Effect of online solution-focused counseling on the sexual quality of life of women with a history of breast cancer: a clinical trial

BACKGROUND

Breast cancer, as the most prevalent malignancy among women globally and in Iran, affects important aspects of the lives of the survivors of this condition, especially the quality of sexual life. Solution-focused brief therapy is one of the therapeutic counseling approaches used in various fields, including sexual function problems. In recent years, online and internet-mediated counseling methods have received more attention.

OBJECTIVE

This study investigated the effect of online counseling based on a solution-focused approach in improving the sexual quality of life (SQL) of women with breast cancer.

MATERIALS & METHODS

In this clinical trial, the research population consisted of women with a history of breast cancer with a recorded file in Shahid Ramazanzadeh Radiation Oncology Center in Yazd and at least 6 months had elapsed since the end of their treatment. After selecting 80 samples based on the random numbers table, they were assigned into two groups of 40, i.e., active control and intervention, using random allocation software. Participants in the intervention group were given online counseling through the Skyroom space with a solution-focused approach. Eight weekly sessions were held each lasting 60-90 min. The active control group received an educational file to improve the SQL. All participants in two groups completed the SQL questionnaire at the beginning of the study, at the end of the study, and 1 month after the study. Data were analyzed with SPSS18 using descriptive and inferential statistics.

RESULTS

Finally, the data of 33 participants in the intervention group and 32 participants in the active control group were analyzed. The mean score of the SQL in the intervention group increased from 68.57 ± 18.63 before the intervention to 78.84 ± 12.7 immediately after the intervention (P = 0.015), and to 79.60 ± 19.88 1 month after the intervention (P = 0.012). The mean score of the SQL in the active control group increased from 64.45 ± 22.76 before the intervention to 67.20 ± 20.29 immediately after the intervention (P = 0.33), and to 68.70 ± 20.76 1 month after the intervention (P = 0.62). The difference in the mean score of the SQL before and after the intervention between the two groups was statistically significant (P = 0.007).

CONCLUSION

It seems that the use of counseling with a solution-focused approach in women with a history of breast cancer improves the SQL. Thus, considering the effectiveness of this type of training, it is recommended that this method be used as a sexual health counseling method in medical centers.

TRIAL REGISTRATION

This clinical trial is registered in Iranian registry center of clinical trials (IRCT) by registration code of IRCT20201221049784N1 in 06/03/2021.

A Clinical Case Study of Solution-Focused Brief Therapy for Young Adult Cancer Patients’ Psychological Distress: Focusing on Positive Emotions

Psychological distress is highly prevalent among adolescent and young adult (AYA) cancer patients, an age-defined population (15–39) disproportionately impacted by their cancer diagnosis. Solution-focused brief therapy (SFBT) is a strength-based and evidence-supported approach for youth with medical conditions. The use of SFBT in young cancer patients, however, has been rarely described. Building on the broaden-and-build theory of positive emotions, this study describes how SFBT clinicians intentionally foster positive emotions, especially hope, in an AYA cancer patient to foster therapeutic change. We found improvements in the patient’s psychological distress as well as growth in levels of hope both in the immediate post-intervention assessment and in the 2-week follow-up. The findings of the study suggested that SFBT is a promising approach to the unique challenges confronting AYAs with cancer. It was not feasible for this case study to match the sex and racial identities for a therapist with the client’s preference, which is considered a main limitation of this study.

A unique service: how an embedded psychology team can help patients and genetics clinicians within a clinical genetics service

The Genetics service at Guy's hospital has dedicated in-house psychology provision aimed at supporting patients embarking on genetic testing through to coping with the aftermath of genetic diagnoses. This provision offers assessment and intervention within a brief 6-session therapy model and provides a range of therapeutic approaches. Patient satisfaction with the service is high and referral rates have greatly increased over the recent years. The Psychology Team also provides indirect support for patients as well as support for the Genetics Team such as contributing to MDT and informal case discussions, as well as teaching and training clinicians about psychological concepts. There are many advantages to having an embedded psychology service both for patients and genetics clinicians, such as good opportunities for liaising around referrals and conducting joint clinical sessions, as well as being easily able to identify psychological training needs. The service plans to further develop by offering group interventions and training opportunities to doctoral psychology trainees. We conclude that clinical psychologists can play a highly integral and essential role in the provision of psychosocial support for clinical genetics teams and provide an overview of the first such integrated clinical psychology service within clinical genetics in the United Kingdom.

The Effects of the Solution-Focused Model on Anxiety and Postpartum Depression in Nulliparous Pregnant Women

Background

Solution-focused model (SFM) is an intervention method that fully mobilizes patients’ initiative through their potential. We aimed to investigate the effects of SFM on anxiety and postpartum depression (PPD) in nulliparous pregnant women compared with routine care services.

Methods

We chose the mothers diagnosed as depressed or with depressive tendency by Edinburgh Postpartum Depression Scale (EPDS) at 28 weeks of gestation and divided them into the intervention and control groups. The control group only took the routine pregnancy healthy nursing, while the SFM group took the regular nursing and SFM counselling. Different assessments were conducted at 28 weeks of gestation, post-delivery, and post-intervention to evaluate the anxiety and depression levels of the patients. Finally, nursing satisfaction was evaluated by the nursing satisfaction questionnaire.

Results

Compared with the control group, SFM could decrease the scores of anxiety and depression more effectively and influence sleep quality more positively. We also found that SFM resulted in significantly higher nursing satisfaction than that in the control group (p = 0.0046).

Conclusion

In conclusion, SFM could effectively alleviate anxiety and PPD in nulliparous pregnant women.

Existential uncertainty in the patient cancer experience: Delimiting the concept

OBJECTIVE

To delimit the concept of existential uncertainty in the patient cancer experience from other, related aspects of uncertainty in the context of an existing framework of health-related uncertainty.

METHODS

In-depth interviews were carried out with six people living with cancer and analyzed using theory-driven, concept-focused thematic analysis.

RESULTS

Our analysis suggests that existential uncertainty is concerned with meaning rather than information; with the person rather than the disease; and with the fundamental nature of our human being-in-the-world rather than the more practical aspects of our relationships with others. Patient expressions of existential uncertainty may involve a nonscientific discourse of metaphor, analogy, and imagination.

SIGNIFICANCE OF RESULTS

It is important for professionals working in supportive oncology to have a conceptual understanding of uncertainty in order to choose how best to respond to patients' needs, as different interventions may be more or less appropriate to different aspects of patient uncertainty.

Solution-focused brief therapy with families who have a child with intellectual disabilities: A description of the content of initial sessions and the processes

Solution-focused brief therapy (SFBT) is used in a range of child services but little is known about its application to families who have a child with severe or profound intellectual disabilities. This qualitative study examines SFBT with seven such families. It considers the content of sessions and the processes that occur from the practitioner's perspective. Participants' experiences are reported elsewhere (Lloyd & Dallos, submitted). A thematic analysis of seven initial sessions indicated that SFBT highlighted parents' competencies, goals and achievements. The 'miracle question' prompted a change in rapport, discussion about the impossibility of the child becoming 'normal' and a shift away from wishful thinking towards problem solving. In sessions processes emerged of empowerment, integration of the goals into the mothers' life narrative, understanding the child's abilities and clarification of the preferred future. These themes resonated with the literature on effective coping styles for these families. The cases suggest that SFBT can generate a useful parent-professional partnership. However, difficulties were encountered when a child with autism participated in the session. Consideration is given to the 'miracle question' and the inclusion of measures of self-efficacy, coping and the therapeutic relationship.