Stress Management in Patients with Breast Cancer Using a Supportive Approach: A systematic Review

Maedeh Rezaei (1), Forouzan Elyasi (2), Zeinab Hamzehgardeshi (3), Ghasem Janbabai (4), Mahmood Moosazadeh (5)
(1) Department of Midwifery, Gorgan Branch, Islamic Azad University, Gorgan, Iran, Iran, Islamic Republic of,
(2) Department of Psychiatry, Cancer Research Center, Psychiatry and Behavioral Research Center, Addiction Institute, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran, Iran, Islamic Republic of,
(3) Department of Reproductive Health and Midwifery, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran, Iran, Islamic Republic of,
(4) Department of Hematology-Oncology, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran, Iran, Islamic Republic of,
(5) Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran, Iran, Islamic Republic of


Background: Stress is a reaction to physical, psychological and emotional events. Respective to other chronic diseases, breast cancer (BC) is a dire stressful situation greatly disheartening the patients. Therefore, patients with BC need long lasting physical and emotional support to cope with the stress. The purpose of this study was to systematic studies concerning with supportive stress management interventions in patients with BC.

Methods: In this review, the literature search was performed in scientific databases including Google Scholar, Scientific Information Database (SID), Magiran, and Irandoc,  Web of Science, Science Direct, PubMed [including Medline], and Elsevier. The keywords were retrieved from Medical Subject Headings (Mesh). The articles published from 1997 to 2017 were included. Accordingly, 440 articles were initially retrieved. After reading titles and abstracts, 152 articles were selected for reading full-texts.  Finally, 54 articles including 3 books were used to structure the review.

Results: All the included studies had an interventional design focusing on stress management approaches and their related covariates in women with BC. The findings were assessed regarding two distinct approaches.   First, the studies assessing stress management interventions were scrutinized. Next, the impacts of the duration of the interventional sessions, the number of the participants and the contents of sessions were explored. Of the selected articles, 6 were about mindfulness, 2 about relaxation, and 7 about stress-related cognitive-behavioral therapy. In addition, one study was related to resilience training and 2 studies investigated problem-based approaches.

Conclusion: Stress management interventions can be helpful in reducing stress in BC patients. Therefore, it is advisable to incorporate stress management strategies along with  routine pharmaceutical therapies in these patients.

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Maedeh Rezaei
Forouzan Elyasi (Primary Contact)
Zeinab Hamzehgardeshi
Ghasem Janbabai
Mahmood Moosazadeh
Rezaei M, Elyasi F, Hamzehgardeshi Z, Janbabai G, Moosazadeh M. Stress Management in Patients with Breast Cancer Using a Supportive Approach: A systematic Review. Arch Breast Cancer [Internet]. 2019 Feb. 28 [cited 2023 Dec. 2];:6-16. Available from:

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