In this study, IPT was found to be effective in reducing anxiety and depression. This was consistent with the previous studies (23–25). This finding was consistent with one meta-analysis and a randomized controlled trial study, which indicates the usefulness of psychological intervention for cancer survivors with depression and anxiety (23, 24). Similarly, a randomized controlled study conducted in France found a significant reduction in anxiety and depression in the intervention group (25).
Our analysis showed a significant negative association between post-intervention anxiety score and the patient being in the highest quintile. Similarly, a study done in India indicated that those patients with low monthly income and less financial support tend to be more anxious than the other contrasts (26). This is because cancer treatment imposes unbearable costs which cause frustration among patients.
In our study, we found a positive association between post-intervention anxiety score, radiotherapy, and mastectomy treatment. Similarly, another study found that radiotherapy leads to increased emotional distress, anxiety, and depression (27). The potential reason for this may be, patients tend to worry about the critical side effects that they may experience due to the radiotherapy. Patients also tend to frustrate about the likelihood of radiotherapy damaging other organs or giving them to other forms of cancer.
Similarly, breast cancer patients who had mastectomy experienced emotional disturbance (28). Females with mastectomy suffered emotional disturbance. This might be due to the perception that the breast is a sign of womanhood in many cultures, and its absence is believed to affect sexual attraction towards the opposite sex.
In this study physical functioning of patients in the IPT group was improved significantly when compared with that of the control group. This was in line with other randomized controlled trial studies (29–31). Age and depression were negatively associated with physical functioning. This was consistent with the study conducted in Germany (32). This could be due to the high risk of reduced physical functioning and the natural physiological phase of aging among older patients.
There is a significant association between depression and physical functioning. In line with our finding another study showed that, by reducing depressive symptoms, there could be an improvement in physical functioning (33). This may be because depression results in some physical symptoms such as tiredness, weight loss, and loss of appetite, and such physical signs may affect physical functioning.
Insomnia was significantly affected by the therapy administered, similarly, another study found an improved self-rated sleep parameter among breast cancer patients (34), and reduced incidence of sleep disturbances among patients (35). Similarly, another study that implemented 12 weeks of mindfulness-based stress reduction technique found improved sleep quality in patients with breast cancer (36) which implied that sleep difficulties can be alleviated by psychotherapeutic intervention. In our study patients that encountered sleep disturbance were offered sleep hygiene that in turn helped them to alleviate the problem.
Fatigue is also another symptom scale that was improved by IPT. This finding was consistent with another study that determined the effect of mindfulness-based stress reduction technique on reducing fatigue and other study conducted on investigating the effect of supportive-expressive group discussion on quality of life, in cancer survivors (37, 38) which they found a decreased fatigue score among the intervention group. Our result showed that being stage IV highly predicted fatigue. The possible explanation for this could be that as the stage of the cancer increases physical deterioration becomes inevitable, thereby, patients also started to experience severe pain and fatigue.
The health-related quality of life of breast cancer patients was improved by IPT. Similarly, other studies that used different kinds of therapy techniques have found an improved health-related quality of life (31, 38). Our result revealed that there was a significant association between the patient being in the highest quintile and health-related quality of life. In line with this finding, a study showed that socio-economic status has an impact on health-related quality of life in which the potential explanation could be that levels of income are related to nutrition, accommodation, and access to health care, all of which are important to the HRQOL of a person (39, 40).