Reviews
11 September 2025
Vol. 3 (2025)
Enhancing quality of life in Iranian women with breast cancer: the efficacy of psychological interventions. A meta-analysis
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
17
Views
5
Downloads
Authors
This meta-analysis assessed the impact of psychological interventions on the quality of life of breast cancer patients in Iran, reviewing sources from 2006 to 2021, including theses, journals, and international research by Iranian authors. The study analyzed 40 clinical trials with effect sizes, sourced from databases like Magiran, Civilica, Normgs, Scientific-Research Journals, Irandoc, PubMed, Scopus, and PsycINFO, involving 1946 participants. The overall effect size was 0.45, with a significant level of p<0.001, indicating a considerable impact on patients’ quality of life. The highest effect sizes were d=1.91 and Fisher’s z (Zr)=0.84, while the lowest were d=0.28 and Zr=0.14. According to Cohen’s interpretation, these interventions have a moderate effect size, suggesting they can effectively improve the quality of life for breast cancer patients. The study highlights the potential of psychological interventions as a non-pharmacological strategy for enhancing patient well-being, emphasizing their importance in breast cancer care in Iran. This research supports the adoption of psychological interventions to improve the quality of life among individuals diagnosed with breast cancer.
Altmetrics
Downloads
Download data is not yet available.
Citations
DeSantis C, Ma J, Bryan L, Jemal A. Breast cancer statistics, 2013. CA Cancer J Clin. 2014;64:52-62. DOI: https://doi.org/10.3322/caac.21203
National Cancer Institute. Cancer stat factsheets: acute myeloid leukemia. 2018. Available from: https://seer.cancer.gov/statfacts/html/amyl.html.
Dinapoli L, Colloca G, Di Capua B, Valentini V. Psychological aspects to consider in breast cancer diagnosis and treatment. Curr Oncol Rep 2021;23:38. DOI: https://doi.org/10.1007/s11912-021-01049-3
Paluch-Shimon S, Pagani O, Partridge AH, et al. ESOESMO 3rd international consensus guidelines for breast cancer in young women (BCY3). Breast 2017;35:203-17. DOI: https://doi.org/10.1016/j.breast.2017.07.017
Avis NE, Crawford S, Manuel J. Quality of life among younger women with breast cancer. J Clin Oncol 2005;23:3322-30. DOI: https://doi.org/10.1200/JCO.2005.05.130
Yfantis A, Intas G, Tolia M, et al. Health-related quality of life of young women with breast cancer. Review of the literature. J BUON 2018;23:1-6.
Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2019;144:1941-53. DOI: https://doi.org/10.1002/ijc.31937
Jazayeri SB, Saadat S, Ramezani R, Kaviani A. Incidence of primary breast cancer in Iran: ten-year national cancer registry data report. Cancer Epidemiol 2015;39:519-27. DOI: https://doi.org/10.1016/j.canep.2015.04.016
Seyed-Nezhad M, Effatpanah M, Moradi T, et al. Incidence, prevalence, mortality, and direct costs of breast cancer in Iran: using the iran health insurance organization database. Int J Cancer Manag 2025;18:e157981. DOI: https://doi.org/10.5812/ijcm-157981
Walker L, Heys SD, Walker M, et al. Psychological factors can predict the response to primary chemotherapy in patients with locally advanced breast cancer. Eur J Cancer 1999;35:1783-8. DOI: https://doi.org/10.1016/S0959-8049(99)00169-0
Barlow DH. Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. Am Psychol 2000;55:1247-63. DOI: https://doi.org/10.1037//0003-066X.55.11.1247
Montgomery GH, David D, Goldfarb AB, et al. Sources of anticipatory distress among breast surgery patients. J Behav Med 2003;26:153-64. DOI: https://doi.org/10.1023/A:1023034706298
Ng CG, Mohamed S, Kaur K, et al. Perceived distress and its association with depression and anxiety in breast cancer patients. PLoS One 2017;12:e0172975. DOI: https://doi.org/10.1371/journal.pone.0172975
Boing L, Pereira GS, Araújo CdCRd, et al. Factors associated with depression symptoms in women after breast cancer. Rev Saude Publica 2019;53:30. DOI: https://doi.org/10.11606/S1518-8787.2019053000786
Price M, Bell ML, Sommeijer D, et al. Physical symptoms, coping styles, and quality of life in recurrent ovarian cancer: a prospective population-based study over the last year of life. Gynecol Oncol 2013;130:162-8. DOI: https://doi.org/10.1016/j.ygyno.2013.03.031
Behzadipour S, Keshavarzi F, Farzad V, Naziri G. The effectiveness of cognitive behavioral stress management intervention on quality of life and coping strategies in women with breast cancer. J Methods psychol Mod 2013;3:29-46.
Lai HL, Chen CI, Lu CY, Huang CY. Cognitive behavioral therapy plus coping management for depression and anxiety on improving sleep quality and health for patients with breast cancer. Brain Sci 2021;11:1614. DOI: https://doi.org/10.3390/brainsci11121614
Gall TL, Guirguis‐Younger M, Charbonneau C, Florack P. The trajectory of religious coping across time in response to the diagnosis of breast cancer. Psychooncology 2009;18:1165-78. DOI: https://doi.org/10.1002/pon.1495
Schreiber JA, Brockopp DY. Twenty-five years later—what do we know about religion/spirituality and psychological well-being among breast cancer survivors? A systematic review. J Cancer Surviv 2012;6:82-94. DOI: https://doi.org/10.1007/s11764-011-0193-7
Esmali Kooraneh A, Alizadeh M, Khanizadeh Balderlou K. The effectiveness of group psychotherapy based on acceptance and commitment on quality of life in women with breast cancer. J Urmia Univ Med Sci 2016;27:365-74.
Lu Q, Chen L, Shin LJ, et al. Improvement in quality of life and psychological well-being associated with a culturally based psychosocial intervention for Chinese American breast cancer survivors. Support Care Cancer 2021;29:4565-73. DOI: https://doi.org/10.1007/s00520-020-05942-8
Rashidi A, Faramarzi S, Shamsi A. Meta-analysis of the effectiveness of neuropsychological interventions on improving the academic performance of students with special learning disorders. J Cogn 2020;6:125-40. DOI: https://doi.org/10.29252/shenakht.6.6.125
Abedi A, Oreizy H, Shavakhi A. Meta-analysis of influential factors on research application in the Ministry of Education. J Educ Innov 2008;7:65-82.
Farahani H, Oreizi H. Advanced research methods in humanities. Isfahan, Iran: University Jahad; 2008.
Ali D. Research methods in psychology and educational sciences. Tehran, Iran: Virayesh; 2017.
Howitt D, Cramer D. Understanding statistics in psychology with SPSS. 7th ed. London, UK: Pearson Education; 2017.
Shareh H. Effectiveness of behavioral activation group therapy on attributional styles, depression, and quality of life in women with breast cancer. J Fundam Ment Health 2016;18:179-88.
Rad M, Borzoee F, Mohebbi M. The effect of humor therapy on fatigue severity and quality of Life in breast cancer patients undergoing external radiation therapy. J Adv Med Biomed Res 2016;24:102-14.
Afrasiabifar A, Hamzhiekia S, Hosseini N. The effect of self-care program using Orem’s self-care model on the life quality of women with breast cancer undergoing chemotherapy: a randomized controlled trial. Armaghanj 2018;23:1-13.
Barandeh M, Mehdizadeh Toorzani Z, Babaei M, Sharifian R. The effect of self-care education on the quality of life of breast cancer patients undergoing chemotherapy. Nurs Midwifery J 2017;15:199-207.
Yazdani F. The effects of Yoga on function scales quality of life in women with breast cancer undergoing radiation therapy: a randomized clinical trial. Avicenna J Nurs Midwifery Care 2015;23:49-62.
Kalhor M, Fathi M, Ghaderi B, et al. Effect of five A model self-management on quality of life in patients with breast cancer. Avicenna J Nurs Midwifery Care 2019;27:269-80. DOI: https://doi.org/10.30699/ajnmc.27.4.269
Salehi M, Shariati A, Ansari M, Latifi SM. Effect of Benson relaxation intervention on symptom scales quality of life (QOL) in breast cancer patients undergoing chemotherapy. Jundishapur J Chronic Dis Care 2012;1:e102595.
Esmi Z, Paivastegar M, Parhoon H, Rezaei SA. Effect of acceptance and commitment therapy (act) on quality of life, mental health and self-care behavior in breast cancer patients. Iran J Psychiatr Nurs 2020;7:45-53.
Salehi S, Tajvidi M, Ghasemi V, Raee Z. Investigating the effect of nurses’ supportive and educative care on the quality of life in breast cancer patients referred for radiotherapy in Seyedoshohada hospitals in Isfahan in 1392. J Clin Nurs Midwifery 2016;5:9-18.
Bahreinian A, Radmehr H, Mohammadi H, et al. The effectiveness of the spiritual treatment group on improving the quality of life and mental health in women with breast cancer. J Res Relig Health 2017;3:64-78.
Habibi J, Habibi M, Malekzade M, Ghanbari N. Effectiveness of cognitive-behavioral stress management on increasing quality of life in patients with breast cancer. Res Clin Psychol Couns 2017;6:96-110.
Salmani S, Nikbakht Nasrabadi A, Imanipour M, Hosseini M. The effects of discharge planning on quality of life in breast cancer patients. Curr Res Med Sci 2016;1:26-33. DOI: https://doi.org/10.21859/mci-supp-86
Akbari M, Alipour A, Zare H. The effect of coping skills training program on pain and quality of life in breast cancer patient. Health Psychol 2015;4:21-36. [Article in Persian].
Heidarian A, Mohsenzadeh F, Asadpour I, Zahrakar K. The effectiveness of Gottman group cognitive-systemic educational based intervention on quality of life and relationship patterns in patients with breast cancer and their partners. J Health Care 2019;21:66-76. DOI: https://doi.org/10.29252/jhc.21.1.66
Gozashti MA, Daboui P, Moradi S. Effectiveness of group poetry therapy in reducing psychological problems and improving quality of life in patients with breast cancer. J Mazandaran Univ Med Sci 2016;26:98-107.
Shafieitabar M, Khodapanahi MK, Heidari M. The effectiveness of a psycho-educational intervention in improving the quality of life of patients with breast cancer. Dev Psychol 2013;9:351-61.
Moradizallani E, Azarbayjani M, Hassanabadi H, Ahmaidifaraz M. Comparison of the effects of two interventional programs of group cognitive therapy with group Islamic-based spiritual intervention in palliative care on quality of life, anxiety, and depression in patients with breast cancer. J Ilam Uni Med Sci 2020;28:93-102. DOI: https://doi.org/10.29252/sjimu.28.3.93
Sharbafchi MR, Rajabi F, Sheshboluki F, et al. The effect of educational sessions for couples on quality of life among patients with breast cancer undergoing mastectomy. J Isfahan Med Sch 2019;37:1-8.
Monemi Motlagh S, Shoa Kazemi M. The effectiveness of 4-factor psychotherapy (awareness, hope, relationship therapy and behavioral regulation) on improving the quality of life of women with breast cancer. Iran J Breast Dis 2012;5:50-9.
Yazdani F, Babazade S. The effects of Yoga on life quality of patients with breast cancer undergoing chemotherapy. Complement Med J 2014;3:624-38.
Pedram Razi S, Haghighat S, Jarban M, et al. The effect of reflexology on quality of life of breast cancer patients during chemotherapy. Iran J Breast Dis 2013;6:23-34.
Shirvani H, Alhani F, Montazeri A. The effect of implementing family-centered empowerment model on functional quality measures of women with breast cancer undergoing chemotherapy. Iran J Breast Dis 2017;10:62-72.
Moradi Manesh F, Babakhani K. Effectiveness of cognitive-behavioral group therapy on self-efficacy and quality of life in women with breast cancer: a clinical trial. Iran J Breast Dis 2018;10:7-17.
Heidarian A, Asadpour E, Mohsenzadeh F, Zahrakar K. Effect of a group intervention based on acceptance and commitment therapy on quality of life and communication patterns in patients with breast cancer and their spouses. Iran J Breast Dis 2020;13:24-34. DOI: https://doi.org/10.30699/ijbd.13.1.24
Safarzade A, Roshan R, Shams J. Effectiveness of stress management and relaxation training in reducing the negative affect and in improving the life quality of women with breast cancer. J Res Psychol Health 2013;6:21-35.
Omidbeygi M, Hassanabadi H, Hatami M, Vaezi AA. The effectiveness of acceptance and commitment therapy on psychological flexibility, post traumatic growth and quality of life in women with breast cancer. J Clin Psychol 2020;12:47-58.
Shariati A, Salehi M, Ansari M, Latifi SM. Evaluation of the effect of Benson relaxation method on functional scales of quality of life in patients with breast cancer undergoing chemotherapy. Jundishapur Sci Med J 2010;9:625-32.
Heravi Karimovi M, Pourdehqan M, Jadid Milani M, et al. Study of the effects of group counseling on quality of sexual life of patients with breast cancer under chemotherapy at Imam Khomeini Hospital. J Mazandaran Univ Med Sci 2006;16:43-51.
Karimvi HM, Pourdehghan M, Faghihzadeh S, et al. The effects of group counseling on symptom scales of QOL in patients with breast cancer treated by chemotherapy. J Kermanshah Univ Med Sci 2006;10:e81704.
Akbari M, Alipur A, Zare H, Sheykhi AK. The effectiveness of mindfulness based on stress reduction program on quality of life and pain in patients with breast cancer. J Appl Psychol 2014;8:7-28.
Sharif F, Abshorshori N, Hazrati M, et al. Effect of peer-lead education on quality of life of mastectomy patients. Payesh. 2012;11:703-10.
Hosseini SM, Musavi M, Rafiey H, Reza Sultani P. The effect of social capital on quality of life in women with breast cancer. Refahj 2015;14:243-69.
Hosseini H, Loripoor M, Roeintan F. The effect of palliative-care education on quality of life of women with breast cancer. Iran J Cancer Care 2022;1:31-8. DOI: https://doi.org/10.29252/ijca.1.2.31
Ghahari S, Fallah R, Rad MM, et al. 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 Med J 2017;6:409-14. DOI: https://doi.org/10.15562/bmj.v6i2.581
Nasiri F, Keshavarz Z, Davazdahemami M, et al. The effectiveness of religious-spiritual psychotherapy on the quality of life of women with breast cancer. J Babol Univ Med Sci 2019;21:67-73.
Olyaie Z, Touzandehjani H, Kiafar Z. Evaluation effectiveness of mindfulness-based cognitive therapy on quality of life and mood in women with breast cancer undergoing mastectomy. J Fundam Ment Health 2017;19:463-73.
Fatehi S, Maasoumi R, Atashsokhan G, et al. The effects of psychosexual counseling on sexual quality of life and function in Iranian breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat 2019;175:171-9. DOI: https://doi.org/10.1007/s10549-019-05140-z
Koolaee AK, Falsafinejad MR, Akbari ME. The effect of stress management model in quality of life in breast cancer women. Iran J Cancer Preven 2015;8:e3435. DOI: https://doi.org/10.17795/ijcp-3435
Helgeson VS, Cohen S. Social support and adjustment to cancer: reconciling descriptive, correlational and intervention research. Health Psychol 2004;15:135-48. DOI: https://doi.org/10.1037//0278-6133.15.2.135
Behzadipour S, Sepah Mansour M, Arshad Keshavarzi F, et al. Effectiveness of stress management based on cognitive-behavioral intervention on quality of life and coping styles for females with breast cancer. Psychol Methods Models 2013;3:29-46.
Fann JR, Thomas-Rich AM, Katon WJ, et al. Major depression after breast cancer: a review of epidemiology and treatment. Gen Hosp Psychiatry 2008;30:112-26. DOI: https://doi.org/10.1016/j.genhosppsych.2007.10.008
Lueboonthavatchai P. Prevalence and psychosocial factors of anxiety and depression in breast cancer patients. J Med Assoc Thai 2007;90:2164-74.
Hamilton JB, Powe BD, Pollard AB, et al. Spirituality among African American cancer survivors: having a personal relationship with God. Cancer Nurs 2007;30:309-16. DOI: https://doi.org/10.1097/01.NCC.0000281730.17985.f5
Amirsardari L, Azari S, Kooraneh AE. The relationship between religious orientation, and gender with a cognitive distortion. Iran J Psychiatry Behav Sci 2014;8:84-9.
Taleghani F, Yekta ZP, Nasrabadi AN. Coping with breast cancer in newly diagnosed Iranian women. J Adv Nurs. 2006;54:265-72. DOI: https://doi.org/10.1111/j.1365-2648.2006.03808_1.x
Ghaempanah Z, Aghababaei N, Rafieinia P, et al. Good for coping, not for eudaimonia: the effectiveness of a spiritual/religious intervention in the healthcare of breast cancer patients. Pastoral Psychol 2024;73:631-45. DOI: https://doi.org/10.1007/s11089-024-01134-x
Tong G, Guo G. Meta-analysis in sociological research: power and heterogeneity. Sociol Methods Res 2022;51:566-604. DOI: https://doi.org/10.1177/0049124119882479
Faller H, Schuler M, Richard M, et al. Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol 2013;31:782-93. DOI: https://doi.org/10.1200/JCO.2011.40.8922
Rehse B, Pukrop R. Effects of psychosocial interventions on quality of life in adult cancer patients: meta-analysis of 37 published controlled outcome studies. Patient Educ Couns 2003;50:179-86. DOI: https://doi.org/10.1016/S0738-3991(02)00149-0
Kalter J, Verdonck‐de Leeuw I, Sweegers MG, et al. Effects and moderators of psychosocial interventions on quality of life, and emotional and social function in patients with cancer: An individual patient data meta‐analysis of 22 RCTs. Psychooncology 2018;27:1150-61. DOI: https://doi.org/10.1002/pon.4648
De La Torre-Luque A, Gambara H, López E, Cruzado JA. Psychological treatments to improve quality of life in cancer contexts: a meta-analysis. Int J Clin Health Psychol 2016;16:211-9. DOI: https://doi.org/10.1016/j.ijchp.2015.07.005
How to Cite
1.
Enhancing quality of life in Iranian women with breast cancer: the efficacy of psychological interventions. A meta-analysis. Mental Wellness [Internet]. 2025 Sep. 11 [cited 2025 Sep. 17];3. Available from: https://www.mental-wellness-journal.net/mw/article/view/25
Copyright (c) 2025 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.