Effectiveness of Positive Thinking Training on Perceived Stress, Metacognitive Beliefs, and Death Anxiety in Women with Breast Cancer

Abstract

Background: Women with breast cancer suffer high levels of stress due to their disease-induced emotional, cognitive, behavioral and physical problems which increase their metacognitive beliefs, death anxiety, and rumination, disrupt the treatment process, and exert a negative impact. The present study aimed to investigate the effectiveness of positive thinking training on perceived stress, metacognitive beliefs, and death anxiety in women with breast cancer in Ahvaz in 2019.
 Methods: This was a quasi-experimental study with pretest-posttest control group design. Statistical population consisted of all women with breast cancer visiting Shafa Health Center of Ahvaz in 2019, among whom 30 women were selected as the sample using convenience sampling. Cancer patients were randomly divided into intervention (n=15) and control (n=15) groups. The research instruments included the Perceived Stress Scale, the Metacognitions Questionnaire (MCQ-30), and the Scale of Death Anxiety (SDA). Univariate and multivariate analysis of covariance were used to analyze data.
 Results: Results suggested that positive thinking training reduced perceived stress, metacognitive beliefs and death anxiety in women with breast cancer in the intervention group compared with those in the control group (P<0.001).
 Conclusion: According to the results of the study, positive thinking training was effective in reducing perceived stress, metacognitive beliefs, and death anxiety in women with breast cancer.

Psychometric Properties of the Positive Thinking Skills Scale (PTSS) among Portuguese Adults

“…The authors argue that positive thinking is a way of helping to build resilience [27]. On the other hand, positive thinking has been negatively correlated with mental health problems [38]. We assessed the reliability of the PTSS by examining interitem correlations, in which every correlation was statistically significant and positive.…”

“…Developing cognitive reappraisal, which may involve replacing initially identified negative thoughts with positive thoughts, can be more adaptive and lead to better emotional regulation, adaptive behaviors, and problem solving [1]. Some studies have shown that positive thinking training reduces stress and anxiety [38]. Individuals who practice positive thinking can improve their physical and social functioning, increasing their emotional health and quality of life [39].…”

“…The PTSS has demonstrated positive correlations with other constructs, such as resilience [37], perceived social support, self-esteem [27], positive emotions, resourcefulness, and general well-being, as well as negative correlations with depression [2] and suicide resilience [27]. Furthermore, some studies show that positive thinking training reduces mental health problems [38,39].…”

Metacognitive Processes in Cancer: A Review

“…35 Also, one study found out the effectiveness of positive thinking training in reducing metacognitive beliefs. 47 There are other therapies such as Acceptance Commitment-Based Therapy [52][53][54] and Cognitive Behavior Therapy 55,56 that are used to treat emotional distress in patients with cancer. However, from our literature search we did not find any comparative studies to understand the effectiveness of metacognitive therapy with the other therapies.…”

“…35 In another study, it was found that positive thinking training effectively reduces metacognitive beliefs in patients with breast cancer. 47 To address the chemotherapy-induced cognitive impairment, a study found that Cognitive Orientation to Daily Occupational Performance (CO-OP), a type of metacognitive strategy training, has positive effect on cognitive performance and neural connectivity in women with breast cancer. theoretical paper suggests that metacognition can act as educational technology and help breast cancer survivors to engage in preventive self-care practices for lymphedema.…”