• Logo
  • SBMUJournals

Improvement in patient–reported outcomes after group poetry therapy of women with breast cancer

Mohammad Ali Gozashti, Siavash Moradi, Forouzan Elyasi, Pouran Daboui




Background: One of the best ways of achieving the patients’ views and expectations about the effects of a therapeutic or palliative intervention on their quality of life is using PatientReported Outcome Measures (PROMs). Poetry therapy as a psychotherapy intervention has been used for palliation of stressful conditions of several chronic diseases and disabilities. In the present study, we aimed to evaluate the effectiveness of group poetry therapy on the quality of life measures in women with breast cancer.

Methods: A total of 30 women with breast cancer, undergoing chemotherapy at a referral center in the north of Iran, participated in the current quasi-experimental before-after study conducted in 2016. The study protocol included eight weekly sessions of group poetry therapy using poems from the great Persian poets. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) was completed by the patients before beginning group poetry therapy and, twice more, one week and two months after the last session. Items of the questionnaire were manually scored and then analyzed using appropriate statistical tests in IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.

Results: A total of 28 patients participated in all the group poetry therapy sessions and completed the questionnaire. The mean and standard deviation of age were 45±66. The changes in the score of quality of life from 51.8 to 65.5 and 69 were observed to be significant in the one-week and two-month follow ups (both with P=0.002). Also, changes in symptom score from 34.5 to 23.7 (P=0.01) and functional score from 65.6 to 77.2 (P=0.01) in the two-month follow up were found to be statistically significant.

Conclusion: Based on the findings of the study, it can be concluded that group poetry therapy, as a psychotherapy approach, can be used to improve quality of life in breast cancer patients.


Breast Neoplasms; Cancer; Group therapy Poetry; Quality of life; Psychotherapy


Marcum JA. An introductory philosophy of medicine: Humanizing modern medicine. Springer Science & Business Media; 2008; 63-77. 2. Richardson MM, Grobert ME, Meyer KB. Randomized controlled trials 3: Measurement and analysis of patient-reported outcomes. Methods Mol Biol. 2015;1281:191-206.

Black N. Patient reported outcome measures could help transform healthcare. BMJ. 2013;346:f167. 4. Marshall S, Haywood K, Fitzpatrick R. Impact of patient-reported outcome measures on routine practice: a structured review. J Eval Clin Pract. 2006;12(5):559-68. 5. Gotay CC, Kawamoto CT, Bottomley A, Efficace F. The prognostic significance of patient-reported outcomes in cancer clinical trials. J Clin Oncol. 2008;26(8):1355-63. 6. Kotronoulas G, Kearney N, Maguire R, Harrow A, Domenico DD, Croy S, et al. What Is the Value of the Routine Use of Patient-Reported Outcome Measures Toward Improvement of Patient Outcomes, Processes of Care, and Health Service Outcomes in Cancer Care? A Systematic Review of Controlled Trials. Journal of clinical oncology 2014;32(14):1480-510. 7. Luckett T, Butow PN, King MT. Improving patient outcomes through the routine use of patientreported data in cancer clinics: future directions. Psychooncology. 2009;18(11):1129-38. 8. Kerr DJ, Haller DG, van de Velde CJ, Baumann M, editors. Oxford textbook of oncology. Oxford University Press; 2016: 302-11. 9. Gordon BBE, Chen RC. Patient-reported outcomes in cancer survivorship. Journal Acta Oncologica. 2017;56(2):166-73. 10. Goldzweig G, Baider L, Andritsch E, Pfeffer R, Rottenberg Y. A Dialogue of Depression and Hope: Elderly Patients Diagnosed with Cancer and Their Spousal Caregivers. J Cancer Educ. 2017;32(3):549-555. 11. LeBlanc TW. Addressing End-of-Life Quality Gaps in Hematologic Cancers: The Importance of Early Concurrent Palliative Care. JAMA Intern Med. 2016;176(2):265-6. 12. Shin JA, El-Jawahri A, Parkes A, Schleicher SM, Knight HP, Temel JS. Quality of Life, Mood, and Prognostic Understanding in Patients with Metastatic Breast Cancer. J Palliat Med. 2016;19(8):863-9. 13. Gozashti MA, Daboui P, Moradi S. Effectiveness of Group Poetry Therapy in Reducing Psychological Problems and Improving Quality of Life in Patients with Breast Cancer. J Mazandaran Univ Med Sci. 2016;26(144):98-107. (Full text in Persian). 14. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 199;85(5):365-76 15. Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, et al. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): translation and validation study of the Iranian version. Support Care Cancer 1999; 7: 400-6. 16. Safaee A, Dehkordi Moghimi B, Tabatabaie SHR. Reliability and Validity of the QLQ-C30 Questionnaire in cancer Patients. Armaghan Danesh 2007; 12(2): 79-87 (Full text in Persian). 17. Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A, on behalf of the EORTC Quality of Life Group. The EORTC QLQ-C30 Scoring Manual (3rd Edition). Published by: European Organisation for Research and Treatment of Cancer, Brussels 2001. 18. Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, et al. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): translation and validation study of the Iranian version. Support Care Cancer. 1999;7(6):400-6. 19. Urdaniz JI, Mañas JJ, Gutiérrez MT, García RV, Arteaga EP, Oset MM, Dominguez MÁ, Álvarez JJ. Quality of life in breast cancer patients assessed using the EORTC questionnaires. Revista de Oncología. 2001;3(2):100-6. 20. Jang SH, Kang SY, Lee HJ, Lee SY. Beneficial Effect of Mindfulness-Based Art Therapy in Patients with Breast Cancer-A Randomized Controlled Trial. Explore (NY). 2016;12(5):333-40. 21. Puetz TW, Morley CA, Herring MP. Effects of creative arts therapies on psychological symptoms

and quality of life in patients with cancer. JAMA Intern Med. 2013;173(11):960-9. 22. Boehm K, Cramer H, Staroszinsky T, Ostermann T. Arts therapies for anxiety, depression, and quality of life in breast cancer patients: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2014; 2014:103297 23. Archer S, Buxton S, Sheffield D. The effect of creative psychological interventions on psychological outcomes for adult cancer patients: a systematic review of randomised controlled trials. Psychooncology. 2015;24(1):1-10. 24. Chong Guan N, Mohamed S, Kian Tiah L, Kar Mun T, Sulaiman AH, Zainal NZ. Psychotherapy for cancer patients. Int J Psychiatry Med. 2016;51(5):414-430. 25. Zhang M, Huang L, Feng Z, Shao L, Chen L. Effects of cognitive behavioral therapy on quality of life and stress for breast cancer survivors: a metaanalysis. Minerva Med. 2017;108(1):84-93. 26. Jassim GA, Whitford DL, Hickey A, Carter B. Psychological interventions for women with nonmetastatic breast cancer. Cochrane Database Syst Rev. 2015;(5):CD008729. 27. Zamaniyan S, Bolhari J, Naziri G, Akrami M, Hosseini S. Effectiveness of spiritual group therapy on quality of life and spiritual well-being among patients with breast cancer. Iran J Med Sci. 2016;4(12):140-4.

DOI: https://doi.org/10.22037/sdh.v3i2.17845


  • There are currently no refbacks.