Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Apr 10, 2020
Date Accepted: Mar 19, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The effects of psycho-educational interventions on anxiety and self-esteem of women with breast cancer using mobile application and mobile-based online group discussions: a randomized controlled trial
ABSTRACT
Background:
Psycho-education has turned into an effective tool in taking care of cancer patients and improving their psycho-physical symptoms and quality of life. Despite the growing utilization of mobile phone applications in medical settings for improving health, evidence supporting their effectiveness in the psycho-education of breast cancer patients is rarely available.
Objective:
The present study was conducted to investigate the effect of psycho-educational interventions on anxiety and self-esteem in women with breast cancer using a mobile application and an online support group.
Methods:
An unblinded randomized controlled trial based on mobile phones was conducted in Shiraz, Iran. Eighty-two women with non-metastatic breast cancer aged 20-60 years were recruited offline and randomly assigned to an intervention group (N=41) and a wait-list control group (N=41) through blocked randomization. The intervention group received psycho-educational interventions through a mobile phone application and participated in nurse-assisted online mobile support sessions for a total four weeks, whereas the control group was put on a waiting list. The state-trait anxiety inventory (STAI) developed by Spielberger and the Rosenberg self-esteem scale (RSES) were respectively used to measure the levels of anxiety and self-esteem as the main outcomes in the two groups at baseline and one week after the intervention. The data were analyzed in IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, N.Y., USA).
Results:
Comparing the post-intervention mean scores of anxiety and its two subscales using the independent-test showed statistically-significant differences between the mobile psycho-education group and the controls (P<.001). The paired t-test used to compare the post-intervention mean scores of anxiety with its pre-intervention scores in the intervention group showed significant reductions in the scores of anxiety and its two subscales (P<.001). Comparing the post-intervention mean scores of self-esteem showed statistically-insignificant differences between the control and intervention groups (P=.24). In contrast to in the controls, using the paired t-test showed that the increase in the post-intervention mean scores of self-esteem were statistically significant in the intervention group compared to the pre-intervention scores (P<.001). No statistically-significant differences were observed in anxiety and self-esteem scores in the control group between before and after the intervention (P>.05).
Conclusions:
The present study demonstrated the key role of mobile applications in decreasing anxiety and improving self-esteem in breast cancer women through psycho-educational interventions. Similar studies with longer follow-ups are recommended that be conducted in this context. Clinical Trial: Iranian Registry of Clinical Trials IRCT20150721232279N2; https://en.irct.ir/trial/19882
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