*Result*: Effect of Problem-Based Learning Combined With Rational Emotive Behavior Therapy on Psychological Outcomes, Self-Efficacy, Adverse Events, Quality of Life, and Treatment Compliance in Breast Cancer Care: A Non-Randomized Study.
Title:
Effect of Problem-Based Learning Combined With Rational Emotive Behavior Therapy on Psychological Outcomes, Self-Efficacy, Adverse Events, Quality of Life, and Treatment Compliance in Breast Cancer Care: A Non-Randomized Study.
Authors:
Zhou Y; Department of Nursing, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin, China., Han Y; Department of Pediatrics, Hangu Traditional Chinese Medicine Hospital, Tianjin, China., Jin R; School of Nursing, Yanbian University, Yanbian Korean Autonomous Prefecture, China.
Source:
Nursing & health sciences [Nurs Health Sci] 2026 Mar; Vol. 28 (1), pp. e70299.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Blackwell Science Asia Country of Publication: Australia NLM ID: 100891857 Publication Model: Print Cited Medium: Internet ISSN: 1442-2018 (Electronic) Linking ISSN: 14410745 NLM ISO Abbreviation: Nurs Health Sci Subsets: MEDLINE
Imprint Name(s):
Original Publication: Carlton, Vic. : Blackwell Science Asia, c1999-
MeSH Terms:
Breast Neoplasms*/psychology , Breast Neoplasms*/therapy , Breast Neoplasms*/complications , Problem-Based Learning*/methods , Problem-Based Learning*/standards , Behavior Therapy*/methods , Behavior Therapy*/standards , Treatment Adherence and Compliance*/psychology , Treatment Adherence and Compliance*/statistics & numerical data , Self Efficacy*, Quality of Life/psychology ; Humans ; Female ; Middle Aged ; China ; Adult ; Surveys and Questionnaires ; Aged
References:
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Pires, A., M. de Oliveira, A. de Almeida, and R. Guirro. 2021. “An Educational Program for the Prevention of Lymphedema in Women After Breast Cancer Surgery: A Randomized Clinical Trial.” Journal of Obstetric, Gynecologic, and Neonatal Nursing 50, no. 1: 74–83.
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Smedley, A., D. Coulson, K. Hancox, T. Levett‐Jones, and N. Carver. 2012. “Problem Based Learning in Mental Health Nursing: The Students' Experience.” International Journal of Mental Health Nursing 21, no. 2: 175–183.
Stegenga, K., K. Blonquist, L. Million, H. Spotts, and M. Andersen. 2020. “Young Women With Breast Cancer: Treatment, Care, and Nursing Implications.” Clinical Journal of Oncology Nursing 24, no. 2: 139–147.
Sulistyowati, T., and S. Sumartini. 2021. “Integrating Peer Learning Activities and Problem‐Based Learning in Clinical Nursing Education.” SAGE Open Nursing 7: 23779608211000262.
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Wang, M., N. Wang, Q. Chen, et al. 2022. “Implementation of the Flipped Classroom Combined With Problem‐Based Learning in a Medical Nursing Course: A Quasi‐Experimental Design.” Healthcare (Basel) 10, no. 12: 2572.
Wang, X., Q. Lai, Y. Tian, and L. Zou. 2020. “Effect of Evidence‐Based Nursing Intervention on Upper Limb Function in Postoperative Radiotherapy Patients With Breast Cancer.” Medicine 99, no. 11: e19183.
Zabalegui, A., L. Macia‐Soler, M. de Rodriguez Agueda, B. Zuazua‐Rico, and I. H. Cillero. 2017. “Effect of a PBL Teaching Method on Learning About Nursing Care for Patients With Depression.” Nurse Education Today 52: 109–115.
Bøje, J., E. Abildgren, Y. Dürrenberger, A. C. Allin, C. Stormacq, and L. Gerson. 2018. “Facilitating Problem‐Based Learning Among Undergraduate Nursing Students: A Qualitative Systematic Review.” Nurse Education Today 60: 67–74.
Cai, X., Y. Li, Y. Li, Y. Yang, and Y. Xiao. 2022. “Aromatherapy Plus Music Therapy Improve Pain Intensity and Anxiety Scores in Patients With Breast Cancer During Perioperative Periods: A Randomized Controlled Trial.” Clinical Breast Cancer 22, no. 2: 115–120.
Clavijo, M., F. Yévenes, I. Gallardo, A. M. Contreras, and C. Santos. 2020. “Escala de Autoeficacia General: Reevaluación de su Evidencia de Confiabilidad y Validez en Chile [The General Self‐Efficacy Scale (GSES): Reevaluation of its Reliability and Validity Evidence in Chile].” Revista Médica de Chile 148, no. 10: 1452–1461.
de Souza, D., M. Otani, S. Tonhom, and M. Marin. 2019. “Degree in Nursing: Education Through Problem‐Based Learning.” Revista Brasileira de Enfermagem 72, no. 4: 1071–1077.
Feizi, H., V. Ravanipour, and N. R. Manesh. 2018. “The Effect of Training Problem‐Based Learning on the Quality‐Of‐Life Symptom Scales in Patients Suffering From Breast Cancer.” Journal of Family Medicine and Primary Care 7, no. 6: 1203–1208.
Giesinger, J. M., J. M. Kieffer, P. M. Fayers, et al. 2016. “Replication and Validation of Higher Order Models Demonstrated That a Summary Score for the EORTC QLQ‐C30 Is Robust.” Journal of Clinical Epidemiology 69: 79–88.
Hamilton, M. 1959. “The Assessment of Anxiety States by Rating.” British Journal of Medical Psychology 32, no. 1: 50–55.
Hamilton, M. 1960. “A Rating Scale for Depression.” Journal of Neurology, Neurosurgery, and Psychiatry 23: 56–62.
Harbeck, N., and M. Gnant. 2017. “Breast Cancer.” Lancet 389, no. 10074: 1134–1150.
Hu, H., E. Deng, X. Xiang, and S. Ouyang. 2021. “Application of 3D Printing Technology Combined With PBL Teaching Model in Teaching Clinical Nursing in Congenital Heart Surgery: A Case‐Control Study.” Medicine 100, no. 20: e25918.
Hung, F., and C. C. Chin. 2009. “Experience of Problem‐Based Learning in Nursing Education at Kaohsiung Medical University.” Kaohsiung Journal of Medical Sciences 25, no. 5: 258–263.
Jefford, M., E. Ristevski, L. Teleni, et al. 2020. “Breast Cancer Nursing Interventions and Clinical Effectiveness: A Systematic Review.” BMJ Supportive & Palliative Care 10, no. 3: 276–286.
Lyu, M.‐M., R. C.‐J. Siah, A. S. L. Lam, and K. K. F. Cheng. 2022. “The Effect of Psychological Interventions on Fear of Cancer Recurrence in Breast Cancer Survivors: A Systematic Review and Meta‐Analysis.” Journal of Advanced Nursing 78, no. 10: 3069–3082.
Pires, A., M. de Oliveira, A. de Almeida, and R. Guirro. 2021. “An Educational Program for the Prevention of Lymphedema in Women After Breast Cancer Surgery: A Randomized Clinical Trial.” Journal of Obstetric, Gynecologic, and Neonatal Nursing 50, no. 1: 74–83.
Rouzbeh, M., M. Namadian, E. Shakibazadeh, J. Hasani, and R. Rouzbeh. 2018. “The Effect of Group Counseling Using Ellis's A‐B‐C Technique on Irrational Beliefs and Self‐Efficacy About Breast Self‐Awareness of Women Health Volunteers.” Journal of Transcultural Nursing 29, no. 4: 346–353.
Shourjeh, R., A. Memarian, A. Yaghoobzadeh, S. Baraz, A. Hakim, and Y. H. Chan. 2017. “Effect of Face‐To‐Face Education, Problem‐Based Learning, and Goldstein Systematic Training Model on Quality of Life and Fatigue Among Caregivers of Patients With Diabetes.” Iranian Journal of Nursing and Midwifery Research 22, no. 3: 208–214.
Smedley, A., D. Coulson, K. Hancox, T. Levett‐Jones, and N. Carver. 2012. “Problem Based Learning in Mental Health Nursing: The Students' Experience.” International Journal of Mental Health Nursing 21, no. 2: 175–183.
Stegenga, K., K. Blonquist, L. Million, H. Spotts, and M. Andersen. 2020. “Young Women With Breast Cancer: Treatment, Care, and Nursing Implications.” Clinical Journal of Oncology Nursing 24, no. 2: 139–147.
Sulistyowati, T., and S. Sumartini. 2021. “Integrating Peer Learning Activities and Problem‐Based Learning in Clinical Nursing Education.” SAGE Open Nursing 7: 23779608211000262.
Sun, Z., M. Zhang, C. Wang, et al. 2021. “The Effect of PBL Combined With Comparative Nursing Rounds on the Teaching of Nursing for Traumatology.” American Journal of Translational Research 13, no. 4: 3618–3625.
Sung, H., J. Ferlay, R. L. Siegel, et al. 2021. “Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.” CA: A Cancer Journal for Clinicians 71, no. 3: 209–249.
Wang, M., N. Wang, Q. Chen, et al. 2022. “Implementation of the Flipped Classroom Combined With Problem‐Based Learning in a Medical Nursing Course: A Quasi‐Experimental Design.” Healthcare (Basel) 10, no. 12: 2572.
Wang, X., Q. Lai, Y. Tian, and L. Zou. 2020. “Effect of Evidence‐Based Nursing Intervention on Upper Limb Function in Postoperative Radiotherapy Patients With Breast Cancer.” Medicine 99, no. 11: e19183.
Zabalegui, A., L. Macia‐Soler, M. de Rodriguez Agueda, B. Zuazua‐Rico, and I. H. Cillero. 2017. “Effect of a PBL Teaching Method on Learning About Nursing Care for Patients With Depression.” Nurse Education Today 52: 109–115.
Grant Information:
TJYXZDXK-3-016B Tianjin Key Medical Discipline (Specialty) Construction Project
Contributed Indexing:
Keywords: adverse events; breast cancer; problem‐based learning; quality of life; rational emotive behavior therapy; self‐efficacy; treatment compliance
Entry Date(s):
Date Created: 20260218 Date Completed: 20260218 Latest Revision: 20260218
Update Code:
20260219
DOI:
10.1111/nhs.70299
PMID:
41707047
Database:
MEDLINE
*Further Information*
*To evaluate the effectiveness of combined problem-based learning (PBL) and rational emotive behavior therapy (REBT) on Psychological Outcomes, Self-Efficacy, Adverse Events, Quality of Life, and Treatment Compliance in breast cancer care. In this non-randomized study conducted at a tertiary hospital in China, 180 patients with breast cancer treated between October 2021 and August 2022 were divided into a control group (n = 90) receiving conventional education and a study group (n = 90) receiving PBL combined with REBT. Outcomes were assessed using validated scales including the Hamilton Anxiety/Depression Rating Scales, EORTC QLQ-C30, General Self-Efficacy Scale, a hospital-designed compliance questionnaire, and adverse event follow-up. After intervention, the study group demonstrated significantly greater improvements in psychological outcomes (p < 0.05), self-efficacy (p < 0.05), lower adverse event rates (13.33% vs. 31.11%; p < 0.01), quality of life domains (p < 0.05), treatment compliance (p < 0.05), compared to the control group. The combined PBL and REBT approach enhances postoperative care for patients with breast cancer by improving psychological outcomes (e.g., reducing anxiety), enhancing self-efficacy, minimizing adverse events, improving quality of life, and promoting treatment compliance.
(© 2026 John Wiley & Sons Australia, Ltd.)*