Background & Objectives: Psychosocial problems of breast cancer patients, such as anxiety, depression, anger, sadness and despair, along with spiritual distress like a misunderstanding of illness as divine punishment, despair of God's mercy, and dissatisfaction with destiny, should be considered in oncology health services. More than 90% of Iranians are Muslims. They believe in God, the management of the world by God, the existence of the soul in man and the universe, life after death, and the feedback of their verbal and non–verbal behaviors. The Sound Heart spiritual care model is designed and validated based on religious evidence. This model is in harmony with the religious culture of the patients. In third–wave psychotherapy, mindfulness, as the result of combining Eastern spiritual traditions such as meditation techniques with traditional cognitive–behavioral therapy, seeks to draw the patient's attention from dysfunctional thoughts and feelings to the body and the nature around him. This study was conducted to compare the effectiveness of spiritual therapy based on the Sound Heart Model and Mindfulness training based on Kabat–Zinn perspective on the resilience of patients with breast cancer.
Methods: This quasi–experimental research was carried out with a pretest–posttest design with two experimental groups in 2019. The samples consisted of women with breast cancer treated in Baqiyatollah Hospital in Tehran City, Iran, to investigate the effect of two types of interventions on patients' resilience. In this study, due to the type and duration of intervention, the type of disease and to avoid creating moral ambiguities, there was no external control group. Thirty eligible volunteer patients were included in the study by the available sampling method. Samples were randomly assigned to two experimental groups (1 and 2). The inclusion criteria were as follows: being able to communicate and understand the taught material; lacking a history of chronic mental illness in the past and present; not taking psychotropic drugs or having a history of drug addiction; lacking familiarity with the Persian language; not having other diseases or complications leading to hospitalization in the intensive care unit; being 35–55 years old; scoring the degree of disease level between 1 and 3; having education more than a high school diploma. The exclusion criteria were unwillingness to continue the research, simultaneous participation in another research, and the occurrence of an important crisis in life in addition to the crisis of the disease during the study. After explaining the purpose of the research and obtaining informed written consent, for each group, the intervention was performed in eight sessions, face to face, 30–45 minutes, once a week, with prior coordination for each patient. The samples completed the Connor–Davidson Resilience Scale (Connor and Davidson, 2003) before and after the intervention. The collected data were entered into the SPSS version 22 and described using centrality and dispersion indices. The paired t test was used to compare the results before and after the interventions. To compare the two intervention methods in the posttest, covariance analysis was used.
Results: The results of the paired t test to compare before and after the interventions showed a significant difference between the mean scores of the resilience variable in the pretest and posttest stages in the experimental groups (p<0.001). The analysis of covariance showed that the mean resilience in the posttest was significantly different between the two spiritual therapies based on sound heart and mindfulness training, after eliminating the effect of the pretest (p<0.001). Due to the high average resilience in spiritual therapy based on a sound heart (57.33) compared to mindfulness training (52.26), this treatment was more effective than mindfulness training.
Conclusion: Based on the findings of this study, spiritual therapy and mindfulness training has a positive and greater effect on patients' resilience. So, spiritual therapy based on a sound heart model which is in harmony with the culture and values of the Muslim people of Iran is recommended for the treatment of cancer patients.