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Published: 2021-07-30

The Effectiveness of Spiritual Intervention in Overcoming Anxiety and Depression Problems in Gynecological Cancer Patients

Program Study of Nursing, Faculty of Sports and Health Education, Universitas Pendidikan Indonesia, Bandung 40154
Faculty of Nursing, Universitas Indonesia, Depok 16424
Faculty of Nursing, Universitas Indonesia, Depok 16424
anxiety cancer depression spiritual intervention

Abstract

Anxiety and depression are psychological distress that often occurs in gynecological cancer patients. However, there are few studies related to interventions to overcome these problems. The purpose of this study was to determine the effect of a spiritual intervention on anxiety and depression in such cancer patients. The research design was quasi-experimental, employing pretest and posttest on the intervention and the control groups. The total number of respondents was 108 patients, consisting of 54 in each group. The instrument used in the study was the Hospital Anxiety and Depression Scale (HADS). The spiritual intervention consisted of four sessions, namely an introduction and relaxation session, a control session, an identity session, and a relationship and prayer therapy session, held over two weeks. The data analysis showed a change in the mean score of anxiety and depression in the intervention group after the spiritual intervention (p = 0.001). Also, there were differences in the mean scores of anxiety and depression between the intervention and control groups (p = 0.001). The result implies that spiritual intervention can be applied as part of holistic nursing care for cancer patients, especially gynecological ones.


Abstrak

Efektifitas Intervensi Spiritual dalam Mengatasi Masalah Kecemasan dan Depresi pada Pasien Kanker Ginekologi. Kecemasan dan depresi merupakan gangguan psikologis yang sering terjadi pada pasien kanker ginekologi. Namun, penelitian terkait intervensi dalam mengatasi masalah tersebut belum banyak dilakukan. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh intervensi spiritual terhadap kecemasan dan depresi pada pasien kanker ginekologi. Desain penelitian ini adalah quasi eksperimen menggunakan kelompok intervensi dan kontrol dengan pre-test dan post-test. Jumlah responden sebanyak 108 pasien yang terdiri dari 54 orang di setiap kelompok. Instrumen yang digunakan dalam penelitian ini adalah Hospital Anxiety and Depression Scale (HADS). Intervensi spiritual terdiri dari empat sesi: sesi pengenalan dan relaksasi, sesi kontrol, sesi identitas, dan sesi terapi hubungan dan doa, yang diberikan selama dua minggu. Analisis data menunjukkan adanya perubahan rerata skor kecemasan dan depresi pada kelompok intervensi setelah diberikan intervensi spiritual (p = 0,001). Selain itu, terdapat perbedaan rerata skor kecemasan dan depresi antara kelompok intervensi dan kontrol (p = 0,001). Penelitian ini mengimplikasikan bahwa intervensi spiritual dapat diterapkan sebagai bagian dari asuhan keperawatan holistik pada pasien kanker, terutama yang ginekologi.

Kata Kunci: depresi, intervensi spiritual, kanker, kecemasan

References

  1. Abbasi, B., Mirzakhany, N., Oshnari, L.A., Irani, A., Hosseinzadeh, S., Tabatabaei, S.M., & Haghighat, S. (2018). The effect of relaxation techniques on edema, anxiety and depression in post-mastectomy lymphedema patients undergoing comprehensive decongestive therapy: A clinical trial. Plos One, 13 (1), e0190231. doi: 10.1371/journal.pone.0190231.
  2. Afiyanti, Y., & Milanti, A. (2013). Physical sexual and intimate relationship concerns among Indonesian cervical cancer survivors: A phenomenological study. Nursing and Health Sciences, 15 (2), 151–156. doi: 10.1111/nhs.12006.
  3. Afiyanti, Y., Milanti, A., & Putri, R.H. (2018). Supportive care needs in predicting the quality of life among gynaecological patients. Winter Canadian Oncology Nursing Journal, 28 (1), 22–29. doi: 10.5737/236880762812229.
  4. Akalin, A., & Pinar, G. (2016). Unmet needs of women diagnosed with gynecologic cancer: An overview of literature. Journal of Palliative Care & Medicine, 6 (2), 1–6. doi: 10.4172/2165-7386.1000249.
  5. Carvalho, C.C., Chaves, E., Iunes, D., Simao, T., Grasselli, C., & Braga, C. (2014). Effectiveness of prayer in reducing anxiety in cancer patients. Rev Esc Enferm USP, 48 (4), 684–690. doi: 10.1590/S0080-623420140000400016.
  6. Cassedy, H.F., Tucker, C., Hynan, L.S., Phillips, R., Adams, C., Zimmerman, M.R., Pitts, S., Miltenberger, P., & Stringer, C.A. (2018, April). Frequency of psychological distress in gynecologic cancer patients seen in a large urban medical center. In Baylor University Medical Center Proceedings, 31 (2), 161–164. Taylor & Francis. doi: 10.1080/08998280.2018.144 0857.
  7. Cornah, D. (2018). The impact of spirituality on mental health: A review of the literature. Mental Health Foundation. Retrieved from https://www.mentalhealth.org.uk/sites/default/files/impact-spirituality.pdf
  8. Ghahari, S., Fallah, R., Rad, M.M., Farrokhi, N., Bolhari, J., Mousavi, M., Razzaghi, Z., & Akbari, M.E. (2017). Effect of cognitive-behavioral therapy and spiritual-religious intervention on improving coping responses and quality of life among women survivors of breast cancer in Tehran. Bali Medical Journal, 6 (2), 409–414. doi: 10.15562/bmj.v6i2.581.
  9. Hailemariam, T., Yohannes, B., Aschenaki, H., Mamaye, E., Orkaido, G., & Seta, M. (2017). Cancer science & therapy prevalence of cervical cancer and associated risk factors among women attending cervical cancer screening and diagnosis center at Yirgalem, 9 (11), 730–735. doi: 10.4172/1948-5956.1000500.
  10. Hansen, D.G., Larsen, P.V., Holm, L.V., Rottmann, N., Bergholdt, S.H., & Søndergaard, J. (2013). Association between unmet needs and quality of life of cancer patients: A population-based study. Acta Oncologica, 52 (2), 391–399. doi: 10.3109/0284186X.2012.742204.
  11. Heckel, L., Fennell, K. M., Reynolds, J., Osborne, R. H., & Chirgwin, J. (2015). Unmet needs and depression among carers of people newly diagnosed with cancer. European Journal of Cancer, 51 (14), 2049–2057. doi: 10.1016/j.ejca.2015.06.129.
  12. Hosseini, L., Kashani, F.L., Akbari, S., Akbari, M. E., & Mehr, S. (2016). The Islamic perspective of spiritual intervention effectiveness on bio-psychological health displayed by gene expression in breast cancer patients. Iran J Cancer Prev, 9 (2), 4–9. doi: 10.17795/ijcp-6360.Research.
  13. Jafari, N., Farajzadegan, Z., Zamani, A., Bahrami, F., Emami, H., Loghmani, A., & Jafari, N. (2013). Spiritual therapy to improve the spiritual well-being of Iranian women with breast cancer: A randomized controlled trial. Evidence-Based Complementary and Alternative Medicine, 2013, 353262. doi: 10.1155/2013/ 353262.
  14. Jafari, N., Zamani, A., Farajzadegan, Z., & Bahrami, F. (2012). The effect of spiritual therapy for improving the quality of life of women with breast cancer: A randomized controlled trial. Psychology, Health & Medicine, 18 (1), 56–69. doi: 10.1080/13548506.2012.679738.
  15. Kaban, A., & Tekin, B. (2017). Depression and Anxiety in Ovarian Cancer. Journal of Gynecology and Women’s Health, 4 (4), 6–8. doi: 10.19080/JGWH.2017.04.555647.
  16. Kamali, Z., Tafazoli, M., Ebrahimi, M., & Hosseini, M. (2018). Effect of spiritual care education on postpartum stress disorder in women with
  17. preeclampsia. Journal of Education and Health Promotion, 7 (73), 1–8. doi: 10.4103/jehp.jehp.
  18. Kashani, F., Babaee, S., Bahrami, M., & Valiani, M. (2012). The effects of relaxation on reducing depression, anxiety and stress in women who underwent mastectomy for breast cancer. Iranian Journal of Nursing and Midwifery Research, 17 (1), 30–33.
  19. Levine, E.G., Aviv, C., Yoo, G., Ewing, C., & Au, A. (2009). The benefits of prayer on mood and well being of breast cancer survivors. Support Care Cancer, 17 (3), 295–306. doi: 10.1007/s00520-008-0482-5.
  20. Lin, C., & Pakpour, A.H. (2017). Using Hospital Anxiety and Depression Scale (HADS) on patients with epilepsy: Confirmatory factor analysis and Rasch models. Seizure: European Journal of Epilepsy, 45, 42–46. doi: 10.1016/j.seizure.2016.11.019.
  21. Macmillan, A., Macmillan, S., Hyde, N., & Hodgkiss, A. (2018). Depression and anxiety in patients with cancer. BMJ, 361, k1415. doi: 10.1136/bmj.k1415.
  22. Martin, H., Brähler, E., Härter, M., Keller, M., Schulz, H., Wegscheider, K., Boehncke, A., Reuter, K., Richard, M., Sehner, S., Koch, U., & Mehnert, A. (2017). Unmet needs for information and psychosocial support in relation to quality of life and emotional distress: A comparison between gynecological and breast cancer patients. Patient Education and Counseling, 100 (10), 1934–1942. doi: 10. 1016/j.pec.2017.05.031.
  23. Memaryan, N., Ghaempanah, Z., & Saeedi, M.M. (2017). Content of spiritual counselling for cancer patients undergoing chemotherapy in Iran: A qualitative content analysis. Asian Pacific Journal of Cancer Prevention, 18 (7), 1791–1797. doi: 10.22034/APJCP.2017.18.7.1791.
  24. Moeini, M., Taleghani, F., Mehrabi, T., & Musarezaie, A. (2014). Effect of a spiritual care program on levels of anxiety in patients with leukemia. Iranian Journal of Nursing and Midwifery Research, 19 (1), 88–93.
  25. Musarezaie, A., Ghasemipoor, M., Ghaleghasemi, T., Khodaee, M., & Taleghani, F. (2015). A study on the efficacy of spirituality-based intervention on spiritual well-being of patients with leukemia: A randomized clinical trial. Middle East Journal of Cancer, 6 (2), 97–105.
  26. Musarezaie, A., Moeini, M., Taleghani, F., & Mehrabi, T. (2014). Does spiritual care program affect levels of depression in patients with Leukemia? A randomized clinical trial. Journal of Education and Health Promotion, 3, 96. doi: 10.4103/2277-9531.139678.
  27. Nanjaiah, R., Khan, M.A., & Rao, V.N. (2017). Psychological impact of cancer diagnosis among gynaecological cancer subjects in a tertiary care centre. International Journal of Community Medicine and Public Health, 4 (2), 433–439. doi: 10.18203/2394-6040.ijcmph2017 0268.
  28. Oh, P., & Kim, S.H. (2014). The effects of spiritual interventions in patients with cancer: A meta-analysis. Oncology Nursing Forum, 41 (5), E290–301. doi: 10.1188/14.ONF.E290.
  29. Rafsanjani, T.H., Arab, M., Ravari, A., Miri, S., & Safarpour, H. (2017). A study on the effects of spiritual group therapy on hope and the mental and spiritual health of patients with colorectal cancer. Progress in Palliative Care, 25 (4), 171–176. doi: 10.1080/09699260.2017.1339518.
  30. Sankhe, A., Dalal, K., Agarwal, V., & Sarve, P. (2017). Spiritual care therapy on quality of life in cancer patients and their caregivers: A prospective non-randomized single cohort study. Journal of Religion and Health, 56 (2), 725–731. doi: 10.1007/s10943-016-0324-6.
  31. Silverberg, J.I.D., Gelfand, J.M., Margolis, D.J., Boguniewicz, M., Fonacier, L., Grayson, M.H., Ong, P.Y., Chiesa Fuxench, Z.C., & Simpson, E.L. (2019). Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults. British Journal of Dermatology, 181 (3), 554–565. doi: 10.1111/ jd.17683.
  32. Song, Q., Xu, R., Zhang, Q., Ma, M., & Zhao, X. (2013). Relaxation training during chemotherapy for breast cancer improves mental health and lessens adverse events. International Journal Clin Exp Med, 6 (10), 979–984.
  33. Tuck, I. (2012). A critical review of a spirituality intervention. Western Journal of Nursing Research, 34 (6), 712–735. doi: 10.1177/01939 45911433891.
  34. Watts, S., Prescott, P., Mason, J., Mcleod, N., & Lewith, G. (2015). Depression and anxiety in ovarian cancer: A systematic review and meta-analysis of prevalence rates. BMJ Open, 5 (11), e007618. doi: 10.1136/bmjopen-2015-007618.
  35. Weaver, A.J. (2018). The role of religion/spirituality for cancer patients and their caregivers. Southern Medical Journal, 97 (12), 1210–1214. doi: 10.1097/01.SMJ.0000146492.276 50.1C.
  36. Xing, L., Guo, X., Bai, L., Qian, J., & Chen, J. (2018). Are spiritual interventions beneficial to patients with cancer? A meta-analysis of randomized controlled trials following PRISMA. Medicine, 97 (35), 1–11. doi: 10.18203/2394-6040.ijcmph20170268.
  37. Yaman, S., & Ayaz, S. (2016). Psychological problems experienced by women with gynecological cancer and how they cope with it: A phenomenological study in turkey. National Association of Social Workers, 41 (3), 173–181. doi: 10.1093/hsw/hlw030.
  38. Zamaniyan, S., Bolhari, J., Naziri, G., Akrami, M., & Hosseini, S. (2016). Effectiveness of spiritual group therapy on quality of life and spiritual well-being among patients with breast cancer. Iran Journal Med Sci, 41 (2), 140–144.

How to Cite

Nasution, L. A., Afiyanti, Y., & Kurniawati, W. (2021). The Effectiveness of Spiritual Intervention in Overcoming Anxiety and Depression Problems in Gynecological Cancer Patients. Jurnal Keperawatan Indonesia, 24(2), 99–109. https://doi.org/10.7454/jki.v24i2.990