• The Effect of Midwifery-Led Supportive Program on Coping Strategies and Stress in Breast Cancer Women: A Randomized Controlled Clinical Trial
  • Zohreh Shahhosseini,1 Forouzan Elyasi,2 Seyed Nouraddin Mousavinasab,3 Leila Shojaee,4 Ehsan Zaboli,5 Elahe Samami,6,*
    1. Sexual and Reproductive Health Research Center. Mazandaran University of Medical Sciences. Sari, Iran.
    2. Psychiatry and Behavioral Sciences Research Center, Sexual and Reproductive Health Research Center, Addiction Institute, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
    3. Health Sciences Research Center, School of Health, Mazandaran University of Medical Sciences, Sari, Iran.
    4. Department of Surgery, School of Medicine, Gastrointestinal Cancer Research Center Mazandaran University of Medical Sciences, Sari, Iran.
    5. Department of Hematology & Oncology, School of Medicine, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
    6. M.Sc. Student of Midwifery counseling. Student Research committee. Mazandaran University of Medical Sciences. Sari, Iran.


  • Introduction: Breast cancer is the most common cancer in women accounting for 33% of all types of cancer and 19% of deaths caused by cancer in women. Its diagnosis and treatment are one of the sources of stress and crisis in women's lives. Coping strategies are one of the effective mechanisms to help breast cancer patients; as these patients need help to adopt their disease, effectively, and encounter with it correctly. Breast cancer women have more psychological problems and need to some interventions to cope with these problems. This study aims to determining the effect of midwifery-led supportive program on coping strategies and stress in breast cancer women.
  • Methods: This randomized controlled clinical trial was conducted on the breast cancer women referring to the outpatient chemotherapy ward of Imam Khomeini Hospital in Sari during 2018. Therefore, permuted block randomization method was used to assign 60 cases into two groups of intervention (n=30) and control (n=30). Six 90-mintue intervention sessions were held weekly. Instruments of the study included sociodemographic and clinical characteristics, Ways of Coping Questionnaire, Depression-Anxiety-Stress Questionnaire, Medical Outcomes Study Social Support Survey and the Religious Attitude Scale Revised, which were completed by the patients before, immediately, and one month after the intervention for follow-up. Data were analyzed with SPSS -18.
  • Results: The score of the problem-focused coping strategies increased 17.12 in the intervention group comparing the control group (P<0.001). Moreover, the scores of emotion-focused coping strategies and Stress decreased 7.84 score and 4.89 score in the intervention group comparing to the control group (P<0.001).
  • Conclusion: According to the effectiveness of the midwifery-led supportive program on the enhancing coping strategies and reducing stress in breast cancer women, it is recommended to promote the health of women with breast cancer by informing oncologists, surgeons, and patients about non-pharmaceutical methods, including the midwifery-led supportive program and give the patients a choice to choose these methods beside empowering the health care providers.
  • Keywords: Breast cancer, coping strategies, stress, supportive program, midwifery-led care