Meaning-Centered Group Psychotherapy: An Effective Intervention for Improving Psychological Well-Being in Patients With Advanced Cancer

被引:352
|
作者
Breitbart, William [1 ]
Rosenfeld, Barry [2 ]
Pessin, Hayley [1 ]
Applebaum, Allison [1 ]
Kulikowski, Julia [1 ]
Lichtenthal, Wendy G. [1 ]
机构
[1] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA
[2] Fordham Univ, New York, NY 10023 USA
关键词
METASTATIC BREAST-CANCER; QUALITY-OF-LIFE; EXPRESSIVE GROUP-THERAPY; SUPPORT; QUESTIONNAIRE; SPIRITUALITY; EXPERIENCE; DISTRESS; PROGRAM; PEOPLE;
D O I
10.1200/JCO.2014.57.2198
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose To test the efficacy of meaning-centered group psychotherapy (MCGP) to reduce psychological distress and improve spiritual well-being in patients with advanced or terminal cancer. Patients and Methods Patients with advanced cancer (N = 253) were randomly assigned to manualized eight-session interventions of either MCGP or supportive group psychotherapy (SGP). Patients were assessed before and after completing the treatment and 2 months after treatment. The primary outcome measures were spiritual well-being and overall quality of life, with secondary outcome measures assessing depression, hopelessness, desire for hastened death, anxiety, and physical symptom distress. Results Hierarchical linear models that included a priori covariates and only participants who attended three sessions indicated a significant group x time interaction for most outcome variables. Specifically, patients receiving MCGP showed significantly greater improvement in spiritual well-being and quality of life and significantly greater reductions in depression, hopelessness, desire for hastened death, and physical symptom distress compared with those receiving SGP. No group differences were observed for changes in anxiety. Analyses that included all patients, regardless of whether they attended any treatment sessions (ie, intent-to-treat analyses), and no covariates still showed significant treatment effects (ie, greater benefit for patients receiving MCGP v SGP) for quality of life, depression, and hopelessness but not for other outcome variables. Conclusion This large randomized controlled study provides strong support for the efficacy of MCGP as a treatment for psychological and existential or spiritual distress in patients with advanced cancer. (C) 2015 by American Society of Clinical Oncology
引用
收藏
页码:749 / 754
页数:6
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