Effect of a Health Literacy Promotion Program on the Level of Health Literacy and Death Anxiety in Women with Breast Cancer

Masoud Bahrami, Marjan Aboudzadeh Behbahani


Background: With regard to the high rate of death anxiety in women with breast cancer and low levels of health literacy in these patients, this study aimed to investigate the effect of a health literacy promotion program on the level of health literacy and death anxiety in women with breast cancer.

Materials and Methods: This is a clinical trial that was conducted in two groups of 30 women with breast cancer using a convenient sampling method in 2018. An educational program consisting of four sessions was arranged once every 2 weeks for the intervention group. The data collection tools were Templer Death Anxiety Scale and the Health Literacy For Women with Breast Cancer (HELBA) questionnaire with a demographic information record form.

Results: Mann‑Whitney test showed that there were no significant differences in the level of death anxiety and health literacy before the intervention between the control and intervention groups (p ≥ 0.05). But there were significant differences in the level of death anxiety between the intervention and control groups immediately after the intervention (Z = 3.38, p = 0.001) and one month later (Z = 3.10, p = 0.002). Also, there was significant differences in the level of health literacy immediately after the intervention (Z = 4.74, p < 0.001) and 1 month later (Z = 4.92, p < 0.001).

Conclusions: The findings of this study showed that the use of a health literacy promotion program for women with breast cancer might increase their health literacy while it might decrease their level of death anxiety.


Anxiety, breast cancer, death, health literacy, nursing

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