Kashani, F., Kashani, P., Moghimian, M., & Shakour, M. (2015). Effect of stress inoculation training on the levels of stress, anxiety, and depression in cancer patients. Iranian Journal of Nursing and Midwifery Research, 20, 359–364.

To investigate the effects of inoculation training on stress, anxiety, and depression

Forty patients were randomly selected and randomly assigned to study and control groups. Study group patients had weekly group education sessions for eight weeks. Sessions were aimed at understanding stress, relaxation, education, concepts of cognition, feelings and behaviors, role of negative self-talk, concentration and distraction techniques, and problem solving skills. Data were obtained before and after the intervention period.

• N = 40  
• AGE RANGE: 28-65 years
• MALES: 31.73%,FEMALES: 68.27%
• KEY DISEASE CHARACTERISTICS: Patients had non-hematologic cancers and were in the third course of chemotherapy. None were receiving radiation therapy.

• SITE: Single site  
• SETTING TYPE: Not specified    
• LOCATION: Iran

• PHASE OF CARE: Active antitumor treatment

• Randomized, controlled trial

• Depression Anxiety and Stress Scale (DASS)

Anxiety and depression declined after the intervention, but did not decline in the control group. After eight weeks, anxiety was significantly lower in the intervention group (p = 0.00) and depression was significantly lower than controls (p = 0.04). Stress increased in the control group, but declined in the intervention group (p = 0.01).

The psychoeducational intervention tested here was associated with significantly less anxiety and depression compared to patients who did not receive this intervention.

• Small sample (less than 100)
• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Unintended interventions or applicable interventions not described that would influence results
• Measurement/methods not well described
• Other limitations/explanation: No information is provided about the types of cancer, stage of disease, type of chemotherapy provided, other associated symptoms, or use of medication that may affect anxiety or depression–all of which could be expected to influence outcomes. The specific timing of postintervention measurement is not stated.

Findings suggest that the type of psychoeducational intervention provided here was helpful to manage anxiety and depression. Study design limitations affect the strength of evidence from this particular study; however, findings are in general concert with the body of evidence regarding effectiveness of psychoeducational interventions. Various psychoeducational interventions have been shown to be effective for anxiety and depression. These interventions can be incorporated into usual nursing practice.