The Effects of Psychological Nursing Intervention Program on Psychological Distress and Quality of Life in Women with Breast Cancer Undergoing Chemotherapy

Friday, 25 July 2014

Yeon Hee Kim, PhD, RN
Asan Medical Center, Seoul, South Korea
Kyung Sook Choi, PhD, RN
Department of Nursing, Chung Ang University, Seoul, South Korea


The purpose of this study was to develop a psychological nursing intervention program and evaluate the effect on psychological distress and quality of life for women breast cancer patients undergoing chemotherapy.


The research design was pre and post randomized controlled trials.

Development of the psychological nursing intervention program proceeded as follows:

(1) The program was based on the guideline of psychological intervention proposed by Fawzy(1996), focusing on chemotherapy symptom management education, coping skill for negative emotion while treatment process, and emotional support: body image, self concept, stress coping, expressing fear of cancer recurrence, how to overcome difficulty in personal relation, utilization of social resource, sharing experience related to sexual life, and self acceptance etc.

This program was structured to express their feelings and provide emotional support.

The program consisted eight 30~60 minute sessions over the weekly counseling with face to face counsel combined with telephone counsel.

(2) The psychological nursing intervention program was finalized after expert group validation of structure, formation, and content.

To evaluate the effect of the intervention, the high risk group for depression was sampled among women breast cancer patients scheduled chemotherapy at outpatient clinic, a tertiary hospital. A total of 44 participants were recruited and allocated to an experimental group and a control group.

The effect of the program was evaluated by measuring psychological distress such as mood, anxiety, and depression and quality of life.

The data were analyzed using SPSS program for descriptive statistics, independent t-test, x2-test, Fisher’s exact test, and RM-ANOVA.


The results of this study are as follows:

1. Hypothesis 1: “The experimental group which participated in the program will show lower psychological distress than the control group.”

1) Hypothesis 1-1: “The experimental group which participated in the program will show more improved mood than the control group.” was supported (F=7.290, p=0.003).

2) Hypothesis 1-2: “The experimental group which participated in the program will show lower anxiety level than the control group.” was supported (F=7.770, p=0.002).

3) Hypothesis 1-3: “The experimental group which participated in the program will show lower depression level than the control group.” was supported (F=11.921, p=0.000).

2. Hypothesis 2: “The experimental group which participated in the program will show higher quality of life than the control group.” was not supported (F=1.144, p=0.313).

Conclusion: this psychological nursing intervention program for women breast cancer undergoing chemotherapy was effective for reducing psychological distress and improving quality of life in some domain. The program will reduce psychological distress for breast cancer patients undergoing one more therapy and enable them to improve long term survival rate as well as to improve their quality of life. More psychological intervention programs will be needed.