Effects of Supportive Group Therapy on Levels of Hopelessness in Patients with Cervical Cancer at Cancer Diseases Hospital in Lusaka, Zambia

Abstract

Background: Hopelessness is a subjective appraisal of negative expectations about the occurrence of a highly valued outcome coupled with the sense that one lacks control over desired events in the future. Hopelessness is an early symptom of depression and is comorbid with cervical cancer. Supportive Group therapy offers an economical and time efficient solution. In Zambia and particularly at Cancer Disease Hospital such structured supportive group therapy is not being offered. This study aims to ascertain whether supportive group therapy can reduce levels of hopelessness in cervical cancer patients at Cancer disease hospital in Lusaka Zambia.
Methodology: This was a double blinded Randomized Controlled Trial conducted at Cancer Disease Hospital in Lusaka Zambia. It was
conducted between March 2019 and September 2020. Patients with histologically confirmed diagnosis of cervical cancer were recruited. Sociodemographic characteristics and clinical presentations were elicited by detailed history taking and file review. All the participants completed PreHAI Questionnaire and their results were noted. They were then divided into a control and intervention group using computer generated numbers. The intervention group then attended one hour Supportive group therapy sessions weekly for four weeks. The control group continued to receive the usual support of their family members and Cancer disease hospital staff. Both  groups were then administered the Post- HAI Questionnaire and their results were noted.
Results: 49 patients were recruited. Patient retention was 92% (n= 45). Majority of the participants were of the age group 41-50 years i.e. control group (n =12) intervention group (n= 7). Majority were; married control (n= 11) intervention (n= 12), unemployed control (n=14) intervention (n= 18), had social support control (n=14) intervention (n= 18). Only social support correlated with lower HAI scores (p= 0.047). There was no correlation between therapy and post HAI scores as both p- values i.e. control (p= 0.683) intervention (p= 0.368) were greater than confidence interval 0.05. The intervention group had a greater reduction in HAI scores from (p= 0.621 to p= 0.368) in comparison to the control group (p= 0.707 to p= 0.683).
Conclusion: There was a difference (yet statistically insignificant) in treatment outcomes of cervical cancer patients receiving  supportive group therapy to those not receiving supportive group therapy. That is to say that the intervention group showed a greater reduction in HAI scores in comparison to the control group. Social support is the only significant factor associated with lower levels of hopelessness.

Keywords: Hopelessness, Hopelessness assessment in illness questionnaire (HAI), Cervical cancer, Supportive group therapy