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432
Ciência eNatura, Santa Maria, v. 37 Part 1 2015, p. 432−436
ISSN impressa: 0100-8307 ISSN on-line: 2179-460X
The effectiveness of positive psychotherapy on the psychological well-
being of breast cancer patients
Zahra Jamshidifar1, Shohreh Mortezaei Shemirani2, Afshin Ahramian3, Armindokht
Ahmadi4, Salva Shamsedini Lory5,*, Mohammad Moradi-Joo6
1 Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Ma, Department of Clinical Psychology, Islamic Azad University, Roudehen Branch, Roudehen, Iran
3 Ma, Department of Counseling, Boushehr University of Medical Sciences, Boushehr, Iran
4 PhD Student, Department of Exceptional Children, Islamic Azad University, Science and Research
Branch, Tehran Branch, Tehran, Iran.
5 PhD Student, Department of Counseling, Young Researchers And Elite Club, Roudehen Branch, Islamic
Azad University, Roudehen, Iran.
6 Ms.C Health Technology Assessment (Tums) Cancer Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
*corresponding author:mahoor_princes@yahoo.com
Abstract
Many cancer patients become very anxious and stressed in response to cancer diagnosis. The fear of
disease symptoms incidence, the loss of abilities and facing death, creates serious crisis for the patient and
threatens one’s well-being. This study aims to determine the effectiveness of positive psychotherapy on the
psychological well-being of breast cancer patients. For this purpose, 24 patients with breast cancer in
Shohada-e-Tajrish Hospital were selected through available sampling and were tested in terms of
psychological well-being questionnaire. The results of analysis of covariance data, showed that positive
psychotherapy is effective on the subscales of dominance, relationships and acceptance of psychological
well-being in these patients but had no effect on the autonomy, growth, and goal. Therefore, this therapy
can be used as an effective approach for the treatment of cancer patients.
Keywords: positive psychotherapy, psychological well-being and cancer
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1 Introduction
Diagnosis of cancer can make patients become
very anxious and stressed in response to the
initial diagnosis. The fear of disease symptoms
incidence, the loss of abilities and facing death,
creates serious crisis for the patient and
emotionally puts one in a position that affects
the treatment and threatens one’s well-being. It
also causes a person not to have an active
participation in the treatment of his/her illness
for failing to control their negative emotions
(Shapiro, 2001; Peril, 2004; Badger, 2007). Cancer
is a disease that could endanger a person's well-
being. Psychological well-being has a significant
role in various aspects of life such as social
acceptance, having relationships with people,
intimacy, sense of efficacy, having a social
status, especially among youth (Ferkish, 2009).
One of the main concepts of the model of health
is well-being. Basically, there has been two basic
approaches to define well-being. Approach
based on hedonism, which believes that well-
being means to maximize pleasure and
minimize pain. That throughout history, has its
own supporters such as Epicurus, Hobbes and
Steward Mill. The second approach is based on
Aristotle's virtue ethics. According to this
approach, satisfying desires, despite making
pleasure in us, does not always lead to well-
being. Rather, well-being includes efforts to
perfection and the realization of one's true
potential which may not always be with a sense
of pleasure (Ferkish, 2009). One of the problems
that can endanger people's well-being is
suffering from diseases, especially cancer.
Growth of cancer in recent decades and its
adverse effects on all aspects of physical,
emotional, spiritual, social and economic, has
caused not only the people but also the experts,
to give more attention to the disease. It also
introduces cancer as a major health problem of
the century. In the meantime, many effective
interventions have been carried out that positive
psychotherapy uses techniques that leads to
happiness, joy and prosperity. Also, this method
emphasis on the importance of choosing a goal,
focusing on the goal, the use of positive
emotions, eliminating the vicious cycle of
negative emotions, insisting on strategies for
change, maintaining change, the usage of areas
of strength, and the importance of considering
the best aspects of human existence as the best
solution to overcome man’s confusion
(Connolly, 2009). In this method, it is assumed
that although negative emotions may be helpful
in the short term (for example, in situations that
are frightening, it activates fight and flight
responses and protects the person) but being
angry, afraid, worried, or stressed caused by
negative emotions is harmful in the long run
(Connolly, 2009; Wilson, 2008; Frijda, 1986). In
contrast, positive emotions creates long-term
benefits because the mental resource will
expand, causing flexibility and psychological
well-being and postpones the stimuli of negative
emotions and causes emotional regulation
(Miller, 2007; Frederickson, 2004). Thus, with
reference to the above, our research aims to
answer the question that whether positive
psychotherapy is effective on the psychological
well-being in patients with cancer?
2 Method
This is a quasi-experimental with a pre-
test, post-test design with control group. The
study population included all the Shohada-e-
Tajrish Hospital breast cancer patients in Tehran
in 2013. 24 patients were selected from the
population and randomly divided into
experimental (n=12) and control (n=12) groups.
The experimental group underwent positive
psychotherapy in 8 sessions but the control
group only received relaxation training.
3 Tool
Ryff's Psychological Well-Being Scale:
According to Ryff’s theory (1995) psychological
well-being questionnaire includes six basic
aspects. Ryff and Keyes (1955) calculated the
reliability coefficient of the test between 0.86 to
0.93, on a sample of 321 cases of male and
female subjects. Bayati and Kuchaki calculated
the same amount from 0.81 to 0.88 (according to
the Farkish, 2009).
434
4 Findings
To investigate the effectiveness of positive
psychotherapy on the psychological well-being
of breast cancer patients, descriptive data (mean
and standard deviation) is presented in Table 2.
Table 2: Mean and standard deviation of the components of well-being
Variables
Group
Phase
Mean
SD
Autonomy
Control group
Pretest
49.25
5.61
Posttest
43.91
9.01
Experimental group
Pretest
39.58
6.86
Posttest
41.33
8.06
Domination
Control group
Pretest
39.5
7.39
Posttest
37.25
8.58
Experimental group
Pretest
37.16
8.87
Posttest
39.58
7.39
Growth
Control group
Pretest
49.33
5.61
Posttest
49.25
5.46
Experimental group
Pretest
49.33
5.61
Posttest
49.25
5.61
Relationships
Control group
Pretest
39.58
6.86
Posttest
40
7.71
Experimental group
Pretest
39.58
6.86
Posttest
43.83
7.69
Goal
Control group
Pretest
38.66
7.1
Posttest
37.5
7.57
Experimental group
Pretest
38.66
7.1
Posttest
38.58
7.3
Acceptance
Control group
Pretest
44.16
7.64
Posttest
43.91
7.76
Experimental group
Pretest
44.16
7.64
Posttest
51
6.78
According to Table 2 the mean of post-test
scores in the experimental group of components
of autonomy, dominance, relationships and
acceptance were more than the pre-test scores.
The mean of post-test scores in the experimental
group of components of growth and goal were
less than the pre-test scores. Although the pre-
test scores of the two groups is close to each
other, there is a significant difference in their
post-test scores. Then, by using inferential
statistics (MANCOVA) we will examine the
significance of these differences.
Table 3: MANCOVA effectiveness of positive psychotherapy on components of well-being
Name Test
Amount
F
Df hypothesis
Df error
Level Significant
Group
Pillai's Trace Test
0.73
5.12
6
11
0.01
Wilks' lambda test
0.26
5.12
6
11
0.01
Hotelling trace test
2.79
5.12
6
11
0.01
Roy's largest root test
2.79
5.12
6
1
0.01
435
As shown in Table 3, findings from MANCOVA
indicates that multivariate F value at the level of
P<0.0001 is statistically significant. Therefore, we
can say there is a significant differences between
the experimental and control groups in at least
one of the dependent variables. To discover the
difference, the results of the test effects among
subjects is presented in Table 4.
Table 4: Results of MANOVA on the difference between the components of well-being
Variables
Total Square
Degrees of freedom
Mean square
F value
Significance level
Autonomy
2.37
1
2.37
0.11
0.74
Domination
90.06
1
90.06
8.9
0.00
Growth
0.00
1
0.00
0.01
0.89
Relationships
70.56
1
70.56
7.87
0.01
Goal
21.45
1
21.45
1.92
0.18
Acceptance
140.38
1
140.38
14.35
0.00
As shown in table 4, the mean difference
between control and experimental groups
(pretest-posttest) has a significant difference in
dominance, relationships and acceptance. As
well as the mean difference between control and
experimental groups (pretest-posttest) have no
significant difference in autonomy, growth and
goal. Therefore, by the studies on the
effectiveness of positive psychotherapy on the
psychological well-being of women with breast
cancer, we found that the experimental group
and the control group experienced greater well-
being. Positive psychotherapy has helped to the
well-being of patients with breast cancer.
5 Conclusion
In the study of the research hypothesis based on
the effectiveness of positive psychotherapy on
the psychological well-being, the findings
indicated that this treatment is effective in the
subscales of dominance, acceptance and
relationships in breast cancer patients. But there
is no significant effect in the subscales of
autonomy, growth and goal. These findings are
in line with the results of Conoley, &
Conoley(2007), Dockray& Steptoe(2010) and
Connelly & Denney(2007). In explaining these
findings we can say that it seems that positive
psychotherapy can not only make a positive
resource but it can also have a mutual impact on
negative syndrome as well as being a barrier for
its recurrence. Research-based on meaning in
the form of positive psychotherapy also shows
that people who have used the meaning to
change the cycle of misery into happiness make
the most of their treatment programs.
According to positive psychology under the
terms of disaster survival and durability
condition is dependent on two functions,
personal characteristics and value systems
related to their group or community. In fact the
ultimate goal of positive approach is to identify
methods which causes well-being and happiness
in people, by focusing on the talents and
capabilities of people instead of dealing with
abnormalities and disorders (Connolly, 2009).
However, since the purpose and orientation in
life is the ability to find meaning, and to follow
it which all of these are in opposition to
happiness, personal growth or the blossoming of
all the forces and their self-talents, depends on
nurturing and obtaining new abilities that are
required to deal with difficult situations and
problems to other variables and capabilities of
people. Because facing these situation makes
one to seek one’s inner forces and also gain new
abilities. It had no significant difference with
positive training. In fact, if we want to know
when it is most likely to find these forces?
When a person is under pressure, these talents
are discovered frequently and show their power
436
to change the situation. Self-actualization of
people during challenges and unpleasant
conditions, expresses human mental ability to
cope with problems, endure a lot of suffering
and return back to normal after leaving it
behind and progress after passing obstacles.
Autonomy in these people also means that the
people can act and live according to their beliefs
and living standards, even if it is against the
accepted beliefs and customs in society. Jang
(1993), emphasis that a fully grown
man and self -flourish is the one whom is free
from any age and society. Therefore, a person
who chooses such an approach to life, is usually
familiar with its consequences and has accepted
it. Therefore, positive perspective training has
no significant effect on these variables.
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