scholarly journals The Impact of Matching to Psychotherapy Preference on Engagement in a Randomized Controlled Trial for Patients With Advanced Cancer

2021 ◽  
Vol 12 ◽  
Author(s):  
Allison Marziliano ◽  
Allison Applebaum ◽  
Anne Moyer ◽  
Hayley Pessin ◽  
Barry Rosenfeld ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Controlled Trial ◽  
Treatment Preference ◽  
The Novel ◽  
Advanced Cancer Patients ◽  
Novel Therapy ◽  
Supportive Psychotherapy ◽  
Randomized Controlled ◽  
The Impact ◽  
Therapy Sessions

Objective: This study examined whether patients who were randomly assigned to their preferred therapy arm had stronger engagement with their treatment than those who were randomly assigned to a non-preferred therapy arm.Method: Data were drawn from a RCT comparing Individual Meaning-Centered Psychotherapy (IMCP), with Individual Supportive Psychotherapy (ISP), in patients with advanced cancer. Treatment engagement was operationalized as patients' perceptions of the therapeutic alliance with their therapist and therapy sessions attended. Two 2 by 2 Analysis of Variance (ANOVA) models were used, with treatment preference (IMCP vs. ISP) and treatment assignment (IMCP vs. ISP) as the independent variables and working alliance and number of sessions attended as outcome variables.Results: Patients who preferred and were assigned to IMCP reported a significantly stronger alliance than those who preferred IMCP but were assigned to ISP.Conclusions: The findings from this study have broader implications for research on psychotherapy beyond the appeal of IMCP in advanced cancer patients. Patients who prefer a novel psychotherapy that they cannot engage in elsewhere, but receive the standard treatment may experience weaker alliance than patients who prefer the standard but receive the novel therapy.Trial registration:Clinicaltrial.gov ID: NCT01323309

Modes of relating to contingency: An exploration of experiences in advanced cancer patients

2016 ◽  
Vol 15 (4) ◽  
pp. 444-453 ◽  
Author(s):  
Renske Kruizinga ◽  
Iris D. Hartog ◽  
Michael Scherer-Rath ◽  
Hans Schilderman ◽  
Hanneke Van Laarhoven
Keyword(s):  
Cancer Patients ◽  
Life Events ◽  
Advanced Cancer ◽  
Controlled Trial ◽  
Comparative Method ◽  
Real Life ◽  
Advanced Cancer Patients ◽  
Individual Care ◽  
Constant Comparative Method ◽  
The Impact

ABSTRACTObjective:Throughout their lives, people are confronted with unexpected life events, which can be difficult to incorporate into their life narratives. Such a confrontation can result in an experience of contingency. Different ways of relating to contingency have been described by Wuchterl: denying, acknowledging, and “encounter with the Other.” In the present article, we aim to trace these theoretical distinctions in real-life experiences of patients.Method:We analyzed 45 interviews using the constant comparative method with a directed content analysis approach in the Atlas.ti coding program. The interviews originated from a randomized controlled trial evaluating an assisted reflection on life events and ultimate life goals. Seven spiritual counselors from six hospitals in the Netherlands conducted the interviews from July of 2014 to March of 2016. All 45 patients had advanced cancer.Results:We found four different modes into which relating to contingency can be classified: denying, acknowledging, accepting, and receiving. With denying, patients did not mention any impact of the life event on their lives. In acknowledging, the impact was recognized and a start was made to incorporate the event into their life. In accepting, patients went through a process of reinterpretation of the event. In receiving, patients talked about receiving insights from their illness and living a more conscious life.Significance of results:Our study is the first to investigate the different ways of relating to contingency in clinical practice. The defined modes will improve our understanding of the various ways in which cancer patients relate to their disease, allowing caregivers to better target and shape individual care.

Advanced cancer patients’ reported wishes at the end of life: a randomized controlled trial

2016 ◽  
Vol 24 (10) ◽  
pp. 4273-4281 ◽  
Author(s):  
Marvin O. Delgado-Guay ◽  
Alfredo Rodriguez-Nunez ◽  
Vera De la Cruz ◽  
Susan Frisbee-Hume ◽  
Janet Williams ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Controlled Trial ◽  
Advanced Cancer Patients ◽  
Randomized Controlled

Randomized Controlled Trial of a Prompt List to Help Advanced Cancer Patients and Their Caregivers to Ask Questions About Prognosis and End-of-Life Care

2007 ◽  
Vol 25 (6) ◽  
pp. 715-723 ◽  
Author(s):  
Josephine M. Clayton ◽  
Phyllis N. Butow ◽  
Martin H.N. Tattersall ◽  
Rhonda J. Devine ◽  
Judy M. Simpson ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
End Of Life Care ◽  
Controlled Trial ◽  
Life Care ◽  
Advanced Cancer Patients ◽  
Randomized Controlled ◽  
Life Issues ◽  
End Of Life Issues

Purpose To determine whether provision of a question prompt list (QPL) influences advanced cancer patients’/caregivers’ questions and discussion of topics relevant to end-of-life care during consultations with a palliative care (PC) physician. Patients and Methods This randomized controlled trial included patients randomly assigned to standard consultation or provision of QPL before consultation, with endorsement of the QPL by the physician during the consultation. Consecutive eligible patients with advanced cancer referred to 15 PC physicians from nine Australian PC services were invited to participate. Consultations were audiotaped, transcribed, and analyzed by blinded coders; patients completed questionnaires before, within 24 hours, and 3 weeks after the consultation. Results A total of 174 patients participated (92 QPL, 82 control). Compared with controls, QPL patients and caregivers asked twice as many questions (for patients, ratio, 2.3; 95% CI, 1.7 to 3.2; P < .0001), and patients discussed 23% more issues covered by the QPL (95% CI, 11% to 37%; P < .0001). QPL patients asked more prognostic questions (ratio, 2.3; 95% CI, 1.3 to 4.0; P = .004) and discussed more prognostic (ratio, 1.43; 95% CI, 1.1 to 1.8, P = .003) and end-of-life issues (30% v 10%; P = .001). Fewer QPL patients had unmet information needs about the future (χ21 = 4.14; P = .04), which was the area of greatest unmet information need. QPL consultations (average, 38 minutes) were longer (P = .002) than controls (average, 31 minutes). No differences between groups were observed in anxiety or patient/physician satisfaction. Conclusion Providing a QPL and physician endorsement of its use assists terminally ill cancer patients and their caregivers to ask questions and promotes discussion about prognosis and end-of-life issues, without creating patient anxiety or impairing satisfaction.

The advanced cancer patient experience of undertaking meaning and purpose (MaP) therapy

2012 ◽  
Vol 10 (3) ◽  
pp. 177-188 ◽  
Author(s):  
Carrie Lethborg ◽  
Penelope Schofield ◽  
David Kissane
Keyword(s):  
Advanced Cancer ◽  
Controlled Trial ◽  
Potential Effect ◽  
Effect Sizes ◽  
Convenience Sample ◽  
Therapeutic Goals ◽  
Randomized Controlled ◽  
Meaning And Purpose ◽  
Therapeutic Frame ◽  
Therapy Sessions

AbstractObjective:The objective of this study was to describe the experience of undertaking meaning and purpose (MaP) therapy for patients with advanced cancer, with an aim of refining therapeutic processes involved prior to pilot testing. Specifically, we were interested in examining the themes arising from participation in the intervention in relation to our therapeutic goals, and how acceptable both the number of sessions and processes used were.Method:A convenience sample of people living with advanced cancer was recruited to participate in this process, resulting in 24 therapy sessions for analysis.Results:A thematic analysis of each session illustrated that the process of MaP therapy is one that encourages reflection, offers insights, and can be confrontational, but can also allow participants to “shift” their perspective and focus onto meaningful goals. Results illustrate how the therapist creates a therapeutic frame that holds up a poignant portrayal of the meaning of life lived, and mirrors this to the patient, such that they grasp its rich texture. Participants' descriptions showed how they were buoyed forward as a result, with renewed vigor and enthusiasm, despite their illness and any physical restrictions that it imposed.Significance of results:A planned pilot test of this intervention will enable us to determine potential effect sizes of this therapy in reducing distress and increasing meaning prior to a full randomized controlled trial. Understanding the processes involved and the experiences of participation in meaning-based therapies is crucial to the future strength of this area of psychotherapy.

scholarly journals Lessons learned from a randomized controlled trial on a home delivered meal service in advanced cancer patients undergoing chemotherapy: a pilot study

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Vera IJmker-Hemink ◽  
Nora Lize ◽  
Sandra Beijer ◽  
Natasja Raijmakers ◽  
Geert Wanten ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Missing Values ◽  
Controlled Trial ◽  
Dropout Rate ◽  
Lessons Learned ◽  
Advanced Cancer Patients ◽  
Randomized Controlled ◽  
Meal Service

Abstract Background Performing a randomized controlled trial (RCT) in the field of nutrition is challenging and success highly depends on understanding the factors that influence recruitment and dropout of participants. Our aim was to assess the feasibility of a RCT that evaluated a home delivered meal service in advanced cancer patients while receiving chemotherapy. Methods This pilot RCT aimed to enroll 20 participants who were randomized into the home delivered meal service group or usual care group. Study procedures took place before chemotherapy (T0), 3 weeks after T0 (T1), 6 weeks after T0 (T2) and 3 months after T2 (T3). All information regarding recruitment, dropout and study procedures was recorded. Patient satisfaction was assessed by in-depth interviews. Results Over 7 months, 20 of 41 approached patients (49%) were included, followed by a dropout rate of 35%. At baseline, hand grip strength (n = 8/16), the Short Physical Performance Battery (n = 12/16) and nutritional intake (n = 8/16) had the highest rate of missing values. Study procedures were not experienced as burdensome and planning of these procedures in line with fixed hospital appointments contributed to this low burden. Keeping the symptom diary was mentioned as being burdensome. Conclusions It is feasible to conduct a RCT on a home delivered meal service in advanced cancer patients during chemotherapy, although recruitment is challenging. Close contact of patients with recruiting personnel is essential to sustain motivation. To increase compliance with the study protocol it is important to carefully instruct participants on how to complete questionnaires and to emphasize to use these in the communication with their practitioners. Trial registration ClinicalTrials.gov NCT03382171.

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