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Capaldi JM, Shabanian J, Finster LB, Asher A, Wertheimer JC, Zebrack BJ, Shirazipour CH. Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions. Health Psychol Rev 2024; 18:41-74. [PMID: 36632776 DOI: 10.1080/17437199.2022.2162947] [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: 10/26/2021] [Accepted: 12/21/2022] [Indexed: 01/13/2023]
Abstract
The detrimental effects of Post-Traumatic Stress Symptoms (PTSS) and Post-Traumatic Stress Disorder (PTSD) and the benefits of Post-Traumatic Growth (PTG) are well established for cancer survivors. Increased cancer survival rates necessitate an understanding of how these two paradoxical outcomes, PTSS/PTSD and PTG, are targeted through interventions. This systematic scoping review aims to (a) examine existing evidence on interventions targeting PTSS/PTSD and/or PTG among cancer survivors and (b) identify knowledge gaps to inform future research. Following the six steps of a scoping review, 76 articles met the inclusion criteria. Quantitative articles were examined using descriptive analysis. Frequency counts of the collated data were tabulated into summary tables. Qualitative articles were reviewed using meta-synthesis. Most articles were quantitative (n = 52) and targeted PTG (n = 68) through promising intervention approaches such as psychotherapy, mindfulness, physical activity, and psilocybin-assisted therapy. Three key implications for future research and practice were synthesized: (1) mechanistic considerations for intervention design that provide a roadmap for rigorous and theoretically-grounded research; (2) the need for improved representation of cancer survivors in trials; and (3) potential facilitators of intervention efficacy. Together, these findings can direct future research to optimize interventions to reduce PTSS/PTSD and promote PTG achievement among cancer survivors.
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Affiliation(s)
- Jessica M Capaldi
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia Shabanian
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Laurel B Finster
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arash Asher
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Wang S, Zheng M, Zhu Y, Zhang L, Li X, Wan H. Exploring the experience of meaning-centered group psychotherapy among Chinese cancer patients during active treatment: a descriptive qualitative study. Front Psychiatry 2023; 14:1264257. [PMID: 37867777 PMCID: PMC10590054 DOI: 10.3389/fpsyt.2023.1264257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Meaninglessness poses a significant psychological challenge for cancer patients, negatively affecting their quality of life and increasing the risk of suicide. Meaning-Centered Group Therapy (MCGP) is an intervention designed specifically to enhance the meaning of life of cancer patients. Extensive research has documented its effectiveness across various cultures and populations. However, limited research has been conducted on the subjective experiences and perspectives of participants engaged in MCGP. Thus, the purpose of this study was to employ a qualitative design to explore the experiences and viewpoints of Chinese cancer patients who have undergone MCGP. Methods Within a two-week timeframe following the conclusion of MCGP, semi-structured interviews were administered to twenty-one participants who had engaged in the therapy. The interview data were transcribed and subjected to thematic analysis. Results Four main themes were identified: (a) Self-perceived personal change, (b) Overall experience of group therapy, (c) Barriers to participation of MCGP, and (d) Suggestions for future interventions. Conclusion Despite the barriers to participation in the MCGP process, the overall experience for Chinese cancer patients undergoing active treatment is valuable and positive, providing multiple benefits. Future studies could explore the adaptation of MCGP to a broader range of cancer populations and diverse study populations.
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Affiliation(s)
- Shuman Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Mimi Zheng
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Lijuan Zhang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Xiaoru Li
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
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3
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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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4
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Levy K, Grant PC, Depner RM, Tenzek KE, Beaupin LK, Pailler ME, Brewer-Spritzer E. The Photographs of Meaning Program for Pediatric Palliative Caregivers and Its Impact on Meaning, Well-Being, and Perceived Social Support. Palliat Med Rep 2020; 1:84-91. [PMID: 34223462 PMCID: PMC8241342 DOI: 10.1089/pmr.2020.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2020] [Indexed: 11/12/2022] Open
Abstract
Background: Caring for a child or adolescent with palliative care needs can significantly influence the physical, mental, financial, and social well-being of caregivers. Due to this multifaceted impact, there is a demand for evidence-based support that meets the distinct needs of this population. Objective: This study aims to evaluate the effect the Photographs of Meaning Program (POM) has on meaning and purpose, well-being, and perceived social support of pediatric palliative caregivers (PPCGs). Design: Over an eight-week period, participants followed a meaning-making curriculum via social media. Following the social media portion of the intervention, a reflection and closure event and a community photograph exhibit were held. Participants completed pre- and post-test measures. Setting/Subjects: Eighteen PPCGs participated in POM. Settings included participant homes, the medical campus of the palliative care program, and a community art gallery. Measurements: Participant meaning and purpose were assessed through the Meaning in Life Questionnaire. The Flourishing Scale measured PPCG well-being, while the Social Provisions Scale assessed perceived social support. Participants were also given a satisfaction survey at study closure. Results: Presence (p = 0.003) and search (p = 0.023) for meaning were both positively impacted at post-test. Participants' ratings of well-being (p = 0.037), overall social support (p = 0.004), areas of attachment (p = 0.003), social integration (p = 0.026), reassurance of worth (p = 0.002), and guidance (p = 0.014) significantly increased from pre- to post-test. Conclusions: POM is an effective social media-based intervention for PPCGs. Future research should assess the effectiveness of this intervention in populations with differing demographics and its effect on other psychosocial indicators.
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Affiliation(s)
- Kathryn Levy
- Department of Research, Hospice & Palliative Care Buffalo, Cheektowaga, New York, USA.,Department of Planning and Research, Trocaire College, Buffalo, New York, USA
| | - Pei C Grant
- Department of Research, Hospice & Palliative Care Buffalo, Cheektowaga, New York, USA
| | - Rachel M Depner
- Department of Research, Hospice & Palliative Care Buffalo, Cheektowaga, New York, USA.,Department of Counseling, School and Educational Psychology, University at Buffalo, the State University of New York, Buffalo, New York, USA
| | - Kelly E Tenzek
- Department of Communication, University at Buffalo, the State University of New York, Buffalo, New York, USA
| | - Lynda K Beaupin
- Department of Pediatric Hematology and Oncology, Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Megan E Pailler
- Department of Psychology, Roswell Park Cancer Institute, Buffalo, New York, USA
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5
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Levy K, Grant PC, Depner RM, Tenzek KE, Pailler ME, Beaupin LK, Breier JM, Byrwa DJ. The Photographs of Meaning Program for Pediatric Palliative Caregivers: Feasibility of a Novel Meaning-Making Intervention. Am J Hosp Palliat Care 2019; 36:557-563. [PMID: 30665322 DOI: 10.1177/1049909118824560] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Research indicates that informal caregiving can have intense physical and mental impact on the individual. Relative to caregivers of adults, pediatric palliative caregivers appear less in literature despite experiencing greater mental, physical, financial, and social strain. There is limited research on the creation and evaluation of interventions specifically for this population despite clear need. OBJECTIVE This study aims to evaluate the feasibility and engagement of the Photographs of Meaning Program, a modified meaning-making intervention for pediatric palliative caregivers. DESIGN Participants completed a pre-post intervention meaning-in-life measure. Over a 9-week period, participants followed a meaning-making curriculum whereby they created and shared photo narratives via social media. As part of the intervention, a community photo exhibition was held featuring these photo narratives. Exit interviews were also conducted at study close. SETTING/PARTICIPANTS Nine individuals providing informal care to children in a pediatric palliative care program participated in the intervention. All participants were female and are older than 18 years. Settings for research include participant homes and at The Center for Hospice and Palliative Care in Cheektowaga, New York. RESULTS Participants posted 95 photographs and 96 narratives during the intervention, posting on average once each week. Statistical analysis within the small sample indicated an increased presence of meaning in the lives of participants ( P = .022). Exit interviews conveyed satisfaction with the intervention. CONCLUSIONS Findings suggest that the Photographs of Meaning Program is a practical intervention with life-enhancing potential for pediatric palliative. Future research should aim to collect additional evidence of the intervention's effectiveness.
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Affiliation(s)
- Kathryn Levy
- 1 Palliative Care Institute, The Center for Hospice & Palliative Care, Cheektowaga, NY, USA
| | - Pei C Grant
- 1 Palliative Care Institute, The Center for Hospice & Palliative Care, Cheektowaga, NY, USA
| | - Rachel M Depner
- 1 Palliative Care Institute, The Center for Hospice & Palliative Care, Cheektowaga, NY, USA.,2 Department of Counseling, School and Educational Psychology, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Kelly E Tenzek
- 3 Department of Communication, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Megan E Pailler
- 4 Department of Psychosocial Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | | | - Jennifer M Breier
- 1 Palliative Care Institute, The Center for Hospice & Palliative Care, Cheektowaga, NY, USA
| | - David J Byrwa
- 1 Palliative Care Institute, The Center for Hospice & Palliative Care, Cheektowaga, NY, USA.,6 School of Medicine, University at Buffalo, The State University of New York, Buffalo, NY, USA
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6
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van der Spek N, Vos J, van Uden-Kraan CF, Breitbart W, Cuijpers P, Knipscheer-Kuipers K, Willemsen V, Tollenaar RAEM, van Asperen CJ, Leeuw IMVD. Cost-utility analysis of meaning-centered group psychotherapy for cancer survivors. Psychooncology 2018; 27:1772-1779. [PMID: 29624807 PMCID: PMC6043397 DOI: 10.1002/pon.4726] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Meaning-centered group psychotherapy for cancer survivors (MCGP-CS) improves meaning, psychological well-being, and mental adjustment to cancer and reduces psychological distress. This randomized controlled trial was conducted to investigate the cost-utility of MCGP-CS compared with supportive group psychotherapy (SGP) and care-as-usual (CAU). METHODS In total, 170 patients were randomized to MCGP-CS, SGP, or CAU. Intervention costs, direct medical and nonmedical costs, productivity losses, and health-related quality of life were measured until 6 months follow-up, using the TIC-P, PRODISQ, data from the hospital information system, and the EQ-5D. The cost-utility was calculated by comparing mean cumulative costs and quality-adjusted life years (QALYs). RESULTS Mean total costs ranged from €4492 (MCGP-CS) to €5304 (CAU). Mean QALYs ranged .507 (CAU) to .540 (MCGP-CS). MCGP-CS had a probability of 74% to be both less costly and more effective than CAU, and 49% compared with SGP. Sensitivity analyses showed these findings are robust. If society is willing to pay €0 for one gained QALY, MCGP-CS has a 78% probability of being cost-effective compared with CAU. This increases to 85% and 92% at willingness-to-pay thresholds of €10 000 and €30 000, which are commonly accepted thresholds. CONCLUSIONS MCGP-CS is highly likely a cost-effective intervention, meaning that there is a positive balance between the costs and gains of MCGP-CS, in comparison with SGP and CAU.
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Affiliation(s)
- Nadia van der Spek
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
| | - Joël Vos
- Department of Psychology, University of Roehampton, London, UK
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Cornelia F van Uden-Kraan
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
- Department of Otolaryngology – Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
| | - Kitty Knipscheer-Kuipers
- Ingeborg Douwes Centrum, Center for psychological care for cancer patients, Amsterdam, The Netherlands
| | - Vincent Willemsen
- Ingeborg Douwes Centrum, Center for psychological care for cancer patients, Amsterdam, The Netherlands
| | - Rob AEM Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Christi J van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
- Department of Otolaryngology – Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
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7
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Meaning of life, representation of death, and their association with psychological distress. Palliat Support Care 2017; 16:511-519. [PMID: 28789719 DOI: 10.1017/s1478951517000669] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This paper presents a two-phase cross-sectional study aimed at examining the possible mitigating role of perceived meaning of life and representation of death on psychological distress, anxiety, and depression. METHOD The first phase involved 219 healthy participants, while the second encompassed 30 cancer patients. Each participant completed the Personal Meaning Profile (PMP), the Testoni Death Representation Scale (TDRS), the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT). The primary analyses comprised (1) correlation analyses between the overall scores of each of the instruments and (2) path analysis to assess the indirect effect of the PMP on DT score through anxiety and depression as determined by the HADS. RESULTS The path analysis showed that the PMP was inversely correlated with depression and anxiety, which, in turn, mediated the effect on distress. Inverse correlations were found between several dimensions of the PMP, the DT, and the HADS-Anxiety and HADS-Depression subscales, in both healthy participants and cancer patients. Religious orientation (faith in God) was related to a stronger sense of meaning in life and the ontological representation of death as a passage, rather than annihilation. SIGNIFICANCE OF RESULTS Our findings support the hypothesis that participants who represent death as a passage and have a strong perception of the meaning of life tend to report lower levels of distress, anxiety, and depression. We recommend that perceived meaning of life and representation of death be more specifically examined in the cancer and palliative care settings.
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van der Spek N, Vos J, van Uden-Kraan CF, Breitbart W, Cuijpers P, Holtmaat K, Witte BI, Tollenaar RAEM, Verdonck-de Leeuw IM. Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial. Psychol Med 2017; 47:1990-2001. [PMID: 28374663 PMCID: PMC5501751 DOI: 10.1017/s0033291717000447] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU). METHOD A total of 170 cancer survivors were randomly assigned to one of the three study arms: MCGP-CS (n = 57); SGP (n = 56); CAU (n = 57). The primary outcome measure was the Personal Meaning Profile (PMP; total score). Secondary outcome measures were subscales of the PMP, psychological well-being (Scales of Psychological Well-being; SPWB), post-traumatic growth (Posttraumatic Growth Inventory), Mental Adjustment to Cancer (MAC), optimism (Life Orientation Test-Revised), hopelessness (Beck's Hopelessness Scale), psychological distress (anxiety and depression, Hospital Anxiety and Depression Scale; HADS) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; EORTC QLQ-C30). Outcome measures were assessed before randomization, post-intervention, and after 3 and 6 months of follow-up (FU). RESULTS Linear mixed model analyses (intention-to-treat) showed significant differences between MCGP-CS, SGP and CAU on the total PMP score, and on (sub)scales of the PMP, SPWB, MAC and HADS. Post-hoc analyses showed significantly stronger treatment effects of MCGP-CS compared with CAU on personal meaning (d = 0.81), goal-orientedness (d = 1.07), positive relations (d = 0.59), purpose in life (d = 0.69); fighting spirit (d = 0.61) (post-intervention) and helpless/hopeless (d = -0.87) (3 months FU); and distress (d = -0.6) and depression (d = -0.38) (6 months FU). Significantly stronger effects of MCGP-CS compared with SGP were found on personal growth (d = 0.57) (3 months FU) and environmental mastery (d = 0.66) (6 months FU). CONCLUSIONS MCGP-CS is an effective intervention for cancer survivors to improve personal meaning, psychological well-being and mental adjustment to cancer in the short term, and to reduce psychological distress in the long run.
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Affiliation(s)
- Nadia van der Spek
- VU University, Department of Clinical Psychology, Amsterdam, the Netherlands
- IDC Center for psychological care for cancer patients, OLVG Hospital, Amsterdam, the Netherlands
| | - Joël Vos
- University of Roehampton, Department of Psychology, London, United Kingdom
| | | | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Pim Cuijpers
- VU University, Department of Clinical Psychology, Amsterdam, the Netherlands
| | - Karen Holtmaat
- VU University, Department of Clinical Psychology, Amsterdam, the Netherlands
| | - Birgit I. Witte
- VU University Medical Center, Epidemiology & Biostatistics, Amsterdam, the Netherlands
| | | | - Irma M. Verdonck-de Leeuw
- VU University, Department of Clinical Psychology, Amsterdam, the Netherlands
- VU University Medical Center, Department of Otolaryngology - Head & Neck Surgery, Amsterdam, the Netherlands
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9
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Hill CE, Kline KV, Kivlighan DM, Aaron Z, King S. Changes in meaning in life across the course of psychodynamic psychotherapy. COUNSELLING PSYCHOLOGY QUARTERLY 2017. [DOI: 10.1080/09515070.2017.1340260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Clara E. Hill
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Kathryn V. Kline
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, MD, USA
| | - Dennis M. Kivlighan
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, MD, USA
| | - Zachariah Aaron
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Shakeena King
- Department of Psychology, University of Maryland, College Park, MD, USA
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10
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Holtmaat K, van der Spek N, Witte BI, Breitbart W, Cuijpers P, Verdonck-de Leeuw IM. Moderators of the effects of meaning-centered group psychotherapy in cancer survivors on personal meaning, psychological well-being, and distress. Support Care Cancer 2017; 25:3385-3393. [PMID: 28593462 PMCID: PMC5610658 DOI: 10.1007/s00520-017-3757-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 05/16/2017] [Indexed: 12/01/2022]
Abstract
Purpose There is evidence to support that meaning-centered group psychotherapy for cancer survivors (MCGP-CS) is an effective intervention for improving personal meaning and psychological well-being, as well as reducing psychological distress. In order to investigate which subpopulations MCGP-CS specifically benefits, this explorative study aims to analyze potential sociodemographic, clinical, and psychosocial factors that may moderate the effects. Methods Cancer survivors (N = 114) were randomly assigned to MCGP-CS, or care as usual (CAU). Potential moderators included age, sex, relationship, education, employment, religion, cancer type, tumor stage, cancer treatment, time since treatment, anxiety, depression, other negative life events, and previous psychological treatment. Outcome measures were the Personal Meaning Profile (PMP), Scales of Psychological Well-Being (SPWB), and the Hospital Anxiety and Depression Scale (HADS). Assessment took place at baseline, post-intervention (short-term), and 3- and 6-month follow-ups (long-term). For each moderator, separate short-term and long-term linear mixed models were built. Results Short-term effect of MCGP-CS was moderated by (male) sex (on HADS-D; F(1,98) = 6.1, p = .015) and (a high level of) depressive symptoms at baseline (on SPWB; F(1,93) = 5.7, p = .019). Long-term effect of MCGP-CS was moderated by (not having received) previous psychological treatment (on HADS-total; F(3253) = 3.4, p = .017). Conclusions Most sociodemographic and clinical characteristics do not appear to moderate the positive effect of MCGP-CS on personal meaning. However, MCGP-CS appears to reduce depressive symptoms, particularly in males, and to improve purpose in life of survivors with depressive symptoms. In the long-term, MCGP-CS appears to reduce psychological distress in survivors who had not received psychological treatment in the past year. Trial registration: NTR3571
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Affiliation(s)
- Karen Holtmaat
- Department of Clinical Psychology, Cancer Center Amsterdam (CCA), Amsterdam Public Health (APH), Vrije Universiteit, Amsterdam, The Netherlands
| | - Nadia van der Spek
- Department of Clinical Psychology, Cancer Center Amsterdam (CCA), Amsterdam Public Health (APH), Vrije Universiteit, Amsterdam, The Netherlands.,IDC Center for Psycho-Oncology Care, OLVG Hospital, Amsterdam, The Netherlands
| | - Birgit I Witte
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Pim Cuijpers
- Department of Clinical Psychology, Amsterdam Public Health (APH), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical Psychology, Cancer Center Amsterdam (CCA), Amsterdam Public Health (APH), Vrije Universiteit, Amsterdam, The Netherlands. .,Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health (APH), VU University Medical Center, Amsterdam, The Netherlands.
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11
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Duijts SFA, van Egmond MP, Gits M, van der Beek AJ, Bleiker EM. Cancer survivors' perspectives and experiences regarding behavioral determinants of return to work and continuation of work. Disabil Rehabil 2016; 39:2164-2172. [PMID: 27596990 DOI: 10.1080/09638288.2016.1219924] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Supportive interventions to enhance return to work (RTW) in cancer survivors hardly showed positive effects so far. Behavioral determinants might have to be considered in the development of interventions to achieve sustained employability. This study aimed to explore cancer survivors' perspectives and experiences regarding behavioral determinants of RTW and continuation of work. MATERIALS AND METHODS In this qualitative study, semi-structured telephone interviews were held with 28 cancer survivors. All participants were at working age, 1-2 years after diagnosis and employed at time of diagnosis. Thematic content analysis was performed. RESULTS Work turned out to be a meaningful aspect of cancer survivors' life, and most participants reported a positive attitude towards their job. Social support to RTW or to continue working was mainly received from family and friends, but pressure to RTW from the occupational physician was also experienced. Changes in expectations regarding work ability from negative to positive during the treatment process were observed. Those who applied active coping mechanisms felt equipped to deal with difficulties regarding work. CONCLUSIONS Behavioral determinants should be taken into account in the development of future interventions to support cancer survivors' RTW. However, the causal relationship still has to be determined. Implications for rehabilitation Factors influencing occupational motivation among cancer survivors need to be understood in more detail. Previous studies in non-cancer populations have demonstrated that behavioral determinants, such as a positive attitude towards work, high social support and self-efficacy may increase return to work rates or shorten the time to return to work. Addressing behavioral determinants in future development of work-related interventions for cancer survivors is essential in achieving sustained employability.
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Affiliation(s)
- Saskia F A Duijts
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,b Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Martine P van Egmond
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,c Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc , Amsterdam , The Netherlands
| | - Maxime Gits
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
| | - Allard J van der Beek
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,c Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc , Amsterdam , The Netherlands
| | - Eveline M Bleiker
- b Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
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High-level construal benefits, meaning making, and posttraumatic growth in cancer patients. Palliat Support Care 2015; 14:510-8. [DOI: 10.1017/s1478951515001224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:The present study sought to explore the role of meaning making and high-level construal in the relationship between meaning discrepancy and posttraumatic growth among Chinese cancer patients.Method:The participants were 193 individuals diagnosed with cancer. Meaning discrepancy, meaning making, high-level construal in meaning making, and posttraumatic growth were measured. Bootstrapping and structural equation modeling were performed to test the mediation effects of high-level construal on the meaning-making process.Results:Mediation analysis revealed that perceived discrepancies were associated with individuals' meaning-making efforts. Meaning-making efforts prompted participants to adopt a high-level construal orientation, which in turn enhanced posttraumatic growth.Significance of results:Our study empirically tested construal level theory in a population suffering from severe chronic trauma. The results demonstrate the important role of high-level construal in the meaning-making process of cancer patients, suggesting a specific effective strategy to foster posttraumatic growth. It seems encouraging to indicate that adopting such high-level construal may be included as part of psychological interventions for cancer patients.
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Scheffold K, Philipp R, Engelmann D, Schulz-Kindermann F, Rosenberger C, Oechsle K, Härter M, Wegscheider K, Lordick F, Lo C, Hales S, Rodin G, Mehnert A. Efficacy of a brief manualized intervention Managing Cancer and Living Meaningfully (CALM) adapted to German cancer care settings: study protocol for a randomized controlled trial. BMC Cancer 2015; 15:592. [PMID: 26286128 PMCID: PMC4545321 DOI: 10.1186/s12885-015-1589-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 07/30/2015] [Indexed: 12/21/2022] Open
Abstract
Background Although psycho-oncological interventions have been shown to significantly reduce symptoms of anxiety and depression and enhance quality of life, a substantial number of patients with advanced cancer do not receive psycho-oncological interventions tailored to their individual situation. Given the lack of reliable data on the efficacy of psycho-oncological interventions in palliative care settings, we aim to examine the efficacy of a brief, manualized individual psychotherapy for patients with advanced cancer: Managing Cancer and Living Meaningfully (CALM). CALM aims to reduce depression and death anxiety, to strengthen communication with health care providers, and to enhance hope and meaning in life. We adapted the intervention for German cancer care settings. Methods/Design We use a single-blinded randomized-controlled trial design with two treatment conditions: intervention group (IG, CALM) and control group (CG). Patients in the CG receive a usual non-manualized supportive psycho-oncological intervention (SPI). Patients are randomized between the IG and CG and assessed at baseline (t0), after three (t1) and after 6 months (t2). We include patients with a malignant solid tumor who have tumor stages of III or IV (UICC classification). Patients who are included in the study are at least 18 years old, speak German fluently, score greater than or equal to nine on the PHQ-9 or/and greater than or equal to five on the Distress Thermometer. It is further necessary that there is no evidence of severe cognitive impairments. We measure depression, anxiety, distress, quality of life, demoralization, symptom distress, fatigue as well as spiritual well-being, posttraumatic growth and close relationship experiences using validated questionnaires. We hypothesize that patients in the IG will show a significantly lower level of depression 6 months after baseline compared to patients in the CG. We further hypothesize a significant reduction in anxiety and fatigue as well as significant improvements in psychological and spiritual well-being, meaning and post-traumatic growth in the IG compared to CG 6 months after baseline. Discussion Our study will contribute important statistical evidence on whether CALM can reduce depression and existential distress in a German sample of advanced and highly distressed cancer patients. Trial registration ClinicalTrials.gov NCT02051660
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Affiliation(s)
- Katharina Scheffold
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
| | - Rebecca Philipp
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
| | - Dorit Engelmann
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, Leipzig, 04103, Germany.
| | - Frank Schulz-Kindermann
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
| | - Christina Rosenberger
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
| | - Karin Oechsle
- Department of Oncology, Hematology and Bone Marrow Transplantation with section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Martin Härter
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
| | - Florian Lordick
- University Medical Center Leipzig, University Cancer Center Leipzig (UCCL), Liebigstrasse 20, Leipzig, 04103, Germany.
| | - Chris Lo
- Department of Supportive Care, 16-724, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Sarah Hales
- Department of Supportive Care, 16-724, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Gary Rodin
- Department of Supportive Care, 16-724, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, Leipzig, 04103, Germany.
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14
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van der Spek N, Vos J, van Uden-Kraan CF, Breitbart W, Cuijpers P, Knipscheer-Kuipers K, Willemsen V, Tollenaar RAEM, van Asperen CJ, Verdonck-de Leeuw IM. Effectiveness and cost-effectiveness of meaning-centered group psychotherapy in cancer survivors: protocol of a randomized controlled trial. BMC Psychiatry 2014; 14:22. [PMID: 24467861 PMCID: PMC3942178 DOI: 10.1186/1471-244x-14-22] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 01/24/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Meaning-focused coping may be at the core of adequate adjustment to life after cancer. Cancer survivors who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning. Meaning-Centered Group Psychotherapy for Cancer Survivors (MCGP-CS) was designed to help patients to sustain or enhance a sense of meaning and purpose in their lives. The aim of the proposed study is to evaluate the effectiveness and cost-effectiveness of MCGP-CS. METHODS/DESIGN Survivors diagnosed with cancer in the last 5 years and treated with curative intent, are recruited via several hospitals in the Netherlands. After screening, 168 survivors are randomly assigned to one of the three study arms: 1. Meaning-Centered Group Psychotherapy (MCGP-CS) 2. Supportive group psychotherapy (SGP) 3. Care as usual (CAU). Baseline assessment takes place before randomisation, with follow up assessments post-intervention and at 3, 6 and 12 months follow-up. Primary outcome is meaning making (PMP, PTGI, SPWB). Secondary outcome measures address quality of life (EORTC-30), anxiety and depression (HADS), hopelessness (BHS), optimism (LOT-R), adjustment to cancer (MAC), and costs (TIC-P, EQ-5D, PRODISQ). DISCUSSION Meaning-focused coping is key to adjustment to life after cancer, however, there is a lack of evidence based psychological interventions in this area. Many cancer survivors experience feelings of loneliness and alienation, and have a need for peer support, therefore a group method in particular, can be beneficial for sustaining or enhancing a sense of meaning. If this MCGP-CS is effective for cancer survivors, it can be implemented in the practice of psycho-oncology care. TRIAL REGISTRATION Netherlands Trial Register, NTR3571.
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Affiliation(s)
- Nadia van der Spek
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
| | - Joël Vos
- Department of Psychology, University of Roehampton, London, UK,Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Cornelia F van Uden-Kraan
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands,Department of Otolaryngology - Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
| | - Kitty Knipscheer-Kuipers
- Ingeborg Douwes Centrum, Center for psychological care for cancer patients, Amsterdam, The Netherlands
| | - Vincent Willemsen
- Ingeborg Douwes Centrum, Center for psychological care for cancer patients, Amsterdam, The Netherlands
| | - Rob AEM Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Christi J van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands.
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