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Izgu N, Metin ZG, Eroglu H, Semerci R, Pars H. Impact of spiritual interventions in individuals with cancer: A systematic review and meta-analysis. Eur J Oncol Nurs 2024; 71:102646. [PMID: 38943773 DOI: 10.1016/j.ejon.2024.102646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/05/2024] [Accepted: 06/14/2024] [Indexed: 07/01/2024]
Abstract
PURPOSE This meta-analysis aimed to determine how spiritual interventions affect cancer patients' physical, emotional, and spiritual outcomes and quality of life. METHODS Between 2012 and May 2024, the Cochrane Library, Scopus, PubMed, and Web of Science were searched considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Twenty-six randomized controlled trials were included, and 16 were synthesized in the meta-analysis. Bias risk was evaluated using the Cochrane risk-of-bias methodology for randomized studies. The Grading of Recommendations, Assessment, Development, and Evaluations tool was employed for evidence certainty. Heterogeneity was expressed through I2 and Q statistics. Hedge's g was calculated for effect sizes. Egger's and Kendall's Tau were used for publication bias. RESULTS Spiritual interventions yielded beneficial effects on fatigue (Hedges's g = 0.900, p < 0.001) and pain (Hedges's g = 0.670, p < 0.001) but not for overall symptom burden (Hedges's g = 0.208, p = 0.176). Significant effects were found for anxiety (Hedges's g = 0.301, p < 0.001), depression (Hedges's g = 0.175, p = 0.016), and psychological distress (Hedges's g = 0.178, p = 0.024), except for hopelessness (Hedges's g = 0.144, p = 0.091). Spiritual interventions enhanced faith (Hedges's g = 0.232, p = 0.035), the meaning of life (Hedges's g = 0.259, p = 0.002), spiritual well-being (Hedges's g = 0.268, p < 0.001), and quality of life (Hedges's g = 245, p < 0.001). Moderator analysis pointed out that cancer stage, total duration, delivery format, providers' qualification, content, and conceptual base of spiritual interventions significantly affect physical, emotional, and spiritual outcomes and quality of life. CONCLUSION This meta-analysis highlighted the benefits of spiritual interventions with varying effect sizes on patients' outcomes, as well as quality of life in cancer, and shed on how to incorporate these approaches into clinical practice.
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Affiliation(s)
- Nur Izgu
- Hacettepe University Faculty of Nursing, Internal Medicince Nursing Department, Ankara, Turkey.
| | - Zehra Gok Metin
- Hacettepe University Faculty of Nursing, Internal Medicince Nursing Department, Ankara, Turkey
| | - Hacer Eroglu
- Healthcare Vocational School, Lokman Hekim University, Ankara, Turkey
| | - Remziye Semerci
- Department of Pediatric Nursing, School of Nursing, Koç University, İstanbul, Turkey
| | - Hatice Pars
- Epidemiology MSc Program, The Institute of Health Sciences, Hacettepe University, Ankara, Turkey
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Chen J, Liu L, Wang Y, Qin H, Liu C. Effects of psychotherapy interventions on anxiety and depression in patients with gastrointestinal cancer: A systematic review and network meta-analysis. J Psychosom Res 2024; 179:111609. [PMID: 38394712 DOI: 10.1016/j.jpsychores.2024.111609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Various psychological interventions have been demonstrated to be effective at preventing anxiety and depression symptoms in patients with gastrointestinal (GI) cancer. However, it remains unclear which intervention is the best option. This study aimed to evaluate the impact of various psychological interventions on anxiety and depression in symptomatic patients with GI cancer. METHODS The PubMed, Cochrane Library, Embase, CNKI, WanFang Data, and VIP databases were systematically searched from inception to June 2023 to identify randomized controlled trials (RCTs). The primary outcomes were anxiety and depression levels. Two reviewers independently selected the studies, extracted the data based on prespecified criteria, and evaluated the risk of bias using the Cochrane Collaboration risk of bias tool. Stata 14.0 was used to conduct network meta-analysis. RESULTS Thirty-two RCTs (2453 patients) involving 9 psychological interventions were included. The results of the network meta-analysis showed that cognitive-behavioral therapy (CBT; mean difference [MD] = -4.98, 95% CI (-7.04, -2.93), relaxation therapy (MD = -4.39, 95% CI (-7.90, -0.88), reminiscence therapy (MD = -5.01, 95% CI (-8.20, -1.81)), and narrative nursing (MD = -4.89, 95% CI (-8.54, -1.23)) significantly reduced anxiety levels, and CBT (MD = -2.15, 95% CI (-4.28, -0.02), reminiscence therapy (MD = -7.20, 95% CI (-10.48, -3.91), and narrative nursing (MD = -7.20, 95% CI (-10.48, -3.91)) significantly reduced depression levels in patients with GI cancer compared with conventional nursing care. CONCLUSION The findings of this network meta-analysis revealed that CBT, reminiscence therapy and narrative nursing can be actively considered as part of sequential therapy to reduce anxiety and depression levels in patients with GI cancer.
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Affiliation(s)
- Jianwen Chen
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China.
| | - Li Liu
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China
| | - Yalan Wang
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China
| | - Huiying Qin
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China.
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, 246000 Anqing, Anhui Province, China.
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Sun M, Tian X, Peng Y, Wang Z, Lu Y, Xiao W. Effects of meaning therapy on spirituality, psychological health, and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled trials. Asia Pac J Oncol Nurs 2024; 11:100388. [PMID: 38586470 PMCID: PMC10997828 DOI: 10.1016/j.apjon.2024.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/26/2024] [Indexed: 04/09/2024] Open
Abstract
Objective This study aimed to systematically review studies of meaning therapy on patients with cancer and to evaluate its effectiveness on spiritual outcomes, psychological outcomes, and quality of life (QOL). Methods A comprehensive literature search were performed in five international databases (PubMed, Embase, Web of Science, The Cochrane Library, and CINAHL) and four Chinese databases (CNKI, Wanfang Data, VIP, and CBM) from the inception to August 2023. The methodological quality of each included studies was evaluated by using the revised Cochrane risk-of-bias tool for randomized trials. The random-effects model or fixed-effects model was utilized for effect size analysis, and the standardized mean difference (SMD) or mean difference (MD) along with its corresponding 95% confidence interval (CI) was computed. Meta-analysis was conducted by using the RevMan software 5.4.1. Results Eight randomized controlled trials with 1251 participants were included in this review. Meta-analyses revealed that meaning therapy can significantly improve the spiritual outcomes including meaning in life (SMD = -0.48; 95% CI = -0.89 to -0.07; P = 0.02), hopelessness (SMD = -0.30; 95% CI = -0.51 to -0.09; P = 0.005), self-esteem (MD = -2.74; 95% CI = -4.17 to -1.32; P = 0.0002) and spiritual well-being (MD = -3.32; 95% CI = -5.63 to -1.01; P = 0.005), psychological outcomes including anxiety (MD = -0.66; 95% CI = -1.30 to -0.01; P = 0.05), depression (SMD = -0.37; 95% CI = -0.55 to -0.20; P < 0.0001), psychological distress (SMD = -0.35; 95% CI = -0.70 to -0.01; P = 0.04) and desire for hastened death (MD = -0.76; 95% CI = -1.47 to -0.05; P = 0.04), and QOL (SMD = -0.29; 95% CI = -0.50 to -0.09; P = 0.006) in patients with cancer. Conclusions Meaning therapy has positive effects on improving spirituality, psychological health, and QOL of patients with cancer. More high-quality randomized controlled trials with larger sample sizes are warranted to confirm the results of our review and to clarify the long-term effects of meaning therapy in the future. Systematic review registration PROSPERO (No. CRD42021278286).
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Affiliation(s)
| | | | - Yunyi Peng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zheng Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yongmei Lu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wenli Xiao
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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4
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Xia W, Zheng Y, Guo D, Zhu Y, Tian L. Effects of cognitive behavioral therapy on anxiety and depressive symptoms in advanced cancer patients: A meta-analysis. Gen Hosp Psychiatry 2024; 87:20-32. [PMID: 38280276 DOI: 10.1016/j.genhosppsych.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/09/2023] [Accepted: 01/19/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVE To evaluate the effects of cognitive behavioral therapy on anxiety and depressive symptoms in patients with advanced cancer. METHODS A systematical search was conducted on Embase, PubMed, Web of Science, Cochrane Library, PsycINFO, Chinese Biomedical Database, CNKI, VIP Database, and Wanfang database, and the search time was from the inception to May 26, 2023. Randomized controlled trials focusing on the effects of cognitive behavioral therapy on anxiety and depressive symptoms in patients with advanced cancer were collected using relevant terms such as advanced stage, cancer, anxiety, depression, and cognitive behavioral therapy. The quality of included studies was evaluated using the Cochrane risk of bias (ROB 2.0) tool, and meta-analysis was performed using RevMan5.4 software. RESULTS 15 articles, including 1,597 patients, were included. Twelve of the studies reported the effect of CBT on anxiety symptoms in 1,485 advanced cancer patients; Fifteen studies reported the effect of CBT on depressive symptoms in 1,861 advanced cancer patients. The results of meta-analysis showed that CBT was effective in decreasing anxiety [SMD = -0.55, 95% CI (-0.82, -0.27), P < 0.001, I2 = 84%] and depressive symptoms [SMD = -0.38, 95% CI (-0.58, -0.17), P < 0.001, I2 = 78%] in patients with advanced cancer compared to controls, especially the interventions that were delivered lasted for 2-8 weeks. CONCLUSION Cognitive behavioral therapy lasting for 2-8 weeks is effective for anxiety and depressive symptoms in advanced cancer patients to a moderate degree, but more rigorous research is needed to guide the choice between online and face-to-face delivery mode and the priority of self-guided versus therapist-guided interventions still needs to be studied.
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Affiliation(s)
- Wangjie Xia
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China; School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Yanping Zheng
- Suzhou hospital of Traditional Chinese Medicine, Suzhou 215007, China
| | - Daoxia Guo
- School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Yuelan Zhu
- The First People's Hospital of Kunshan, Suzhou 215000, China.
| | - Li Tian
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China; School of Nursing, Medical College of Soochow University, Suzhou 215006, China.
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Velasco-Durantez V, Cruz-Castellanos P, Hernandez R, Rodriguez-Gonzalez A, Fernandez Montes A, Gallego A, Manzano-Fernandez A, Sorribes E, Zafra M, Carmona-Bayonas A, Calderon C, Jiménez-Fonseca P. Prospective study of predictors for anxiety, depression, and somatization in a sample of 1807 cancer patients. Sci Rep 2024; 14:3188. [PMID: 38326426 PMCID: PMC10850144 DOI: 10.1038/s41598-024-53212-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
In cancer patients, psychological distress, which encompasses anxiety, depression, and somatization, arises from the complex interplay of emotional and behavioral reactions to the diagnosis and treatment, significantly influencing their functionality and quality of life. The aim was to investigate factors associated with psychological distress in cancer patients. This prospective and multicenter study, conducted by the Spanish Society of Medical Oncology (SEOM), included two cohorts of patients with cancer (localized resected or advanced unresectable). They completed surveys assessing psychological distress (BSI-18) before and after cancer treatment and coping (MINI-MAC) and spirituality (FACIT-sp) prior to therapy. A multivariable logistic regression analysis and a Structural Equation Modeling (SEM) were conducted. Between 2019 and 2022, 1807 patients were evaluated, mostly women (54%), average age 64 years. The most frequent cancers were colorectal (30%), breast (25%) and lung (18%). Men had lower levels of anxiety and depression (OR 0.66, 95% CI 0.52-0.84; OR 0.72, 95% CI 0.56-0.93). Colorectal cancer patients experienced less anxiety (OR 0.63, 95% CI 0.43-0.92), depression (OR 0.55, 95% CI 0.37-0.81), and somatization (OR 0.59, 95% CI 0.42-0.83). Patients with localized cancer and spiritual beliefs had reduced psychological distress, whereas those with anxious preoccupation had higher level. SEM revealed a relationship between psychological distress and coping strategies, emphasizing how baseline anxious preoccupation exacerbates post-treatment distress. This study suggests that age, sex, extension and location of cancer, coping and spirituality influence psychological distress in cancer patients.
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Affiliation(s)
- Veronica Velasco-Durantez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain.
- Universidad de Valladolid, Valladolid, Spain.
| | | | - Raquel Hernandez
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Adan Rodriguez-Gonzalez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain
| | - Ana Fernandez Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense, Orense, Spain
| | - Alejandro Gallego
- Department of Medical Oncology, Clínica Universidad de Navarra, Madrid, Spain
| | | | - Elena Sorribes
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Marta Zafra
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Alberto Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain
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6
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Tseng LC, Ku YL, Lee CH, Tu CT. Spiritual care models of patients living with cancer in Taiwan. Int J Palliat Nurs 2024; 30:40-46. [PMID: 38308602 DOI: 10.12968/ijpn.2024.30.1.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
BACKGROUND Psychological, social and spiritual needs are often unmet during the care of patients with cancer in Taiwan. AIM The purpose of this study was to confirm the spiritual care models including the spiritual distress symptoms (SDS), spiritual distress symptoms interventions (SDSI), and spiritual distress outcomes criteria (SDOC) of patients with cancer in the initial, relapse and terminal stages. METHOD This cross-sectional survey collected data from 150 professional nurses about their perceptions of the SDS, SDSI and SDOC for patients with cancer. RESULTS The significant total effects of SDS on SDOC by SDSI of the patients with cancer in the initial, relapse and terminal stages were found. Additionally, the direct effects of SDS on SDOC by SDSI of the patients with cancer from the initial, relapse to terminal stage were gradually enhanced. CONCLUSIONS The relationship between spiritual distress symptoms, interventions and outcomes was significantly higher from the initial to relapse state until at the end of life, based on the perceptions of 150 professional nurses.
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Affiliation(s)
- Ling-Chun Tseng
- Director, Department of Nursing, Taitung MacKay Memorial Hospital, Taitung City Taiwan
| | - Ya-Lie Ku
- Associate Professor, College of Nursing, Fooyin University
| | - Chun-Hsiang Lee
- Staff Nurse, Department of Nursing, Taitung MacKay Memorial Hospital, Taitung City Taiwan
| | - Chin Tang Tu
- Professor, Center for Teacher Education, National Kaohsiung Normal University, Kaohsiung City, Taiwan
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7
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Krueger E, Secinti E, Stewart JC, Rand KL, Mosher CE. Cognitive-behavioral and mindfulness-based interventions for distress in patients with advanced cancer: A meta-analysis. Psychooncology 2024; 33:e6259. [PMID: 38054530 DOI: 10.1002/pon.6259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/17/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE Various psychosocial interventions have been developed to reduce distress and improve quality of life (QoL) in patients with advanced cancer, many of which are traditional cognitive-behavioral interventions (CBIs) or mindfulness-based interventions (MBIs). The aims of this meta-analysis were to determine and compare the overall effects of traditional CBIs and MBIs on distress and QoL in this population and to explore potential moderators of intervention efficacy. METHODS A systematic search was conducted in CINAHL, Embase, PsycINFO, PubMed, and Web of Science. Randomized controlled trials (RCTs) comparing CBIs or MBIs to controls on distress and QoL outcomes were eligible for inclusion. Random effects meta-analyses using standardized baseline to post-intervention mean differences were calculated using Hedges's g. Meta-regressions were used to compare intervention effects and examine potential moderators. RESULTS Across 37 RCTs (21 CBIs, 14 MBIs, 2 combination therapies), there was a small decrease in distress (Hedges's g = 0.21) and a minimal improvement in QoL (Hedges's g = 0.15). Traditional CBIs and MBIs did not differ in effect sizes. Heterogeneity was significant across distress effect sizes but not across QoL effects. Interventions delivered to individuals (vs. dyads/group) had larger effects on QoL. No moderators of intervention effects on distress were found. CONCLUSIONS Findings suggest traditional CBIs and MBIs produce small reductions in distress compared to controls in patients with advanced cancer, although effects on QoL appear minimal. Given limitations in the number of studies and their quality, rigorous trials are needed to directly compare the impact of traditional CBIs and MBIs in this population.
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Affiliation(s)
- Ellen Krueger
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
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8
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Aydın R, Kabukcuoğlu K. The effect of logotherapy-based, nurse-guided meaning attribution conversations on women diagnosed with gynecologic cancer: A Turkish pilot study. Women Health 2023; 63:599-614. [PMID: 37642347 DOI: 10.1080/03630242.2023.2249123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 07/08/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
Although gynecological cancers are among the most common cancers worldwide, these diagnoses are among the most traumatic experiences in women's lives. This study aimed to examine the effects of logotherapy-based, nurse-guided meaning attribution conversations (MACs) on traumatic stress symptoms, post-traumatic growth, spiritual well-being, and life meaning attribution in gynecological cancer patients. This single-blind, randomized controlled trial consisted of face-to-face interviews with 68 women with gynecological cancer who received chemotherapy at Karadeniz Technical University Health Application And Research Center Farabi Hospital in 2019. Women in the intervention group underwent seven MAC sessions, whereas women in the control group only received routine nursing care. Data were collected using the Personal Information Form (PIF), the Traumatic Stress Symptom Scale (TSSS), the Post-Traumatic Growth Inventory (PTGI), the Meaning in Life Questionnaire (MLQ), and the Spiritual Well-Being Scale (SWBS). Descriptive statistics and parametric and nonparametric tests (Mann - Whitney U-test, Friedman test, Chi-squared test, and Fisher's exact test) were used to analyze the data. The study was registered at ClinicalTrials.gov (NCT05246462). We observed statistically significant differences in the post-intervention and follow-up mean TSSS, PTGI, and MLQ scores (p = .000) between groups. However, mean total SWBS scores were not significantly different between groups (p = .145). This study demonstrated that MACs decreased the traumatic stress symptoms of women with gynecological cancer and increased their post-traumatic growth and ability to attribute meaning to life, but did not affect their spiritual well-being.
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Affiliation(s)
- Ruveyde Aydın
- Health Sciences Faculty, Ondokuz Mayıs University, Samsun, Turkey
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9
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Kang KA, Kim SJ, Kim DB, Koh SJ, Park MH, Yoon SJ. Effects of a Meaning-Centered Spiritual Care Training Program for Hospice Palliative Care Teams in South Korea: A Nonrandomized Controlled Trial. Cancer Nurs 2023; 46:405-412. [PMID: 37607376 DOI: 10.1097/ncc.0000000000001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Spiritual care is an essential part and a core component of quality palliative care, as identified by the World Health Organization. However, spiritual care training for hospice palliative care teams (HPCTs) is infrequent. OBJECTIVE The aim of this study was to investigate the effects of a meaning-centered spiritual care training program for HPCTs (McSCTP-HPCT). METHODS This study used a nonrandomized controlled design. The McSCTP-HPCT comprised 5 modules. The participants were HPCTs working in 15 national hospice institutions and were allocated to either the experimental group (n = 33) or the control group (n = 27) based on the participating institutions' preference. Three outcome variables were tested: spiritual care competency, spiritual care therapeutics, and compassion fatigue. Data were analyzed using descriptive statistics, χ 2 test, 1-way analysis of variance, and repeated-measures analysis of variance. RESULTS There was a significant difference in the interaction between measurement time and group assignment in spiritual care competency ( P = .002) and spiritual care therapeutics ( P = .038), whereas no significant difference was found for compassion fatigue ( P = .716). CONCLUSION The McSCTP-HPCT conducted in this study shows effectiveness in increasing the spiritual care competency and spiritual care therapeutics of HPCTs and may support the importance of spiritual care training. IMPLICATIONS FOR PRACTICE The McSCTP-HPCTs adds to the scientific evidence on spiritual care and has the capacity to improve the quality of care for patients with a life-threatening illness.
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Affiliation(s)
- Kyung-Ah Kang
- Author Affiliations: College of Nursing, Sahmyook University (Dr Kang), Seoul; School of Nursing, Hallym University (Dr SJ Kim), Chuncheon; Holistic Healing Institute of Sam Medical Center (Dr DB Kim), Gunpo; Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine (Dr Koh); Hospice & Palliative Center, Seoul St. Mary's Hospital (Dr Park), Seoul; and Dongbaek St. Luke's Hospital, Gyeonggi-do (Dr Yoon), Republic of Korea
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García Torrejon MC, Heras de la Calle G, Martin Delgado MC, Franco Garrobo N, Gordo Vidal F, Varillas Delgado D, Caballero Martínez F, Álvarez Montero S. Spirituality in Critical Care: An Observational Study of the Perceptions of Professionals, Patients and Families, in Spain and Latin America. JOURNAL OF RELIGION AND HEALTH 2023; 62:2391-2411. [PMID: 36729211 DOI: 10.1007/s10943-023-01746-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
This research aims to describe the perspectives of health care professionals, patients, and family members regarding spiritual care options in intensive care units (ICUs). Participants were recruited consecutively from January to August 2019, during which time data collection was conducted. A total of 1211 Spanish-language questionnaires were collected from 41 ICUs in Spain and Latin America. Approximately 655 participants worked as ICU professionals (74.5% of these participants were women, and 47.5% were nurses). Additionally, 340 questionnaires were sent to patients' families, and patients completed 216 questionnaires; 59.7% of these participants were men, and their mean age was 59.4 years. Most (69.7%) of the critical care professionals considered this type of care to be a part of their profession, 50.1% did not feel competent to provide this type of care, and 83.4% felt that training in this area was necessary. Most families (71.7%) and patients (60.2%) felt that spiritual suffering occurred during their stay in the ICU. The results of this study suggest a perceived deficit in spiritual care in ICUs.
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Affiliation(s)
- María Carmen García Torrejon
- Intensive Care Unit, Central Defence Hospital "Gomez Ulla", Glorieta del Ejército s/n, 28047, Madrid, Spain.
- Universidad Francisco de Vitoria, Madrid, Spain.
- International Research Project for the Humanisation of Intensive Care Units (HU-CI Project), Madrid, Spain.
- Spanish Society of Intensive Medicine (SEMICYUC), Madrid, Spain.
| | - Gabriel Heras de la Calle
- Universidad Francisco de Vitoria, Madrid, Spain
- International Research Project for the Humanisation of Intensive Care Units (HU-CI Project), Madrid, Spain
- Spanish Society of Intensive Medicine (SEMICYUC), Madrid, Spain
- Intensive Care Unit, Comarcal Santa Ana de Motril Hospital, Granada, Spain
- Pan American and Iberian Federation of Critical Medicine and Intensive Care (FEPIMCTI), Madrid, Spain
| | - María Cruz Martin Delgado
- Universidad Francisco de Vitoria, Madrid, Spain
- International Research Project for the Humanisation of Intensive Care Units (HU-CI Project), Madrid, Spain
- Spanish Society of Intensive Medicine (SEMICYUC), Madrid, Spain
- Intensive Care Unit, Doce de Octubre University Hospital, Madrid, Spain
- Pan American and Iberian Federation of Critical Medicine and Intensive Care (FEPIMCTI), Madrid, Spain
| | - Nieves Franco Garrobo
- Universidad Francisco de Vitoria, Madrid, Spain
- Spanish Society of Intensive Medicine (SEMICYUC), Madrid, Spain
- Intensive Care Unit, Móstoles University Hospital, Madrid, Spain
| | - Federico Gordo Vidal
- Universidad Francisco de Vitoria, Madrid, Spain
- Spanish Society of Intensive Medicine (SEMICYUC), Madrid, Spain
- Intensive Care Unit, Henares University Hospital, Madrid, Spain
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11
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Merluzzi TV, Salamanca-Balen N, Philip EJ, Salsman JM. "Letting go" - Relinquishing control of illness outcomes to God and quality of life: Meaning/peace as a mediating mechanism in religious coping with cancer. Soc Sci Med 2023; 317:115597. [PMID: 36535230 PMCID: PMC9962851 DOI: 10.1016/j.socscimed.2022.115597] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Relinquishing control (RC) of outcomes to God is a long-standing form of religious coping with serious illness. Placing cancer outcomes "in God's hands" has been positively related to coping and quality of life (QOL). However, the mechanisms involved in this relationship have not been established. A serial mediation model [i.e., RC (X)-Meaning/Peace (M1)-Coping Efficacy (M2)-Symptoms, Physical QOL, Functional QOL (Ys)] tested the hypothesis that Meaning/Peace alone and in conjunction with coping would mediate the RC-QOL relationship. METHOD 548 persons with a cancer diagnosis completed the Religious Problem-Solving Scale (RPSS), FACIT-Sp Meaning and Peace Scales, Cancer Behavior Inventory (coping efficacy), and measures of Physical Quality of Life (PQOL), Functional Quality of Life (FQOL) and Symptoms. RESULTS As hypothesized, the single mediation effects of Meaning/Peace were significant [Indirect Effects: PQOL: .23 (95% CI: 0.15, 0.34); FQOL: 0.46 (95% CI: 0.33, 0.61); Symptoms: -0.18 (95% CI: -0.27, -0.10)]. In addition, mediation was confirmed for the serial mediation model (i.e., Meaning/Peace - Coping Efficacy as serial mediators) with significant indirect effects [Indirect Effects: PQOL: 0.37 (95% CI: 0.27, 0.48); FQOL: 0.57 (95% CI: 0.42, 0.72); Symptoms: -0.25 (95% CI: -0.35, -0.17)]. CONCLUSIONS In the mediation models tested, the RC-QOL and RC-Symptoms relationships were mediated by the confluence of a sense of peace perhaps due to patients' feelings that outcomes were "in God's hands" and a sense of coherence between their current situation and a spiritually-based meaning system. Meaning/Peace was also related to coping efficacy, suggesting that these mediating constructs could be used to inform evidence-based interventions, such as Meaning-Centered therapies, that are sensitive to the belief systems of cancer patients and enhance QOL.
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Affiliation(s)
| | | | - Errol J Philip
- University of Notre Dame, Department of Psychology, United States
| | - John M Salsman
- Wake Forest University College of Medicine, Social Sciences and Health Policy, United States
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ÜLBE S, DİRİK G. Kanser Tanısı almış Kişilere Uygulanan Anlam Temelli Müdahale Programları: Sistematik bir Derleme. KLINIK PSIKOLOJI DERGISI 2022. [DOI: 10.57127/kpd.26024438m0000104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Son yıllarda kanser tanısı almış kişilerin yalnızca yaşadıkları olumsuz psikolojik semptomları azaltmayı değil, aynı zamanda kişilerin yaşamdaki anlam kaynaklarını ve değerleri ile temasa geçerek yaşamlarını zenginleştirmeyi amaçlayan çeşitli anlam temelli müdahale geliştirilmiştir. Mevcut çalışmanın amacı kanser tanısı alan kişilerde doğrudan yaşamda anlam ve amaç duygularını geliştirmeye odaklanan müdahalelerin özelliklerini ve sonuçlarını sistematik olarak incelemektir. Bu kapsamda PsychINFO, MEDLINE, CINAHL Complete, PubMed, Scopus ve Web of Science olmak üzere toplamda altı elektronik veri tabanı kullanılarak sistematik bir literatür taraması yapılmıştır. 2000-2022 yılları arasında yapılan tarama sonucunda kanser tanısı almış kişiler için doğrudan anlam yaratmaya ve yaşamda anlam duygusuna odaklanan 14 farklı müdahale programını içeren 20 çalışmaya ulaşılmıştır. Derlemede yer alan araştırmaların örneklemini çoğunlukla kadın, orta yaş ve üzeri olan ve ileri evre kanser tanısı alan kişiler oluşturmuştur. Meme ve akciğer kanseri bu derlemedeki araştırmalarda en çok yer alan kanser türüdür. Derlemeye dâhil edilen çalışmaların çoğunluğunun kuramsal olarak Frankl’ın çalışmalarından etkilendiği ve psikoterapide varoluşsal yaklaşımı benimsedikleri görülmektedir. Anlam odaklı müdahale programlarının etkileri değerlendirildiğinde ise yapılan müdahalelerin anlam duygusunu, yaşam kalitesini ve spiritüel iyi oluş düzeylerini iyileştirmede büyük oranda etkili olduğu görülmektedir. Ayrıca anksiyete, depresyon, duygusal sıkıntı, iyimserlik ve umutsuzluk düzeyleri üzerinde görece olumlu etkileri olduğu düşünülmektedir. Bu kapsamda anlam odaklı müdahalelerinin kanser tanısı almış kişilerin hem anlam ve varoluşla ilgili sorularını hem de duygusal sıkıntılarını ele almada umut verici bir yaklaşım olduğu görülmektedir. Diğer taraftan anlam odaklı müdahalelere ilişkin daha kapsamlı çıkarımlar yapabilmek için daha titiz bir araştırma metodolojisi kullanan yeni çalışmalara ihtiyaç vardır.
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Almeida M, Ramos C, Maciel L, Basto-Pereira M, Leal I. Meaning in life, meaning-making and posttraumatic growth in cancer patients: Systematic review and meta-analysis. Front Psychol 2022; 13:995981. [PMID: 36570997 PMCID: PMC9784472 DOI: 10.3389/fpsyg.2022.995981] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction The purpose of this systematic review and meta-analysis is to assess the association between meaning in life (MiL), meaning-making and posttraumatic growth (PTG) in the context of cancer. Methods A systematic search was conducted in eighteen electronic databases. The screening and selection process followed the PRISMA guidelines. For the purpose of the meta-analysis, the correlation coefficients between meaning in life and posttraumatic growth were extracted from the included studies. The effect size (r) was calculated using the restricted maximum-likelihood estimator, a random-effects model. Heterogeneity was assessed through the Q statistic, I2 index and forest plot, while publication bias was analyzed with the use of the funnel plot and Egger's test. Results 889 records were considered according to the inclusion criteria. A total of nine articles, published between 2006 and 2021, were included in the systematic review. More than half were published in the last five years. The sample was mostly diagnosed with breast cancer. The meta-analysis included five articles (N = 844) and the results indicate a significant moderate correlation between meaning in life and posttraumatic growth (r = 0.43, 95% IC [0.36, 0.50]). Discussion In conclusion, there is a clear association between meaning in life and posttraumatic growth in cancer patients. Future research should explore this relationship further, in order to better assist and guide meaning centered interventions that can potentiate a positive adjustment and possibly growth from the cancer experience.
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Affiliation(s)
- Margarida Almeida
- Ispa – Instituto Universitário, Lisbon, Portugal,*Correspondence: Margarida Almeida,
| | - Catarina Ramos
- LabPSI – Laboratório de Psicologia Egas Moniz, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Caparica, Portugal
| | - Laura Maciel
- WJCR – William James Center for Research, Ispa – Instituto Universitário, Lisbon, Portugal
| | - Miguel Basto-Pereira
- WJCR – William James Center for Research, Ispa – Instituto Universitário, Lisbon, Portugal
| | - Isabel Leal
- WJCR – William James Center for Research, Ispa – Instituto Universitário, Lisbon, Portugal
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Costanza A, Vasileios C, Ambrosetti J, Shah S, Amerio A, Aguglia A, Serafini G, Piguet V, Luthy C, Cedraschi C, Bondolfi G, Berardelli I. Demoralization in suicide: A systematic review. J Psychosom Res 2022; 157:110788. [PMID: 35334350 DOI: 10.1016/j.jpsychores.2022.110788] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In psychiatric literature, few original studies exist on the topic of demoralization in suicide. In this review, we aim to identify original studies on suicidal ideation (SI)/suicidal behavior (SB) and demoralization in populations of community-dwellers and patients with somatic or psychiatric disorders. METHODS We employed a systematic approach that followed PRISMA guidelines, searching through four major electronic databases (PubMed/MEDLINE, Scopus, Science Direct, and PsychINFO) for relevant titles/abstracts published from January 1980-June 2021. We included original studies that explicitly mentioned the investigation of a potential association between SI/SB and demoralization. RESULTS A total of 18 studies met our inclusion criteria. Their synthesis revealed that demoralization can be associated with SI/SB in a wide range of populations (community dwellers, patients with somatic or psychiatric disorders) and lead to significantly higher suicide risk (odds ratios of >6 were encountered in community dwellers experiencing financial hardship or isolation). Moreover, demoralization alone (about half the patients who were demoralized did not meet the criteria for an affective disorder nor were they clinically depressed) or together with depression has been identified as a major risk factor for SI/SB. Regarding the crucial issue of progression from SI to SA, in the context of the "ideation-to-action" frame, some authors found that the interaction of demoralization and over-arousal could be a useful predictor for this progression, while others found that depression alone was sufficient to differentiate attempters from non-attempters or the interaction with shutdown (helplessness and low positive emotions). CONCLUSION These results emphasize the possibility to identify demoralization as an independent risk factor for suicide. In patients with psychiatric disorders, the association between demoralization and SI/SB may be transnosographic. Overall, from the clinical implications perspective, our findings highlight that: i. Assessment of demoralization may contribute to a more comprehensive suicide risk detection. This appears particularly relevant in Emergency Departments (EDs) where heterogeneous population typologies are usually admitted and a clinical diagnosis of depression is often difficult to be defined. ii. Additionally, since meaninglessness is considered one of the demoralization subcomponents, meaning-centered psychotherapeutic approaches prove to be indicated and they can be initiated already at the EDs upon first contact with the patient. Further studies are necessary to confirm these findings.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
| | - Chytas Vasileios
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University Hospitals of Geneva (HUG), Switzerland
| | - Julia Ambrosetti
- Department of Psychiatry and Department of Emergency, Emergency Psychiatric Unit (UAUP), Geneva University Hospitals (HUG), 1211 Geneva, Switzerland
| | - Sanam Shah
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm U1018, Paris, France
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Valérie Piguet
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University Hospitals of Geneva (HUG), Switzerland
| | - Christophe Luthy
- Division of General Medical Rehabilitation, Geneva University Hospitals (HUG), Switzerland; Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Christine Cedraschi
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University Hospitals of Geneva (HUG), Switzerland; Division of General Medical Rehabilitation, Geneva University Hospitals (HUG), Switzerland; Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Effects of the Heart to Heart Card Game for Patients with Advanced Cancer Receiving Home-Based Palliative Care: A Clinical Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106115. [PMID: 35627652 PMCID: PMC9140332 DOI: 10.3390/ijerph19106115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/08/2022] [Accepted: 05/15/2022] [Indexed: 11/17/2022]
Abstract
The Heart to Heart Card Game improves psychological health outcomes in hospitalized patients with advanced cancer, but effectiveness studies for patients at home are rare. This randomized controlled study was conducted to determine the effectiveness of the Heart to Heart Card Game on patients with advanced cancer receiving home-based palliative care. Sixty-six participants were randomly assigned to the intervention group (n = 34) and control group (n = 32). The quality of life, dignity, and psychological distress were considered as outcomes, which were assessed pre-intervention and six weeks after the intervention. There was a statistical difference in the quality of life (global health statues) between the intervention group and the control group after intervention (z = 2.017, p < 0.05). A significant difference was found in the quality of life (emotional, social function), dignity (symptom distress dimension), and psychological distress in the intervention group through intragroup comparison before and after the intervention. This randomized trial showed that the Heart to Heart Card Game likely alleviates barriers to end-of-life conversations and helps patients with advanced cancer maintain a more stable mental state. This trial has been registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2100049933).
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Whitehead P. Palliative Care and Dementia: What All Advanced Practice Nurses Should Know. Crit Care Nurs Clin North Am 2022; 34:121-127. [PMID: 35210021 DOI: 10.1016/j.cnc.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Dementia is a progressive, incurable condition that causes limitations in life and should be recognized as a life-limiting condition. Health care professionals should understand its trajectory to better manage symptoms and to provide early and ongoing advance care planning. Advanced practice registered nurses are uniquely qualified to work with patients and their families to identify care preferences and then to align treatments to them. Palliative care and hospice are important interventions that should be integrated into the management of patients with dementia. Additionally, early integration of palliative medicine can better manage symptoms and lessen the strain on loved ones.
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Affiliation(s)
- Phyllis Whitehead
- Carilion Roanoke Memorial Hospital Palliative Care Service, 1906 Belleview Avenue Southeast, Roanoke, VA 24014, USA; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24014, USA.
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Ostafin BD, Papenfuss I, Vervaeke J. Fear of the unknown as a mechanism of the inverse relation between life meaning and psychological distress. ANXIETY STRESS AND COPING 2021; 35:379-394. [PMID: 34719300 DOI: 10.1080/10615806.2021.1994556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Although there is accumulating evidence for an inverse relation between life meaning and psychological distress, little is known about the mechanisms of this relation. Using cross-sectional, observational methods, this research examined fear of uncertainty as one potential mechanism. DESIGN AND METHODS Study 1 (N = 141) was completed with a convenience sample, a unidimensional measure of life meaning, and general measures of anxiety and depression. Study 2 (N = 152) was completed with a sample prescreened for anxiety, a multidimensional measure of life meaning, and clinical measures of anxiety and depression. RESULTS The results from both studies generally showed an inverse relation between life meaning and psychological distress. Study 2 further indicated that these relations were stronger for the meaning subscale of perceiving life as coherent/comprehensible than the subscales assessing whether participants' lives are perceived as purposeful or significant. Mediation analyses in both studies showed indirect effects of life meaning on psychological distress through fear of uncertainty. CONCLUSIONS These findings support and extend previous research by showing that (i) meaning-as-comprehension may be particularly important in regards to psychological distress, and (ii) fear of uncertainty may mediate the inverse relation between meaning and measures of anxiety and depression.
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Affiliation(s)
- Brian D Ostafin
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Inka Papenfuss
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - John Vervaeke
- Department of Psychology, University of Toronto, Toronto, Canada
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Dietrich N, Estradé A, Antonio Cruzado J. Efficacy of Meaning-Centered Psychotherapy in adult patients with advanced cancer: A systematic review and meta-analysis. PSICOONCOLOGIA 2021. [DOI: 10.5209/psic.77752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: We conducted a PRISMA-compliant systematic review of clinical trials, and a meta-analysis of randomised clinical trials (RCTs) of manualised Meaning-Centered Psychotherapy (MCP) interventions for adult advanced cancer patients. We searched seven databases for trials published in English and Spanish, until March 27, 2021. Results: Seven trials were included in the systematic review, and four in the meta-analysis. The systematic review favoured the effectiveness of MCP for the improvement of spiritual well-being, quality of life (QoL), sense of meaning and psychological distress, although inconsistencies between the trials were found. In pre-post meta-analytic estimates, MCP had a superior therapeutic effect than control conditions for spiritual well-being (d=0.52, p<0.001), QoL (d=0.60, p<0.001), anxiety symptoms (d=-0.47, p<0.001), depressive symptoms (d=-0.50, p<0.001) and desire for hastened death (d=-0.28, p<0.001). No differences were observed in between-group comparisons. MCP was not associated with an increased risk of abandonment at post-treatment (OR=0.86, p=0.57). Conclusion: Manualised MCP interventions are a promising treatment for the improvement of spiritual well-being and quality of life and the reduction of psychological distress in adult patients with advanced cancer. The evidence base is still in an emerging state and should be expanded by higher methodological quality studies.
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Lim MA, Ang BT, Lam CL, Loh EC, Zainuddin SI, Capelle DP, Ng CG, Lim PK, Khor PY, Lim JY, Huang SY, Low GQJ, Gan XY, Tan SB. The effect of 5-min mindfulness of love on suffering and spiritual quality of life of palliative care patients: A randomized controlled study. Eur J Cancer Care (Engl) 2021; 30:e13456. [PMID: 33913192 DOI: 10.1111/ecc.13456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/15/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Suffering is a common experience in palliative care. In our study, we aimed to determine the effect of 5-min mindfulness of love on suffering and the spiritual quality of life of palliative care patients. METHODS We conducted a parallel-group, blinded, randomized controlled study at the University of Malaya Medical Centre (UMMC), Malaysia from February 2019 to April 2019. Sixty adult palliative care patients with an overall suffering score of 4/10 or above based on the Suffering Pictogram were recruited and randomly assigned to either the 5-min mindfulness of love group (N = 30) or the 5-min supportive listening group (N = 30). RESULTS There were statistically significant improvements in the overall suffering score (mean difference = -2.9, CI = -3.7 to -2.1, t = -7.268, p = 0.000) and the total FACIT-Sp-12 score (mean difference = 2.9, CI = 1.5 to 4.3, t = 4.124, p = 0.000) in the intervention group compared to the control group. CONCLUSION The results provided evidence that 5-min mindfulness of love could affect the actual state of suffering and the spiritual quality of life of palliative care patients.
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Affiliation(s)
- Min Ai Lim
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Bin Ting Ang
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chee Loong Lam
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ee Chin Loh
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Chong Guan Ng
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Poh Khuen Lim
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pei Yi Khor
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jia Yu Lim
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - See Yong Huang
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Xhi Yan Gan
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Seng Beng Tan
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Kang KA, Kim SJ, Kim DB, Park MH, Yoon SJ, Choi SE, Choi YS, Koh SJ. A meaning-centered spiritual care training program for hospice palliative care teams in South Korea: development and preliminary evaluation. BMC Palliat Care 2021; 20:30. [PMID: 33563253 PMCID: PMC7871309 DOI: 10.1186/s12904-021-00718-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Spirituality is a fundamental, intrinsic aspect of human beings and should be a core component of quality palliative care. There is an urgent need to train hospice palliative care teams (HPCTs) to enhance their ability to provide spiritual care. This study aimed to develop and evaluate a meaning-centered, spiritual care training program (McSCTP) for HPCTs (McSCTP-HPCTs). METHODS The modules' content was informed by Viktor Frankl's meaning-centered logotherapy with its emphasis on spiritual resources, as well as the spiritual care model of the Interprofessional Spiritual Care Education Curriculum (ISPEC). Following development, we conducted a pilot test with four nurses. We used the results to inform the final program, which we tested in an intervention involving 13 members of HPCTs. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis test, we analyzed the participants' demographic and career-related characteristics, as well as the degree of variance between three outcome variables: compassion fatigue (CF), spiritual care competencies (SCCs), and spiritual care therapeutics (SCT). RESULTS We divided the McSCTP-HPCTs into five modules. Module I: The HPCTs' SCC evaluation, understanding the major concepts of spiritual care and logotherapy; Modules II-IV: Meaning-centered interventions (MCIs) related to spiritual needs (existential, relational, and transcendental/religious); Module V: The process of meaning-centered spiritual care. The preliminary evaluation revealed significant differences in all three outcome variables at the posttest point (CF, p = 0.037; SCCs, p = 0.005; SCT, p = 0.002). At the four-week follow-up test point, we only found statistical significance with the SCCs (p = 0.006). CONCLUSIONS The McSCTP-HPCTs is suitable for use in clinical settings and provides evidence for assessing the SCCs of HPCTs.
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Affiliation(s)
- Kyung-Ah Kang
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
| | - Shin-Jeong Kim
- School of Nursing, Hallym University, 39 Hallymdaehak-gil, Chuncheon, Gangwon-do 24252 Republic of Korea
| | - Do-Bong Kim
- Holistic Healing Institute of Sam Medical Center, Gunpo, Republic of Korea
| | - Myung-Hee Park
- Hospice & Palliative Center, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
| | - Soo-Jin Yoon
- Dongbaek St. Luke Hospice, Gyeonggi-do, Republic of Korea
| | - Sung-Eun Choi
- Hospice Care Center of the Regional Cancer Center, Chungnam University Hospital, Daejeon, Republic of Korea
| | - Young-Sim Choi
- Department of Nursing, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Lam J, Aftab A, Lee E, Jeste D. POSITIVE PSYCHIATRY INTERVENTIONS IN GERIATRIC MENTAL HEALTH. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2020; 7:471-488. [PMID: 33643770 PMCID: PMC7904105 DOI: 10.1007/s40501-020-00228-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Positive psychiatry shifts the focus of geriatric mental healthcare beyond studying disorders and psychopathology to studying factors that contribute to mental well-being and successful aging. An increasing number of interventional studies are using treatments that target modifiable positive psychosocial characteristics (PPCs) and study their impact on mental health. Here we provide an overview of the literature on positive psychiatry interventions using illustrative examples of interventions targeting social connectedness, meaning in life, wisdom, and resilience. RECENT FINDINGS There is growing evidence that PPCs are modifiable constructs that may be associated with improved well-being, physical health, and mental health outcomes. SUMMARY The preliminary evidence summarized in this narrative review indicates that positive psychiatry interventions targeting social connectedness, meaning in life, wisdom, and resilience can improve overall well-being and other positive health outcomes amongst older adults. The effect sizes of these interventions reported in RCTs and meta-analyses are typically small to medium, but occasionally large effect sizes are also reported. Current literature is restricted by heterogeneous methodology, limiting clinicians' abilities to extrapolate these principles of positive psychiatry into everyday practice. With the expanding body of evidence, positive psychiatry may have the potential to transform the landscape of geriatric mental health.
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Affiliation(s)
- Jeffrey Lam
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Awais Aftab
- Department of Psychiatry, Case Western Reserve University, Cleveland OH
- Northcoast Behavioral Healthcare (Ohio Department of Mental Health and Addiction Services), Northfield, OH
| | - Ellen Lee
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Dilip Jeste
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Department of Neurosciences, University of California San Diego, La Jolla, CA
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Pilot of a novel theoretically derived intervention for cancer-related anxiety with patients with advanced or recurred disease. Behav Cogn Psychother 2020; 49:247-253. [PMID: 33000715 DOI: 10.1017/s1352465820000697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Treatments for cancer-related anxiety show modest benefits, but most have been trialled in patients with early stage disease or patients who are currently disease free. However, many patients with cancer have incurable disease, or their disease is slowly progressing or likely to recur. Treating anxiety in the context of realistic threat and ongoing uncertainty is particularly challenging. Based on a theoretical model of cancer-related anxiety, we developed a transdiagnostic intervention for patients with advanced or recurred disease who are experiencing clinically significant anxieties. The intervention was a novel integration of traditional and contemporary CBT. AIMS To evaluate the feasibility, acceptability and preliminary efficacy of the intervention in a pilot with patients with advanced or recurred cancer. METHOD Twelve patients with advanced or recurred cancer, who were experiencing anxiety, participated. Feasibility and acceptability were assessed with participant's ratings and adherence and retention rates. Psychological outcomes (anxiety, traumatic symptoms, fear of progression, depression, death anxiety and quality of life) were assessed pre-intervention, post-intervention and at 2-month follow-up. RESULTS Eleven of the 12 participants completed at least five therapy sessions of whom eight completed all nine sessions. Participants rated the intervention as having excellent face validity. Post-intervention, statistically significant improvements were demonstrated for anxiety, traumatic symptoms, fear of progression, depression and quality of life. These improvements were maintained at follow-up for anxiety, traumatic symptoms and depression. CONCLUSIONS This pilot provides preliminary evidence for the feasibility, acceptability and effectiveness of the novel intervention for cancer-related anxiety in the context of advanced disease.
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Caruso R, Breitbart W. Mental health care in oncology. Contemporary perspective on the psychosocial burden of cancer and evidence-based interventions. Epidemiol Psychiatr Sci 2020; 29:e86. [PMID: 31915100 PMCID: PMC7214708 DOI: 10.1017/s2045796019000866] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 11/30/2019] [Indexed: 12/18/2022] Open
Abstract
With cancer incidence increasing over time worldwide, attention to the burden of psychiatric and psychosocial consequences of the disease is now mandatory for both cancer and mental health care professionals. Psychiatric disorders have been shown to affect at least 30-35% of cancer patients during all phases of the disease trajectory, and differ in nature according to stage and type of cancer. Other clinically relevant distressing psychosocial and existential conditions (e.g. demoralisation, health anxiety, loss of meaning and existential distress) not included as 'disorders' in the usual diagnostic and nosological systems (i.e. meta-diagnostic conditions) have also been shown to be present in another 15-20% of cancer patients. In this editorial, we will present a summary of the extensive literature regarding the epidemiology of the several psychosocial disorders affecting cancer patients as a cause of distress and burden to be taken into consideration and addressed in cancer care through evidence-based intervention.
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Affiliation(s)
- R. Caruso
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - W. Breitbart
- Department of Psychiatry & Behavioral Sciences, Jimmie C. Holland Chair in Psychiatric Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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