Abstract:
Psychological distress, an affective, cognitive and behavioural response to crisis precipitating
events, is manifested by anxiety and depressive symptoms. Evidence has shown that cervical
cancer patients in Lagos and Ibadan, Nigeria exhibit psychological distress after diagnosis.
Previous research efforts focused on the predisposing factors to psychological distress, with
little attention paid to psychological interventions in managing the psychological distress
among cancer patients. This study, therefore, was carried out to determine effects of
Mindfulness-based Stress Reduction (MbSR) and Diversional Therapy (DT) in the
management of psychological distress among women diagnosed of cervical cancer in Lagos
and Ibadan, Nigeria. It also examined the moderating effects of Health Self-efficacy (HSe)
and Social Support (SS).
The study was anchored to Stress Process Model, while the mixed methods design
(QUAN+qual) was adopted. The multi-stage sampling procedure was used. The purposive
sampling technique was utilised to select three teaching hospitals (Lagos University Teaching
Hospital, Idi Araba, Lagos, Lagos State Teaching Hospital, Ikeja, Lagos and University
College Hospital, Ibadan) that provide comprehensive cancer treatment from Lagos and
Ibadan, Nigeria. The cancer patients attending these teaching hospitals were screened with
Distress Thermometer (α=0.75) and those who scored above the threshold of four were
selected. The teaching hospitals were randomly assigned to MbSR (24), DT (21) and control
(16) groups. The instruments used were Kessler Psychological Distress (K10) (α=0.81);
Health Self-efficacy (α=0.84), Social Support (α=0.89) scales and training manual. Focus
group discussions were held with 10 cervical cancer patients in Ibadan. The intervention
lasted eight weeks. The quantitative data were analysed using descriptive statistics, Analysis
of covariance and Scheffe post-hoc test at 0.05 level of significance, while the qualitative
data were content analysed.
The participants‘ age was 48.00±3.60 years. There was a significant main effect of treatment
on psychological distress among cervical cancer patients (F(2;44) =79.73, partial 2 = 0.7l). The
participants exposed to MbSR had the lowest psychological distress mean score (17.96), as
against those in the DT (20.76) and control (43.19) groups. Health Self-efficacy had a
significant main effect on psychological distress (F(1;44)=6.68, partial 2 =0.13). The
participants with high HSe recorded lower psychological distress mean score (18.00) than
those with low HSe (20.20). There was no significant main effect of social support on
psychological distress of the cervical cancer patients. The two-way and three-way interaction
effects were not significant. Financial help facilitated cervical cancer patients‘ adjustment to
the diagnosis, while frequent awareness programmemes; free vaccine and cervical cancer
screening were suggested ways in which cervical cancer could be prevented.
Mindfulness-based stress reduction and diversional therapy were effective in reducing
psychological distress among cervical cancer patients in Lagos and Ibadan, Nigeria. Clinical
and counselling psychologists should adopt these two therapies in the treatment of
psychological distress among cervical cancer patients.
