Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: A randomized controlled trial in patients with advanced cancer.
Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: A randomized controlled trial in patients with advanced cancer.
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作者：
Breitbart W;Pessin H;Rosenfeld B;Applebaum AJ;Lichtenthal WG;Li Y;Saracino RM;Marziliano AM;Masterson M;Tobias K;Fenn N
晚期癌症患者心理困扰的比例很高，包括抑郁、焦虑和精神绝望。我们研究了以个体意义为中心的心理治疗（IMCP）与支持性心理治疗（SP）和强化常规护理（EUC）在改善晚期癌症患者的精神健康和生活质量以及减少心理困扰方面的有效性。321例患者随机分为IMCP （N=109）、SP （N=108）和EUC （N=104）组。在干预前、治疗中（4周）、治疗后（8周）和治疗后（16周）4个时间点进行评估。与EUC相比，在7个结果变量（生活质量、意义感、精神幸福感、焦虑和对加速死亡的渴望）中的5个方面，观察到IMCP的显著治疗效果（小到中等程度），Cohen的d范围从。1 ~ 0.34；接受支持治疗（SP）的患者无显著改善（d < 0.15, p < 0.05）。IMCP对生活质量和意义感的影响显著大于SP (d= 0.19)，但对其他研究变量的影响不显著。本研究进一步支持了IMCP治疗晚期癌症患者心理和存在/精神痛苦的有效性。与常规治疗相比，观察到显著的治疗效果（小到中等效应），与支持性心理治疗相比，观察到更适度的改善差异（小效应）。因此，MCP的益处似乎是唯一的干预措施，并强调了解决患者接近生命终点的存在问题的重要性。
Patients with advanced cancer have high rates of psychological distress, including depression, anxiety and spiritual despair. We examined the effectiveness of Individual Meaning Centered Psychotherapy (IMCP) compared to supportive psychotherapy (SP) and enhanced usual care (EUC) in improving spiritual well-being and quality-of-life and reducing psychological distress in patients with advanced cancer. 321 Patients were randomly assigned to IMCP (N=109), SP (N=108), or EUC (N=104). Assessments were conducted at 4 time points: pre-intervention, mid-treatment (4 weeks), post-treatment (8 weeks), and post-treatment (16 weeks). Significant treatment effects (small to medium in magnitude) were observed for IMCP, compared to EUC, for five of seven outcome variables (quality-of-life, sense of meaning, spiritual well-being, anxiety and desire for hastened death), with Cohen’s d ranging from .1 to .34; no significant improvement was observed for patients receiving supportive therapy (SP) (d < .15, p > .05 for all variables). The effect of IMCP was significantly greater than SP for quality-of-life and sense of meaning (d=.19), but not for the remaining study variables. This study provides further support for the efficacy of IMCP as a treatment for psychological and existential/spiritual distress in patients with advanced cancer. Significant treatment effects (small to moderate effect sizes) were observed when compared to usual care, and somewhat more modest differences in improvement (small effect sizes) were observed when compared to supportive psychotherapy. Thus, the benefits of MCP appear to be unique to the intervention, and highlight the importance of addressing existential issues with patients approaching the end of life.
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DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
3.9
作者：
Hatcher, RL;Gillaspy, JA
通讯作者：
Gillaspy, JA
影响因子：
45.3
作者：
Breitbart, William;Poppito, Shannon;Cassileth, Barrie R.
通讯作者：
Cassileth, Barrie R.
麦吉尔生活质量问卷--适合晚期疾病患者的生活质量测量方法--有效性和可接受性初步研究
影响因子：
4.4
作者：
COHEN, SR;MOUNT, BM;BUI, F
通讯作者：
BUI, F
影响因子：
17.7
作者：
Rosenfeld, B;Breitbart, W;Galietta, M
通讯作者：
Galietta, M