Meaning-Centered Group Psychotherapy: An Effective Intervention for Improving Psychological Well-Being in Patients With Advanced Cancer
Meaning-Centered Group Psychotherapy: An Effective Intervention for Improving Psychological Well-Being in Patients With Advanced Cancer
复制标题
DOI：
10.1200/jco.2014.57.2198
复制
发表时间：
2015-03-01
影响因子：
45.3
通讯作者：
Lichtenthal, Wendy G.
中科院分区：
文献类型：
--
作者：
Breitbart, William;Rosenfeld, Barry;Lichtenthal, Wendy G.
目的探讨以意义为中心的团体心理治疗（MCGP）对减轻中晚期癌症患者心理困扰、提高精神幸福感的效果。患者和方法晚期癌症患者（N = 253）被随机分配到MCGP或支持性团体心理治疗（SGP）的手动8期干预中。分别在治疗前后和治疗后2个月对患者进行评估。主要结果测量是精神健康和整体生活质量，次要结果测量评估抑郁、绝望、渴望加速死亡、焦虑和身体症状困扰。结果包括先验协变量和仅参加三次会议的参与者的层次线性模型表明，大多数结果变量具有显著的组x时间交互作用。具体而言，与接受SGP的患者相比，接受MCGP的患者在精神健康和生活质量方面表现出更大的改善，在抑郁、绝望、渴望加速死亡和身体症状困扰方面表现出更大的减少。在焦虑变化方面没有观察到组间差异。包括所有患者的分析，无论他们是否参加任何治疗（即，意向治疗分析），没有协变量仍然显示显著的治疗效果（即，接受MCGP和SGP的患者获益更大），对生活质量，抑郁和绝望，但对其他结果变量没有影响。结论本大型随机对照研究为MCGP治疗晚期癌症患者的心理和存在或精神困扰提供了强有力的支持。(C) 2015年由美国临床肿瘤学会出版
PurposeTo test the efficacy of meaning-centered group psychotherapy (MCGP) to reduce psychological distress and improve spiritual well-being in patients with advanced or terminal cancer.Patients and MethodsPatients with advanced cancer (N = 253) were randomly assigned to manualized eight-session interventions of either MCGP or supportive group psychotherapy (SGP). Patients were assessed before and after completing the treatment and 2 months after treatment. The primary outcome measures were spiritual well-being and overall quality of life, with secondary outcome measures assessing depression, hopelessness, desire for hastened death, anxiety, and physical symptom distress.ResultsHierarchical linear models that included a priori covariates and only participants who attended three sessions indicated a significant group x time interaction for most outcome variables. Specifically, patients receiving MCGP showed significantly greater improvement in spiritual well-being and quality of life and significantly greater reductions in depression, hopelessness, desire for hastened death, and physical symptom distress compared with those receiving SGP. No group differences were observed for changes in anxiety. Analyses that included all patients, regardless of whether they attended any treatment sessions (ie, intent-to-treat analyses), and no covariates still showed significant treatment effects (ie, greater benefit for patients receiving MCGP v SGP) for quality of life, depression, and hopelessness but not for other outcome variables.ConclusionThis large randomized controlled study provides strong support for the efficacy of MCGP as a treatment for psychological and existential or spiritual distress in patients with advanced cancer. (C) 2015 by American Society of Clinical Oncology