The influence of cognitive-behaviour therapy on quality of life and self-esteem in women suffering from breast cancer

Abstract

Background

Mastectomy, chemotherapy and radiotherapy, used in the treatment of breast cancer, cause physical and mental stress and may lead to substantial changes in the everyday life of the woman. The patient may also lose her social role and be exposed to increased risk of mental disorders, especially depression and anxiety [1,2]. Breast cancer and its treatment may then have a significantly negative influence on quality of life and self-esteem of women in the physical, mental and social dimensions.

Quality of life is inseparably related to patients' attitude toward the use of their own skills, achieving their goals and being able to satisfy their physical and emotional needs [3]. Health related quality of life is understood as a multi-level concept including all physiological, psychological and social factors that play a significant role for the health status [4]. It is connected with how the patient perceives the influence of the disease and the applied treatment on her functioning and general feeling of life satisfaction [5].

Aim

The aim of the study was to indicate the influence of cognitive-behaviour therapy (CBT) on self-esteem and quality of life (QoL) in women suffering from breast cancer.

Materials/Methods

The study comprised 67 women after mastectomy and undergoing chemotherapy or chemo- and radiotherapy. CBT (Simonton's Program) was adopted for the experimental group (n=35). The control group (n=32) consisted of women awaiting psychotherapy.

The studies were of a linear character, including measurements before and after psychotherapy. The following questionnaire methods were used: EORTC QLQ-C30 and the Self-Esteem Scale by R. Cibor.

Results

An improvement in general QoL, general health status assessment and self-esteem were observed in the period following the therapy among CBT patients in comparison with the control group. Higher self-esteem in the CBT group was related to the fact that the subjects were able to maintain the ideal self at a fixed level while constantly increasing the real self during the therapy.

The analysis of the results in relation to the functional dimensions indicated improvement in the field of cognitive and emotional features, which resulted from participation in the therapy. The CBT patients reported lower intensification of somatic symptoms, which, however, was not tantamount to changes in the self-esteem of physical features. The psychotherapy did not have any impact on the level of social functioning and assessment of features in this respect between the examined groups.

Conclusions

CBT improves QoL and self-esteem in women suffering from breast cancer. It may also be used as a support method enhancing standard oncological treatment and improving the physician-patient relationship.