مقایسه اثربخشی درمان گروهی فعال‌سازی رفتاری، شناخت درمانی مبتنی بر ذهن آگاهی و درمان مبتنی بر پذیرش و تعهد بر افسردگی و کیفیت زندگی افراد مبتلا به سرطان

محسن دربندی ¹ ( دانشجوی دکتری ، گروه روان‌شناسی، واحد بوشهر، دانشگاه آزاد اسلامی، بوشهر، ایران )
ناصر امینی ² ( دانشیار ، گروه روان‌شناسی، واحد بوشهر، دانشگاه آزاد اسلامی، بوشهر، ایران. ( نویسنده مسئول )[e-mail] )
شهدخت آزادی ³ ( استادیار گروه روان‌شناسی واحد گچساران، دانشگاه آزاد اسلامی، گچساران، ایران )
کامران میرزایی ⁴ ( دانشیار گروه پزشکی اجتماعی دانشگاه علوم پزشکی بوشهر، بوشهر، ایران. گروه روان‌شناسی، واحد بوشهر، دانشگاه آزاد اسلامی، بوشهر، ایران )

تاریخ ارسال : 1402/04/12 تاریخ تایید : 1402/09/05

کلید واژه: کیفیت زندگی, افسردگی, سرطان, ذهن‌آگاهی, پذیرش و تعهد, فعال‌سازی رفتاری, شناخت‌درمانی,

چکیده مقاله :

این پژوهش از حیث هدف از نوع کاربردی و از حیث روش یک مطالعه مقطعی از نوع نیمه آزمایشی با طرح پیش‌آزمون- پس‌آزمون- پیگیری بود. جامعه‌ی آماری شامل کلیه‌ی افراد مبتلا به سرطان شهر بوشهر در آبان 1399 تا فروردین 1400 بود. از این جامعه 40 نفر به روش نمونه‌گیری در دسترس انتخاب و به صورت تصادفی در چهار گروه 10 نفری (سه گروه آزمایشی و یک گروه کنترل)، گمارده شدند. پرسشنامه‌های کیفیت زندگی سازمان بهداشت جهانی(1996) و افسردگی بک(1998) به عنوان پیش‌آزمون بر روی کلیه‌ی شرکت‌کنندگان اجرا گردید. سپس افراد گروه آزمایش اول درمان گروهی فعال‌سازی رفتاری، گروه آزمایش دوم درمان مبتنی بر پذیرش و تعهد و گروه آزمایش سوم نیز شناخت‌درمانی مبتنی بر ذهن‌آگاهی را در ده جلسه‌ی 90 دقیقه‌ای دریافت کردند. اما افراد گروه کنترل، مداخله‌ی دریافت نکردند. به دلیل شرایط کرونایی مداخلات درمانی، به صورت ویدیوکال برگزار گردید. در نهایت پرسشنامه‌های مذکور به عنوان پس آزمون بر رو کلیه‌ی شرکت‌کنندگان اجرا شد. به منظور پیگیری اثربخشی، پس از یک ماه، کلیه‌ی شرکت‌کنندگان مجدداً به پرسشنامه‌ها پاسخ دادند. یافته‌ها با استفاده از تحلیل واریانس با اندازه‌گیری‌های مکرر و آزمون‌های تعقیبی توکی و بونفرونی مورد تجزیه و تحلیل قرار گرفت. بر اساس نتایج، میانگین نمرات پس‌آزمون بیماران هر سه گروه آزمایش در متغیر‌های افسردگی و کیفیت‌زندگی به ترتیب کاهش و افزایش معناداری نسبت به گروه کنترل داشت(05/0P<). این تفاوت‌ها در مرحله‌ی پیگیری نیز معنادار بود(05/0P<). با این حال تفاوت میزان اثربخشی سه درمان مذکور بر کاهش افسردگی و افزایش کیفیت زندگی، در سطح معناداری نبود(05/0P>).

چکیده انگلیسی :

This research was applied in terms of purpose and in terms of method it was a semi-experimental cross-sectional study with a pre-test-post-test-follow-up design. The statistical population included all cancer patients in Bushehr city from November 2019 to April 2014. From this population, 40 people were selected by available sampling method and randomly assigned to four groups of 10 people (three experimental groups and one control group). World Health Organization quality of life questionnaires (1996) and Beck depression questionnaires (1998) were administered to all participants as a pre-test. Then the people of the first experimental group received behavioral activation group therapy, the second experimental group received therapy based on acceptance and commitment, and the third experimental group also received cognitive therapy based on mindfulness in ten 90-minute sessions. But people in the control group did not receive intervention. Due to the corona situation, therapeutic interventions were held in the form of video calls. Finally, the aforementioned questionnaires were administered to all participants as a post-test. In order to follow up the effectiveness, after one month, all the participants answered the questionnaires again. The findings were analyzed using analysis of variance with repeated measurements and Tukey and Bonferroni post hoc tests. Based on the results, the mean post-test scores of the patients of all three test groups in the variables of depression and quality of life had a significant decrease and increase, respectively, compared to the control group (P<0.05). These differences were also significant in the follow-up phase (P<0.05). However, the difference in the effectiveness of the three mentioned treatments on reducing depression and increasing quality of life was not significant (P>0.05).

منابع و مأخذ:

ایزدی، راضیه؛ نشاط دوست، حمیدطاهر؛ عسگری، کریم؛ عابدی، محمدرضا (1393). مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و درمان شناختی- رفتاری بر علایم بیماران مبتلا به اختلال وسواس- اجبار. تحقیقات علوم رفتاری، 1(35):19-33.

براری بازیارخیلی، زهرا؛ ابراهیمی، صدیقه .(1400). پیش‌بینی درماندگی روانشناختی و تحمل ناکامی بر اساس نارسایی هیجانی در زنان مبتلا به سرطان پستان. نشریه پرستاری، 34(129): 96-108.

بنی اسدی فاطمه، پورشریفی حمید، برجعلی احمد و مفید بهرام. (1400). اثربخشی درمان مبتنی بر پذیرش و تعهد بر پریشانی روان شناختی افراد مبتلا به سرطان پروستات طب پیشگیری، 8(1):12-22.

بی غم لعل آبادی الهه، نریمانی محمد، حاجی مرادی راضیه. (1401). فراتحلیل اثربخشی درمان فعالسازی رفتاری بر میزان افسردگی نوجوانان، روش ها و مدل های روانشناختی، 13(47): 161-174.

پورعبداله، هما؛ جعفری ورجوشانی، نسرین؛ نمدیان، معصومه .(1401). بررسی کیفیت زندگی بیماران مبتلا به سرطان معده و عوامل مرتبط با آن در شهر زنجان. سلامت جامعه، 16(3): 27- 35.

جعفری، سالم؛ کردتمینی، بهمن؛ کهرازئی، فرهاد (1400). اثربخشی درمان مبتنی بر پذیرش و تعهد بر کاهش افسردگی و نشخوار ذهنی زنان مبتلا به سرطان. مجله علوم پزشکی رازی، 28(3): 210-219.

خدایاری‌فرد، محمد ؛ محمدی‌حاصل، کورش؛ دیده‌دار، مریم .(1398). شناخت رفتار درمانگری یکپارچه شده با ذهن آگاهی: اصول و روش اجرا‏‫. انتشارات دانشگاه تهران.

سوره، جمال؛ حاجلو، نادر؛ عطادخت، اکبر؛ بشرپور، سجاد .(1402). مقایسه اثربخشی درمان شناختی مبتنی بر ذهن‌آگاهی و درمان مبتنی بر معنی و هدف در ارتقای رشد پس از آسیب و سازگاری روانی-اجتماعی بیماران مبتلا به سرطان پستان. رویش روانشناسی، 12(2): 27-38.

علیایی زهرا، محمدی مسعود، انوری کاظم و حسینی سید ابراهیم (1401). برررسی اثربخشی شناخت درمانی مبتنی بر ذهن آگاهی بر افسردگی، کیفیت زندگی و میزان کورتیزول سرم در افراد افسرده، زیست شناسی جانوری، 14(4):153-169.

محمدزاده، سلیمان؛ یوسفی، فایق؛ کمالی اردکانی، سارا؛ مرادویسی، برهان؛ سیدی‌نسب، سیده‌زهرا؛ طه‌زاده، سمیه .(1401). بررسی شیوع افسردگی در کودکان و نوجوانان مبتلا به سرطان بستری شده در بخش انکولوژی بیمارستان بعثت سنندج. مجله روانشناسی و روانپزشکی شناخت، 9(5): 66-76.

میراویسی، سحر؛ احمدیان، حمزه؛ مرادی، امید؛ قادری، بایزید (1402). اثربخشی برنامه آموزشی مبتنی بر سازش با درد بر افسردگی و اضطراب بیماران سرطانی. مجله روانشناسی و روانپزشکی شناخت، 10(2): 107-117.

وهابی ماشک، معصومه؛ مجتبایی، مینا .(1401). اثربخشی آموزش درمان مبتنی بر پذیرش و تعهد بر افسردگی و کیفیت زندگی زنان مبتلا به سرطان پستان. مجله دانشکده پزشکی دانشگاه علوم‌پزشکی مشهد، 65(4): 1858-1869.

American Cancer Society. (2014). The History of Cancer. Available from: www.cancer.org/the-history-of-cancer-pdf. Accessed December 23.

Beck, A. T, Steer, A. R, Garbin, G. (1998). Analysis of the psychometric parties of the Spanish version of the Beck depression inventory in Argentina. Psychiatr Rev, 79(3): 275-85.

Cai T, Verze P, Johansen TE. (2021). The quality of life definition: Where are we going? Uro; 1(1):14-22. DOI: 10.3390/uro1010003

Chambless, D. L., Baker, M. J., Baucom, D. H., Beutler, L. E., Calhoun, K. S., & Crits Christoph, P. (1998). Update on Emprically Validated Therapies, ll. The Clinical Psychologist, 51, 3-16.

Chernyshov, P. V. Lallas, A. Tomas‐Aragones, L. Arenbergerova, M. Samimi, M. Manolache, L. ... & Finlay, A. Y. (2019). Quality of life measurement in skin cancer patients: literature review and position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes, Melanoma and Non‐Melanoma Skin Cancer. Journal of the European Academy of Dermatology and Venereology, 33(5): 816-827.

DeSantis, C. E., Lin, C. C., Mariotto, A. B., Siegel, R. L., Stein, K. D. Kramer, J. L., Alteri, R., Robbins, A. S., & Jemal, A. (2014). Cancer treatment and survivorship statistics, 2014. Article first published online: 1 JUN 2014 DOI: 10.3322/ caac.21235

Fish, J. A., Ettridge, K., Sharplin, G. R., Hancock, B., & Knott, V. E. (2014). Mindfulness‐based Cancer Stress Management: impact of a mindfulness‐based programme on psychological distress and quality of life. European journal of cancer care, 23(3): 413-421.

Frostadottir, A. D., & Dorjee, D. (2019). Effects of Mindfulness Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) on Symptom Change, Mindfulness, Self-Compassion, and Rumination in Clients with Depression, Anxiety, and Stress. Frontiers in Psychology, 10. doi:10.3389/fpsyg.2019.01099

Gollan, J., Atlis, M., & Marlow-OConnor, M. (2003). Behavioral activation: Group treatment for depression (pilot version). Unpublished manual, University of Chicago.

Haun M, Sklenarova H, Hartmann M. (2014). Depression, anxiety and disease-related distress in couples affected by advanced lung cancer. Lung Cancer, 86(2): 274-280.

Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, & Pistorello J. (2013). Acceptance and commitment therapy and contextual behavioral science: examining the rogress of a distinctive model of behavioral and cognitive therapy. Behav Ther, 4(2):180-198.

Hayes, S. C., Strosahl, K. D. & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. New York: Guilford.

Karekla M, & Constantinou M. (2010). Religious coping and cancer: Proposing an acceptance and commitment therapy approach. Cognitive and Behavioral Practice, 17(4): 371-381.

Kim MS, Kim SY, Kim JH, Park B, Choi HG. (2017). Depression in breast cancer patients who have undergone mastectomy: a national cohort study. PLoS One. 12(4): e0175395.

L.Pott Jaime, Delgadillo & StephenKellett. (2022).  Is behavioral activation an effective and acceptable treatment for co-occurring depression and substance use disorders? A meta analysis of randomized controlled trials, Journal of Substance Abuse Treatment, Volume 132, January 2022, 108478.

Leiter, U. Keim, U. & Garbe, C. (2020). Epidemiology of skin cancer: update 2019. Adv Exp Med Biol; 1268:123-139.  doi: 10.1007/978-3-030-46227-7_6.

Li P, Hu Y, Martikainen P. (2023). Pre-existing psychological disorders, diabetes, and pancreatic cancer: A population-based study of 38,952 Finns. Cancer Epidemiology, 82, 102307.

Martell CR, Dimidjian S, Herman-Dann R.(2010). Behavioral activation for depression: a clinician’s guide. New York. The Guilford Press.

May David,  Litvin d, Boris and Allegrante John(2022). Behavioral Activation, Depression, and Promotion of Health Behaviors: A Scoping Review, Journal of Psychosomatic Research, Impact Factor: 4.444 / 5-Year Impact Factor: 3.943

 

Mols F, Schoormans D, de Hingh I, Oerlemans S, Husson O. (2018). Symptoms of anxiety and depression among colorectal cancer survivors from the population based, longitudinal PROFILES Registry: Prevalence, predictors, and impact on quality of life. Cancer, 124(12), 2621-2628.

Petrillo L, El-Jawahri A, Heuer L, Post K, Gallagher E, Trotter C, Plotke R, Temel J, Greer J. (2022).Quality of Life and Depression Symptoms in a Cross-Section of Patients with Advanced Lung Cancer before and During the Coronavirus Disease 2019 (COVID-19) Pandemic (RP322). Journal of Pain and Symptom Management, 63(6), 1079-1080.

Porter, J. F., Spates, R., & Smitham, S. (2004). International Psychotherapy for depression? The need to define its ecological niche. Journal of affective disorders, 95, 1-11.

Rieke K, Schmid KK, Lydiatt W, Houfek J, Boilesen E, Watanabe-Galloway Sh. (2017). Depression and survival in head and neck cancer patients. Oral Oncol, 65, 76-82.

Sánchez-Migallón J, Seignot I, Sendros Madroño MJ. (2023). Prevalence of Obesity in Cancer Patients and Its Concordance with the Pathological History of the Clinical History of the Cancer Patient. Clinical Nutrition ESPEN, 54, 587.

Segrin, C., Badger, T.A., Meek, P., Lopez, A.M., Bonham, E., & Sieger, A.  (2006) Dyadic interdependence on affect and quality of life trajectories among women with breast cancer and their partners. Journal of Social and Personal Relationships. 27,673-689.

Shrestha AD, Neupane D, Vedsted P, Kallestrup P. (2018). Cervical cancer prevalence, incidence and mortality in low and middle income countries: a systematic review. Asian Pacific journal of cancer prevention. Asian Pacific Journal of Cancer Prevention, 19(2), 319-324.

Spiegel D, Riba MB. (2015). Managing anxiety and depression during treatment. Breast J, 21(1): 97–103.

Steinmetz, J. L., Lewinsohn, P. M., & Antonuccio, D. O. (1983). Prediction of individual outcome in a group intervention for depression. Journal of Consulting and Clinical Psychology, 51(3): 331.

Temple J, Salmon P, Smith CT, Huntley CD, Byrne A, Fisher PL. (2020). The questionable efficacy of manualized psychological treatments for distressed breast cancer patients: An individual patient data meta-analysis. Clinical Psychology Review, 80, 101883.

ToonTab Haqiqi S, The quality of sex life among women with breast cancer in fertility ages, M.A thesis in midwifery, Tarbiyat Modarres University, 2019.

 Weitz, Kleiboer, van Straten&  Cuijpers (2018).The effects of psychotherapy for depression on anxiety symptoms: a meta-analysis, 39, 241–254.

Wieman ST, Hall KA, Hall DL. (2023). Treatment-related changes in insomnia, anticipatory pleasure, and depression symptoms: A proof-of-concept study with cancer survivors. Sleep Medicine, 103, 29-32.

Zettle, R. D., & Raines, J. C. (1989). Group cognitive and contextual therapies in treatment of depression. Journal of Clinical Psychology, 45, 438-445.

Zimmermann FF, Burrell B, Jordan J. (2018). The acceptability and potential benefits of mindfulness-based interventions in improving psychological well-being for adults with advanced cancer: a systematic review. Complementary therapies in clinical practice, 30, 68-78.

 

Aliayi Zahra, Mohammadi Masoud, Anuri Kazem and Hosseini Seyyed Ebrahim (1401). Investigating the effectiveness of cognitive therapy based on mindfulness on depression, quality of life and serum cortisol levels in depressed people, Animal Biology, 14(4):153-169. ]persian[

American Cancer Society. (2014). The History of Cancer. Available from: www.cancer.org/the-history-of-cancer-pdf. Accessed December 23.

Beck, A. T, Steer, A. R, Garbin, G. (1998). Analysis of the psychometric parties of the Spanish version of the Beck depression inventory in Argentina. Psychiatr Rev, 79(3): 275-85.

Amiri, Sahar; Ehtshamzadeh, Parvin; Hafizi, Fariba; Barna, Mohammad Reza (2019). Comparison of the effectiveness of activation therapy and therapy based on acceptance and commitment on the executive functions of learning rules, impulsivity inhibition and flexibility in patients with depression. Shafai Khatam Journal of Neuroscience, 9(2): 68-78. ]persian[

Bani Asadi Fatemeh, Hamid Poursharifi, Barjali Ahmed and Mofid Bahram. (1400). The effectiveness of acceptance and commitment therapy on psychological distress of prostate cancer patients. Preventive Medicine, 8(1):12-22. ]persian[

Brari Baziarcheli, Zahra; Ebrahimi, Siddiqa. (1400). Prediction of psychological helplessness and tolerance of failure based on emotional failure in women with breast cancer. Journal of Nursing, 34(129): 96-108. ]persian[

Bigham Lalabadi Elaha, Narimani Mohammad, Haji Moradi Razieh. (1401). A meta-analysis of the effectiveness of behavioral activation therapy on adolescent depression, Psychological Methods and Models, 13(47): 161-174. ]persian[

Cai T, Verze P, Johansen TE. (2021). The quality of life definition: Where are we going? Uro; 1(1):14-22. DOI: 10.3390/uro1010003

Chambless, D. L., Baker, M. J., Baucom, D. H., Beutler, L. E., Calhoun, K. S., & Crits Christoph, P. (1998). Update on Emprically Validated Therapies, ll. The Clinical Psychologist, 51, 3-16.

Chernyshov, P. V. Lallas, A. Tomas‐Aragones, L. Arenbergerova, M. Samimi, M. Manolache, L. ... & Finlay, A. Y. (2019). Quality of life measurement in skin cancer patients: literature review and position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes, Melanoma and Non‐Melanoma Skin Cancer. Journal of the European Academy of Dermatology and Venereology, 33(5): 816-827.

DeSantis, C. E., Lin, C. C., Mariotto, A. B., Siegel, R. L., Stein, K. D. Kramer, J. L., Alteri, R., Robbins, A. S., & Jemal, A. (2014). Cancer treatment and survivorship statistics, 2014. Article first published online: 1 JUN 2014 DOI: 10.3322/ caac.21235

Fish, J. A., Ettridge, K., Sharplin, G. R., Hancock, B., & Knott, V. E. (2014). Mindfulness‐based Cancer Stress Management: impact of a mindfulness‐based programme on psychological distress and quality of life. European journal of cancer care, 23(3): 413-421.

Frostadottir, A. D., & Dorjee, D. (2019). Effects of Mindfulness Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) on Symptom Change, Mindfulness, Self-Compassion, and Rumination in Clients with Depression, Anxiety, and Stress. Frontiers in Psychology, 10. doi:10.3389/fpsyg.2019.01099

Gifford, E.V. Does acceptance and relationship focused behavior therapy contribute to bupropion outcomes? A randomized controlled trial of functional analytic psychotherapy and acceptance and commitment therapy for smoking cessation. Behavior therapy, 2011. 42(4):700-15.

Gollan, J., Atlis, M., & Marlow-OConnor, M. (2003). Behavioral activation: Group treatment for depression (pilot version). Unpublished manual, University of Chicago.

Haun M, Sklenarova H, Hartmann M. (2014). Depression, anxiety and disease-related distress in couples affected by advanced lung cancer. Lung Cancer, 86(2): 274-280.

Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, & Pistorello J. (2013). Acceptance and commitment therapy and contextual behavioral science: examining the rogress of a distinctive model of behavioral and cognitive therapy. Behav Ther, 4(2):180-198.

Hayes, S. C., Strosahl, K. D. & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. New York: Guilford.

Karekla M, & Constantinou M. (2010). Religious coping and cancer: Proposing an acceptance and commitment therapy approach. Cognitive and Behavioral Practice, 17(4): 371-381.

Khodayarifard, Mohammad; Mohammadi Hashel, Koresh; Deheddar, Maryam (2018). Cognitive behavior therapy integrated with mindfulness: principles and implementation method. Tehran University Publications. ]persian[

Kim MS, Kim SY, Kim JH, Park B, Choi HG. (2017). Depression in breast cancer patients who have undergone mastectomy: a national cohort study. PLoS One. 12(4): e0175395.

L.Pott Jaime, Delgadillo & StephenKellett. (2022).  Is behavioral activation an effective and acceptable treatment for co-occurring depression and substance use disorders? A meta analysis of randomized controlled trials, Journal of Substance Abuse Treatment, Volume 132, January 2022, 108478.

Leiter, U. Keim, U. & Garbe, C. (2020). Epidemiology of skin cancer: update 2019. Adv Exp Med Biol; 1268:123-139.  doi: 10.1007/978-3-030-46227-7_6.

Li P, Hu Y, Martikainen P. (2023). Pre-existing psychological disorders, diabetes, and pancreatic cancer: A population-based study of 38,952 Finns. Cancer Epidemiology, 82, 102307.

Martell CR, Dimidjian S, Herman-Dann R.(2010). Behavioral activation for depression: a clinician’s guide. New York. The Guilford Press.

May David,  Litvin d, Boris and Allegrante John(2022). Behavioral Activation, Depression, and Promotion of Health Behaviors: A Scoping Review, Journal of Psychosomatic Research, Impact Factor: 4.444 / 5-Year Impact Factor: 3.943

Miravisi, Sahar; Ahmadian, Hamza; Moradi, Omid; Qadri, Bayazid (1402). The effectiveness of an educational program based on compromise with pain on depression and anxiety in cancer patients. Journal of Cognitive Psychology and Psychiatry, 10(2): 107-117. ]persian[

Mohammadzadeh, Suleiman; Yousefi, Faiq; Kamali Ardakani, Sara; Moradavisi, proof; Sidi Nesab, Sidi Zahra; Tahzadeh, Samiya (1401). Investigating the prevalence of depression in children and adolescents with cancer admitted to the oncology department of Baath Hospital, Sanandaj. Journal of Cognitive Psychology and Psychiatry, 9(5): 66-76. ]persian[

Mols F, Schoormans D, de Hingh I, Oerlemans S, Husson O. (2018). Symptoms of anxiety and depression among colorectal cancer survivors from the population based, longitudinal PROFILES Registry: Prevalence, predictors, and impact on quality of life. Cancer, 124(12), 2621-2628.

Parsley, healthy; Kurdtmini, Bahman; Kehrazaei, Farhad (1400). The effectiveness of treatment based on acceptance and commitment on reducing depression and mental rumination in women with cancer. Razi Journal of Medical Sciences, 28(3): 210-219.

Petrillo L, El-Jawahri A, Heuer L, Post K, Gallagher E, Trotter C, Plotke R, Temel J, Greer J. (2022).Quality of Life and Depression Symptoms in a Cross-Section of Patients with Advanced Lung Cancer before and During the Coronavirus Disease 2019 (COVID-19) Pandemic (RP322). Journal of Pain and Symptom Management, 63(6), 1079-1080.

Porter, J. F., Spates, R., & Smitham, S. (2004). International Psychotherapy for depression? The need to define its ecological niche. Journal of affective disorders, 95, 1-11.

Pourabdallah, Homa; Jafari Varjushani, Nasreen; Namdian, Masoumeh (1401). Investigating the quality of life of gastric cancer patients and related factors in Zanjan city. Community Health, 16(3): 27-35. ]persian[

Rieke K, Schmid KK, Lydiatt W, Houfek J, Boilesen E, Watanabe-Galloway Sh. (2017). Depression and survival in head and neck cancer patients. Oral Oncol, 65, 76-82.

Sánchez-Migallón J, Seignot I, Sendros Madroño MJ. (2023). Prevalence of Obesity in Cancer Patients and Its Concordance with the Pathological History of the Clinical History of the Cancer Patient. Clinical Nutrition ESPEN, 54, 587.

Segrin, C., Badger, T.A., Meek, P., Lopez, A.M., Bonham, E., & Sieger, A.  (2006) Dyadic interdependence on affect and quality of life trajectories among women with breast cancer and their partners. Journal of Social and Personal Relationships. 27,673-689.

Shrestha AD, Neupane D, Vedsted P, Kallestrup P. (2018). Cervical cancer prevalence, incidence and mortality in low and middle income countries: a systematic review. Asian Pacific journal of cancer prevention. Asian Pacific Journal of Cancer Prevention, 19(2), 319-324.

Spiegel D, Riba MB. (2015). Managing anxiety and depression during treatment. Breast J, 21(1): 97–103.

Steinmetz, J. L., Lewinsohn, P. M., & Antonuccio, D. O. (1983). Prediction of individual outcome in a group intervention for depression. Journal of Consulting and Clinical Psychology, 51(3): 331.

Surah, Jamal; Hajlo, Nader; Atadakht, Akbar; Bashrpour, Sajjad. (1402). Comparing the effectiveness of cognitive therapy based on mindfulness and therapy based on meaning and goal in promoting post-traumatic growth and psychosocial adaptation of breast cancer patients. Psychological Development, 12(2): 27-38. ]persian[

Temple J, Salmon P, Smith CT, Huntley CD, Byrne A, Fisher PL. (2020). The questionable efficacy of manualized psychological treatments for distressed breast cancer patients: An individual patient data meta-analysis. Clinical Psychology Review, 80, 101883.

ToonTab Haqiqi S, The quality of sex life among women with breast cancer in fertility ages, M.A thesis in midwifery, Tarbiyat Modarres University, 2019.

Valian, A.M. The Effectiveness of Behavioral Activation Therapy on Depression Symptoms and Cog-nitive-Behavioral Avoidance for Students. Quarterly Journal of Social Work, 2017. 5(4): 31-25.

Wahabi Mashek, Masoumeh; Mojtabai, Mina (1401). The effectiveness of treatment education based on acceptance and commitment on depression and quality of life of women with breast cancer. Journal of the Faculty of Medicine of Mashhad University of Medical Sciences, 65(4): 1858-1869. ]persian[

Weitz, Kleiboer, van Straten&  Cuijpers (2018).The effects of psychotherapy for depression on anxiety symptoms: a meta-analysis, 39, 241–254.

Wieman ST, Hall KA, Hall DL. (2023). Treatment-related changes in insomnia, anticipatory pleasure, and depression symptoms: A proof-of-concept study with cancer survivors. Sleep Medicine, 103, 29-32.

Yazidi, Razia; Neshat Dost, Hamid Taher; Askari, Karim; Abedi, Mohammadreza (2014). Comparing the effectiveness of acceptance and commitment-based therapy and cognitive-behavioral therapy on the symptoms of patients with obsessive-compulsive disorder. Behavioral Science Research, 1(35):19-33.]persian[

Zettle, R. D., & Raines, J. C. (1989). Group cognitive and contextual therapies in treatment of depression. Journal of Clinical Psychology, 45, 438-445.

Zimmermann FF, Burrell B, Jordan J. (2018). The acceptability and potential benefits of mindfulness-based interventions in improving psychological well-being for adults with advanced cancer: a systematic review. Complementary therapies in clinical practice, 30, 68-78.