The Effect Of Group Psychotherapy On The Emotion And Quality Of Life To Women Who Underwent Modified Radical Mastectomy

ObjectiveFor the past few years,the morbidity of breast cancer is increasing at a speed of 3%per year in China.In some metropolises like Shanghai and Beijing,the rate becomes top one in the tumor of women.Modified Radical Mastectomy is a useful treatment which frequently used in patients with breast cancer,and can raise their survival.However,the loss of breast as a result of the operation and the adverse reaction of chemotherapy are a chronic distress which make a negative effect to women's health.As the change of the medical model,people gradually realize the significance of combined therapy.Mental status has a great influence on the development of the cancer;therefore,it's significant to improve patient's psychology and the quality of life.Psychological interventions used in patients with breast cancer include health education,psychological support,coping technique,relaxation training,group psychotherapy,musical treatment and so on.The intervention is proved useful in lessening their distress and advance quality of life.Group psychotherapy has used in cancer patients for about 20 years.The psychological therapist can treat more participants effectively at the same time,there are also more resources or point of views in group which can make members to communicate and support one another.So many therapists have recognized that group psychotherapy could facilitate self-exploration and adaptation.Studies had reported that about two-thirds of the patients who accepted the psychotherapy showed an level of "midrange" or "significant" improvement in emotional disorder,and the effectiveness of group therapy was better than individual psychotherapy in some aspects.Currently,group therapy for cancer patients includes: psychology group,support-expressive group and recognition-behavior group.The use of group psychotherapy to cancer patients starts late in our country,the group usually is composed by patients with different kinds of cancer.Although the effectiveness of the group intervention is obviously,but the direction of the group is indefinite.The objective of our research is to investigate the effectiveness of group psychotherapy to patients with breast cancer who underwent modified radical mastectomy.Methods1.Research tools(1)Schedule table of general state of health.(2)Quality of life questionnaire for breast cancer patients(QLQ-BR53)for quality of life.(3)Self-rating anxiety scale(SAS)and Self-rating depression scale(SDS)for the mood condition.2.Grouping62 patients randomized to experiment or control group for an 8-week observation. Rating Scale was used to compare independently both at baseline and at the end of 8th week,including the SDS,SAS,QLQ-BR53.Each patient signs the informed consent. The experiment group accepts an8-week group psychotherapy except chemotherapy, and the control one only underwent chemo.3.Process of group psychotherapyTo visit the patient,get the message of the mental state of them.Arrange the proceedings according to the group program.Contents of the 8 sessions are:(1)Meeting in the stormy weather.To know each other,clarify and adjust the objective of the group psychotherapy.(2)Sharing with each other.To establish the confidence of the members,let them talk about their doubt of the cancer. (3)Opening an umbrella for you.Promote self-exploration and abreaction.(4)Wandering in the rain.To discuss the alteration coming with the operation, help members to accept the change and build up confidence.(5)Here we are.Enhance the cohesive force of the group and comprehend it.(6)The rainbow in my heart.To face the reality,plan a new life.(7)Over the rainbow.Learn from other's experience.(8)What a fine day after the stormy.Consolidate the achievement and deal with the separation.Results1.Compared to control,after an 8-week GP,the experiment group had less depression and anxiety(p＜0.05).2.Compared to control,the experiment group showed a significant improvement in social function and global health status(p＜0.05)and level of body image(p＜0.05). There is a significant improvement in physical sufferings of languor and loss of appetite(p＜0.05).3.Both of the two group showed a significant improvement in the areas of pain,breast symptoms and arm symptoms(p＜0.05).Conclusion1.For the experiment group,there is a significant improvement in the anxiety and depression after group psychotherapy.2.The experiment group showed a significant improvement in physical sufferings and functional domains.In a word,Group psychotherapy for patients with breast cancer who underwent modified radical mastectomy can lessen depression and anxiety,and build up global quality of life.