The Present State of Existential Interventions Within Palliative Care

Existential psychotherapy is rooted in the European tradition of existential philosophy. Existential philosophers include Husserl and Heidegger, who were German, and Camus, Sartre, de Beauvoir, and Merleau-Ponty, who were French. Their works contain existentially ultimate themes such as death, freedom, meaninglessness, and isolation. Based on their knowledge of existential philosophy, Binswanger, Frankl, and Boss developed the earlier existential psychotherapies such as Dasein-analysis and Logotherapy, while May, Laing, Yalom, May, and Wong started later existential psychotherapies in the British and American culture. Focusing on patients with advanced cancer and/or terminal care, we found nine types of existential psychotherapies which were investigated using randomized controlled trials (RCTs): Meaning-Centered Group Psychotherapy (MCGP), Individual Meaning-Centered Psychotherapy (IMCP), Meaning-Making intervention (MMi), Meaning of Life Intervention, Managing Cancer and Living Meaningfully (CALM), Hope Intervention, Cognitive and Existential Intervention, Dignity Therapy, and Life-Review Interviews, from 19 relevant RCTs. All deal with death, meaninglessness, isolation, and freedom. Particularly, MCGP, IMCP, MMi, Meaning of Life intervention, and CALM emphasize finding and/or making meaning in the individual's life. The effects on existential or spiritual well-being were confirmed in MCGP, IMCP, Meaning of Life intervention, and Life-Review intervention although the number of studies were very few. In the other interventions, there were heterogenous findings and again the number of studies was very small. Further studies are required to investigate the effects of existential psychotherapy on patients with advanced cancer.

Hope-enhancement workshops in the SWOG Cancer Research Network: Feasibility of an online intervention.

210 Background: Research shows that healthcare professionals’ personal hopefulness is associated with burnout and life satisfaction, highlighting the value of hope-enhancement interventions. Feldman and Dreher developed a single-session hope intervention, but this has been used rarely with oncology professionals, and only in in-person format (Shah, Ferguson, Corn et al.). Given SWOG Cancer Research Network’s commitment to assessing hope-enhancement approaches and the need for online interventions given COVID-19, we report a feasibility study of a virtual hope workshop in SWOG members. Methods: The workshop was a single 2-hour session delivered live via Zoom to 6-8 participants at a time. The workshop comprises 3 components: A brief lecture on hope and two exercises—a “hope mapping” exercise (aided by a smartphone app created for the workshop) and a hope visualization exercise—both designed to build hope for a life goal of each participant’s choosing. 29 SWOG members participated. A link to post-workshop measures was sent to participants, which they were given a week to complete. Measures included Thanarajasingamet al’s 5-item Was-it-Worth-it (WIWI) measure; Kirkpatrick’s 4-item Training Evaluation Model (TEM; reaction, learning, behavior, results); and an item assessing the degree to which participants believe concepts from the workshop should be integrated into SWOG studies. Results: In all, 25 participants (86%) completed measures. Participants were physicians (n = 8), nurses (n = 4), patient advocates (n = 3), research staff (n = 3), and others (n = 7); mostly female (n = 17), mostly white (n = 18), with a mean age of 55.5 (SD = 13.95). Results for the WIWI items are as follows: “Was it worthwhile to participate in the Hope Workshop?” (23 Yes, 2 No/Undecided/Missing Answer); “If you had to do over, would you participate in the Hope Workshop again?” (22 Yes, 3 No/Undecided/Missing Answer); “Would you recommend participating in the Hope Workshop to others?” (22 Yes, 3 No/Undecided/Missing Answer). Two additional items on the WIWI asked participants to rate on a 3-point scale the degree to which they believe their quality of life had increased due to the workshop (M = 2.52, SD =.51) and their overall experience in the workshop (M = 2.70, SD =.64). Ratings for Kirkpatrick’s TEM items likewise were high, ranging from 6.91 (SD = 1.31) to 7.70 (SD =.70) on an 8-point scale. Finally, participants gave a mean rating of 4.44 (SD =.59) on a 5-point scale to the item “To what degree do you believe it may be useful to integrate concepts from this workshop into SWOG trials/studies?” Conclusions: It is feasible to implement hope-enhancement workshops in an online platform that includes a smartphone app. Data obtained from two validated tools (WIWI instrument and Kirkpatrick’s TEM) attest to an array of positive outcomes. Participants also overwhelmingly advocated integrating hope concepts into SWOG’s research.

Improving Pregnant Mothers’ Intention toward HIV Testing through Home-based HIV Test and Education (HOPE) in Jember, Indonesia

The HIV testing program's implementation among pregnant mothers is still not going well due to their intention. Their intention is needed because it can affect pregnant mothers' behavior toward HIV testing. New interventions are needed to solve this problem, such as Home-based HIV Test and Education (HOPE). This study aimed to analyze the influence of HOPE to improve HIV testing intention among pregnant mothers. The pre-experimental design was used with one group pretest-posttest approach—thirty pregnant mothers in Jember following this study and involved by using a purposive sampling technique. The data were collected by using the intention questionnaire and analyzed with the Wilcoxon test. The result showed that pregnant mothers' intention of HIV testing numbers increased from 20 to 27. The results indicate that there is a significant influence of HOPE on the intention of HIV testing in pregnant women (p = 0.033). The Home-based HIV Test and Education (HOPE) intervention can improve pregnant mothers' intention toward HIV testing. The HOPE intervention can reach all pregnant mothers (and their husbands) to discover HIV testing information. Involving their husbands on HOPE intervention encouraged pregnant mothers' intention of HIV testing because their husbands were decision-makers in their family, and pregnant mothers will take HIV testing.

Hoping to Pass: Randomized Trial of a One-Time Hope Intervention on Standardized Exam Passing Rates in BSN Students

BACKGROUND: National standardized nursing exams serve as critical measures of student readiness for practice and carry significant consequences for students and academic institutions. Educational interventions that can enhance a student’s performance increase the probability of academic success. Previous studies link hope to grade point average in college students and on standardized exam (SE) scores in nursing students, yet it is not clear if hope can be increased utilizing a one-time intervention in ways that produce lasting benefits for passing SEs. AIMS: Aim 1 tested the efficacy of a one-time hope intervention on increasing SE passing rates among BSN nursing students. Aim 2 examined the role of the interventions, selected state-mechanism variables, and trait characteristics in predicting SE passing. METHOD: This comparative-effectiveness trial utilized a randomized, controlled, multiple-cohort experimental design to compare a one-time 90-minute hope intervention to an attention-matched progressive muscle relaxation intervention on SE passing scores among BSN nursing students. RESULTS: Levels of hope briefly increased following the hope intervention. Both interventions demonstrated short-term improvement in state-level psychosocial indicators but did not affect SE scores. Among trait and mechanism factors, only academic self-efficacy was linked with passing SEs. CONCLUSIONS: This study demonstrated that a single-session hope intervention can increase short-term hope. In this sample of 292 BSN students, there was no statistically significant long-term effect on passing SEs; however, this study may lay the groundwork for future interventions investigating booster sessions, or how to modify the intervention for struggling students.

EFFECT OF GROUP-BASED HOPE INTERVENTION ON DEPRESSION IN FEMALE INMATES

Background: Life in prison may cause negative feelings and thoughts which triggers depression for female inmates. This results in difficulty in finding purpose in life and loss of interest or motivation. Group-based hope intervention seems to be effective in decreasing depression, but it has not yet been applied in female inmates in a prison.Objective: To determine the effect of group-based hope intervention on depression level in female inmates.Methods: This study used a quasi-experimental study with pre-test post-test and control group design. Eighty-eight participants were selected using proportionate stratified random sampling, with 44 assigned into intervention and control groups. Data were collected from September to November 2019. The level of depression was measured using Beck Depression Inventory-II (BDI-II). Mann Whitney U and Wilcoxon tests were used for data analyses.Results: Both group-based hope intervention in the intervention group and routine intervention in the control group has a significant effect on depression level (p<.01). However, further analysis showed that the group-based hope intervention was much more effective than the routine group in decreasing depression level in female inmates (p<.01).Conclusion: Group-based hope intervention is effective in lowering the depression in female inmates. Therefore, this therapy can be used as a valuable intervention in nursing practice, especially in a correctional setting.