Meaning-centered psychotherapy integrated with elements of compassion: A pilot study to assess feasibility and utility

2018 ◽  
Vol 16 (6) ◽  
pp. 643-647 ◽  
Author(s):  
Francisco Gil ◽  
Clara Fraguell ◽  
Llúcia Benito ◽  
Anna Casellas-Grau ◽  
Joaquin T. Limonero

AbstractObjectiveThe main objective of this study is to establish emotional benefits of promoting and maintaining meaning in palliative care patients in the final weeks of life and to assess the benefits of including the compassion and self-compassion constructs in the Meaning-Centered Psychotherapy Model (MCP).MethodFifty-one cancer inpatients were randomly assigned to one of the three brief interventions for cancer patients in the end of life: the MCP-palliative care version, the MCP-compassionate palliative care (MCP-CPC), or standard counseling. Feasibility, acceptability, and utility were assessed in each condition. Likewise, patients’ opinions about the effectiveness of interventions’ elements were also collected.ResultOf the 51 patients that began one of the three interventions, 30 completed the three-session interventional program, as well as the pre- and posttreatment questionnaires. No significant differences were found between therapies in terms of the positive feedback of patients regarding the structure, focus, and length of the all three psychotherapeutic interventions. The most helpful elements or constructs reported by patients were meaning, self-compassion, compassion, legacy, and courage and commitment.Significance of resultsAn abbreviated version of MCP-CPC tailored to the needs of palliative care patients appears to be feasible, acceptable, and helps patients cope with the process of dying. Further research in bigger samples is needed to establish evidence for the feasibility, acceptability, and utility of a brief MCP-CPC for palliative care patients in their last weeks of life. More proposals of further elements are also needed to improve the results. Such research can create or refine previous treatment approaches which improve the quality of life and psychological distress in patients with advanced cancer.

2021 ◽  
Author(s):  
Johanna Sommer ◽  
Christopher Chung ◽  
Dagmar M. Haller ◽  
Sophie Pautex

Abstract Background: Patients suffering from advanced cancer often loose contact with their primary care physician (PCP) during oncologic treatment and palliative care is introduced very late.The aim of this pilot study was to test the feasibility and procedures for a randomized trial of an intervention to teach PCPs a palliative care approach and communication skills to improve advanced cancer patients’ quality of life. Methods: Observational pilot study in 5 steps. 1) Recruitment of PCPs. 2) Intervention: training on palliative care competencies and communication skills addressing end-of-life issues.3) Recruitment of advanced cancer patients by PCPs. 4) Patients follow-up by PCPs, and assessment of their quality of life by a research assistant 5) Feedback from PCPs using a semi-structured focus group and three individual interviews with qualitative deductive theme analysis.Results: 8 PCPs were trained. PCPs failed to recruit patients for fear of imposing additional loads on their patients. PCPs changed their approach of advanced cancer patients. They became more conscious of their role and responsibility during oncologic treatments and felt empowered to take a more active role picking up patient’s cues and addressing advance directives. They developed interprofessional collaborations for advance care planning. Overall, they discovered the role to help patients to make decisions for a better end-of-life.Conclusions: PCPs failed to recruit advanced cancer patients, but reported a change in paradigm about palliative care. They moved from a focus on helping patients to die better, to a new role helping patients to define the conditions for a better end-of-life.Trial registration : The ethics committee of the canton of Geneva approved the study (2018-00077 Pilot Study) in accordance with the Declaration of Helsinki


1997 ◽  
Vol 116 (6) ◽  
pp. 666-673 ◽  
Author(s):  
Eva Hammerlid ◽  
Kristin Bjordal ◽  
Marianne Ahlner-ELMQVIST ◽  
Magnus Jannert ◽  
Stein Kaasa ◽  
...  

Despite modern advances in the treatment of head and neck cancer, the survival rate fails to improve. Considering the different treatment modalities involved, quality of life has been thought of as an additional end point criterion for use in clinical trials. A Nordic protocol to measure the quality of life of head and neck cancer patients before, during, and after treatment was established. Before the study, a pilot study was done with this protocol. The main purpose of this pilot study was to find out whether this cancer population would answer quality-pf-life questionnaires repeatedly (six times) over a 1-year period and whether the chosen questionnaires—a core questionnaire (European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30)), a tumor-specific questionnaire, and a psychological distress measure (Hospital Anxiety and Depression scale (HAD))—were sensitive for changes to functions and symptoms during the study year. The results presented in this article all refer to the pilot study. Forty-eight consecutive patients agreed to participate in the study. The most common tumor locations were the oral cavity (17) and the larynx (12). Almost all patients received combined treatment: 45 of 48 radiation therapy, 18 of 48 chemotherapy, and 17 of 48 surgery. After the primary treatment, 40 patients had complete tumor remission. Four of the 48 patients did not answer any questionnaires and were therefore excluded from the study. Of the remaining 44 patients, 3 died during the study year, and another 6 withdrew for various reasons. Thirty-five (85%) of the 41 patients alive at the 1-year follow-up answered all six questionnaires and thus completed the study. Mailed questionnaires were used throughout the study. All questionnaires were well accepted and found to be sensitive to changes during the study year. The greatest variability was found for symptoms and functions related specifically to head and neck cancer. The symptoms were swallowing difficulties, hoarse voice, sore mouth, dry mouth, and problems with taste. They all showed the same pattern, with an increase of symptoms during and just after finishing the treatment. The HAD scale revealed a high level of psychological distress, with 21% probable cases of psychiatric morbidity at diagnosis. In conclusion, it was shown that the study design and questionnaires were feasible for the forthcoming prospective quality-of-life assessment of Swedish and Norwegian head and neck cancer patients.


2005 ◽  
Vol 19 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Michael A Echteld ◽  
Luc Deliens ◽  
Marcel E Ooms ◽  
Miel W Ribbe ◽  
Gerrit van der Wal

2016 ◽  
Vol 102 (1) ◽  
pp. 96-102 ◽  
Author(s):  
Maria Benedetta Ninu ◽  
Guido Miccinesi ◽  
Francesco Bulli ◽  
Alessio De Massimi ◽  
Maria Grazia Muraca ◽  
...  

2021 ◽  
Author(s):  
Masoumeh Masoumy ◽  
Masoud Bahrami ◽  
Alireza sadeghi ◽  
Rohallah Mosavizadeh

BACKGROUND Introduction: Colorectal cancer (CRC) is the third most common cancer in Iranian men and the second in Iranian women and it is a serious health problem in the Iran health system. OBJECTIVE Objective: The purpose is to develop a holistic palliative care program in order to improve the health and quality of life of colorectal cancer patients. METHODS Methods: This is an exploratory mixed methods study which will be conducted using a sequential qualitative-quantitative design (QUAL quan) consists of four sequential steps using the approach proposed by Ewles & Sminett to develop the program. In the first step, a qualitative study (semi-structured interview), the researcher discovers the needs of colorectal cancer patients from the perspective of patients, family members and care providers. In the second step, the literature review will be performed with the aim of confirming and completing the discovering new needs. In the third step, a initial draft of the palliative care program will be developed based on data extracted from qualitative study and literature review, experts’ panel opinions. In the fourth step, according to the opinions of the panel of experts, the part of the developed program will be implemented as quasi-experimental intervention and the effect of intervention on quality of life will be evaluated. RESULTS This study can will provide a better understanding of the demands and problems of colorectal cancer patients and their families through providing a holistic care and improve their quality of life in the socio-cultural context of Iran. This program can be useful in providing care, education, policy making, future research and colorectal cancer patients' health promotion. CONCLUSIONS This study can will provide a better understanding of the demands and problems of colorectal cancer patients and their families through providing a holistic care and improve their quality of life in the socio-cultural context of Iran. This program can be useful in providing care, education, policy making, future research and colorectal cancer patients' health promotion.


2021 ◽  
Author(s):  
Qasir Abbas ◽  
Nimra Arooj ◽  
Khawer Bilal Baig ◽  
Muhammad Umer Khan ◽  
Muhammad Khalid ◽  
...  

Abstract BackgroundCancer is a worldwide common illness, it evokes psychological distress at different stages, during chemotherapy patient perceives a variety of psychiatric symptoms due to various medication side-effects and psychological distress. Studies have shown a significant impact of CBT in the management of psychiatric symptoms during chemotherapy. This study aims to investigate the effectiveness of CBT for depression, anxiety, stress, death anxiety, satisfaction with life, and self-esteem among cancer patients during chemotherapy (CPdC).MethodsPlace and duration of the study: Department of Applied Psychology, Government College University Faisalabad in collaboration with Department of Oncology, Allied Hospital Faisalabad from November 20, 2020 and July 31, 2021. A total of 90 cancer patients were enrolled. 70 out of 90 met the eligibility criteria and 60 participants fulfilled all requirements. Participants were randomly allocated to four different groups. The pre-assessment screening was started along with the first trial of chemotherapy. The CBT-based treatment plan was formulated and one session per week was given to each patient for 3 to 4months. Participants’ age range was 18–65 years (M ± SD = 47.51 ± 12.36. Demographic form, DASS, DAS, SWLS, and RSES measures were used. Descriptive, t-test, and repeated measure ANOVA statistics were used to investigate the findings.ResultsResults indicated significant mean difference on the variable of depression, anxiety and stress across four conditions (i.e. F (2, 56) = 39.55, p < .000, η2 = .679; F(2,56) = 73.32, p < .000, η2 = .797; F(2,56) = 119.77, p < .000, η2 = .865 respectively). On death anxiety significant difference across four conditions was found (F (2,56) = 22.71, p < .000, η2 = .549) with large effect size. Furthermore, findings indicated significant mean difference on the variable of satisfaction with life and self-esteem across four conditions was found (F(2,56) = 22.05, p < .000, η2 = .542; F(2,56) = 36.19, p < .000, η2 = .660) with large effect size.ConclusionIt is concluded that CBT played a very effective role to reduce depression, anxiety, and stress-related psychiatric symptoms. CBT reduces the level of death anxiety and improving the quality of life and level of self-esteem among CPdC.Trial Registration: The study trial was registered in the Thai Clinical Trial Registry-TCTR (TCTR20201113002).


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Elham Akhlaghi ◽  
Rebecca H. Lehto ◽  
Mohsen Torabikhah ◽  
Hamid Sharif Nia ◽  
Ahmad Taheri ◽  
...  

Abstract Background When curative treatments are no longer available for cancer patients, the aim of treatment is palliative. The emphasis of palliative care is on optimizing quality of life and provided support for patients nearing end of life. However, chemotherapy is often offered as a palliative therapy for patients with advanced cancer nearing death. The purpose of this review was to evaluate the state of the science relative to use of palliative chemotherapy and maintenance of quality of life in patients with advanced cancer who were at end of life. Materials and methods Published research from January 2010 to December 2019 was reviewed using PRISMA guidelines using PubMed, Proquest, ISI web of science, Science Direct, and Scopus databases. MeSH keywords including quality of life, health related quality of life, cancer chemotherapy, drug therapy, end of life care, palliative care, palliative therapy, and palliative treatment. Findings 13 studies were evaluated based on inclusion criteria. Most of these studies identified that reduced quality of life was associated with receipt of palliative chemotherapy in patients with advanced cancer at the end of life. Conclusion Studies have primarily been conducted in European and American countries. Cultural background of patients may impact quality of life at end of life. More research is needed in developing countries including Mideastern and Asian countries.


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