Spiritual Therapy on Alexithymia in Individual with ER and PR Receptor Breast Cancer

Cancer has turned out to be one of the most prevalent health hazards globally. Among the various types, breast cancer is the most common one in women and also is the main cause of cancer mortality in women. Breast cancer is the most common cancer in females in Iran and most of the developed countries. Studies have shown that having chronic stress in individuals predisposes several types of cancer, including breast cancer. In recent years, there has been overwhelming evidence to point out the effects of religion or spirituality on mental and physical health. Rapidly growing evidence shows that stress, negative feelings, and lack of spirituality, such as depression and anxiety, have adverse side effects on physiological systems which are necessary to maintain physical health and increase susceptibility to a wide range of physical disorders. Spiritual factors correlate with indices of breast cancer, so do psychiatric conditions and changes in receptor gene expression in breast cancer. The spiritual therapy program training has a considerable effect on the attitude of an individual with estrogen receptor (ER) and progesterone receptor (PR) receptor breast cancer. Because these individual are facing main problems in alexithymia. Women, especially women with breast cancer in emotional reactions, face many challenges. Undoubtedly, inattention to spiritual therapy can lead to alexithymia in an individual with breast cancer. Therefore, this study aimed to determine the effectiveness of spiritual therapy on alexithymia in the individual with ER and PR receptor breast cancer.

The present research was a quasi-experimental study with pre-test, post-test design with the control group. The participants were 30 women with ER and PR receptor breast cancer aged 30-65 years old in the 2019 year. They were from middle socio-economical class. Subjects were selected by convenient sampling method from Shohaday Persian Gulf hospital in Bushehr city. Subjects divided into experimental with control groups. They assigned into groups with the random method, each group consisting of 15 individuals randomly. The experimental group participated in spiritual therapy program training in 12 sessions (One session weekly; each lasts for 90 minutes), while the control group did not. The alexithymia scale (Bagby, Parker and Taylor, 1994) used for assessment of all participants. The alexithymia scale completed by participants in pre-test and post-test. Data collected through the questionnaire before and after the training sessions. Multivariate analysis of covariance (MANCOVA) used with 24th version of statistical package for social sciences (SPSS).

The first, normality of variables and contingency of variance and covariance assumptions tested. The Kolmogorov Smirnov test showed that all variables were standard. Also, the Box test confirmed the contingency of variance-covariance assumption. So, assumptions of multivariate analysis of covariance test proved and can be used the multivariate analysis of covariance test for analysis of data. Results of multivariate analysis of covariance showed that experimental with control groups had a significant difference in alexithymia (p <0.001). The results of multiple analysis of covariance showed spiritual therapy program training had a significant effect on alexithymia in women with ER and PR receptor breast cancer (p <0.001). Spiritual therapy program training has led to the decrease alexithymia in women with ER and PR receptor breast cancer. It can be said that according to Eta square, 55% of variations of the alexithymia variable, can be explained by the subjects’ participation in spiritual therapy program training. Also, the results revealed that spiritual therapy program training had a significant effect on all subscales of alexithymia (difficulty in identifying feelings, difficulty in describing emotions and objective thinking) in these participants. It can be stated that according to Eta square 53%, 58%, and 54% of variations in components such as difficulty in identifying feelings, difficulty in describing emotions and objective thinking respectively, can be explained by the subjects’ participation in spiritual therapy program training.

Planning for such training programs similar to the spiritual therapy program training has an important role in the decrease of alexithymia in women with ER and PR receptor breast cancer. Based on the finding of this research, the spiritual therapy program training can have improved alexithymia in an individual with ER and PR receptor breast cancer.