6-7 months, not reaching the fourth level, and experience of surgery, chemotherapy and radiotherapy. Exclusion criteria were: Not having mental disorders, taking psychiatric drugs, and absence from more than two intervention sessions. The ST group received the group therapy based on the protocol proposed by Vaziri et al. in 8 sessions of 90 minutes. The CH group received the therapy based on the protocol proposed by Houghton et al. in 8 sessions. The control group did not receive any intervention; they only participated in group meetings.
Before and after the interventions, all three groups underwent assessments. The data collection tool was the Collet-Lester fear of death scale, a 32-item self-report tool that measures the level of fear and anxiety related to death. In this tool, 8 items measure the fear of one’s own death, 7 items measure fear of the process of one’s own dying, 8 items measure fear of the death of others, and 6 items measure fear of the process of others dying. Collet and Lester reported the test-retest reliability of the questionnaire for these four subscales as 0.85, 0.79, 0.86, and 0.83, respectively. Mani and Gorman reported the overall reliability of the Persian version of this questionnaire as 0.93. The collected data were analyzed in SPSS using one-way analysis of covariance (ANCOVA).
Results
The mean age of women was 45±15 years, ranged 30-60 years. Most of them were middle-aged women. The education level of most participants was diploma (50%). The pre-test score of death anxiety had a significant effect on the post-test scores related to the fear of the process of one’s own dying (P<0.01), fear of the process of others dying (P<0.01), and fear of the death of others (P<0.01). The results of ANCOVA showed that the type of treatment had a significant effect on all domains of death anxiety, and there was a significant relationship between the type of treatment and the type of death anxiety (P <0.01). There was no significant difference in the fear of one’s own death between CH and ST groups (P>0.05), but the difference was significant between the CH and control groups and between ST and control groups (P>0.05). There was no significant difference in the fear of the process of one’s own dying between CH and ST groups (P>0.05). There was a significant difference in the fear of the process of others dying between ST and control groups (P<0.05); it was lower by 5.07 in the ST group (Table 1).


Discussion
The findings of the present study showed that the death anxiety in women with breast cancer was higher than the average. Factors such as the duration of the disease and its nature can increase the intensity of death anxiety. Considering that a person’s mental condition during treatment greatly affects the quality and severity of the disease, in addition to drug treatment, psychological treatments such as CH and ST should be an integral part of treatment for women with breast cancer so that they can go through the treatment process more calmly.

Ethical Considerations
Compliance with ethical guidelines

This study has ethical approval No. 0041.061.IR.IAU.Bojnourd.REC approved by Bojnourd University Research Council and registration number in Iran Clinical Trial Registration Center (IRCT) with (Code: IRCT2.0211109053024N1).

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Authors' contributions
All authors equally contributed to preparing this article.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
Shariatnia and Sabouri, the health advisors of Mirdamad Center in Gorgan, and all subjects participating in this research, and the management and staff of Mirdamad Center in Gorgan, are appreciated and thanked.



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Type of Study: Orginal | Subject: Psychology
Received: 2022/08/3 | Accepted: 2022/11/29 | Published: 2022/10/2

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