Psychological intervention in patients with advanced cancer at home through Individual Meaning-Centered Psychotherapy-Pa
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ORIGINAL ARTICLE
Psychological intervention in patients with advanced cancer at home through Individual Meaning-Centered Psychotherapy-Palliative Care: a pilot study Clara Fraguell-Hernando 1,2 & Joaquín T. Limonero 2
&
Francisco Gil 2,3
Received: 24 October 2019 / Accepted: 17 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective To compare Individual Meaning-Centered Psychotherapy-Palliative Care (IMCP-PC) to counselling-based psychotherapy in patients receiving home palliative care (PC). Methods Fifty-one patients with advanced-stage cancer receiving home PC were recruited for this. Two-arm (individual meaning-centered psychotherapy-palliative—IMCP-PC—care vs. counselling) randomized feasibility trial. Anxiety, depression, demoralization, and emotional distress were evaluated before and after three psychotherapy sessions. Patient perceptions of the treatment were assessed after completion of therapy. Results Thirty-two patients (16 in each group) completed all three sessions as well as the pre- and post-therapy questionnaires and were therefore included in the final analysis. All patients in the IMCP-PC group showed a significant decrease in levels of demoralization (despair), anxiety, depression, and emotional distress. By contrast, the only variable that significantly improved in the counselling group was demoralization. The post-treatment questionnaire revealed no significant between-group differences regarding patient perception of the structure, focus, or length of treatment. However, the IMCP-PC group rated the treatment more highly with regard to its value in helping them to find meaning in life. Conclusions IMCP-PC is a specific psychotherapy tailored to the needs of patients with advanced cancer. The results of the present study indicate that this treatment is suitable for patients at end of life that are not able to attend outpatient sessions. Although more research is needed, the findings of this feasibility trial suggest that the IMCP-PC merits consideration for patients receiving home palliative care (PC). Keywords Advanced cancer . Home care . Individual psychotherapy . Meaning . Palliative care . Psychotherapy
Background Managing physical and psychological symptoms— particularly emotional distress—in patients diagnosed with advanced cancer is challenging [1, 2]. Almanza-Muñoz and Holland [3] defined emotional distress as an unpleasant
* Joaquín T. Limonero [email protected] 1
EAPS Mutuam Barcelona, Barcelona, Spain
2
Stress and Health Research Group, Faculty of Psychology, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
3
Psycho-Oncology Unit, Hospital Duran i Reynals, Institut Català d’Oncologia, L’Hospitalet de Llobregat (Barcelona), Spain
emotional experience of a psychological (cognitive, behavioural, and emotional), social, and/or spiritual nature that may interfere with the ability to cope effectively with a disease or other difficult situation [4]. Although group therapy for cancer patie
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