Meaning-Centered Group Psychotherapy in Advanced Cancer

晚期癌症以意义为中心的团体心理治疗

• 批准号: 7545934
• 负责人: William Breitbart
• 金额: $ 42.27万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-01-01 至 2011-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7545934
• 关键词: Acquired Immunodeficiency Syndrome; Advanced Malignant Neoplasm; Anxiety; Buffers; Cancer Patient; Cessation of life; Clinical; Data; Educational Background; Elements; Ethnic Origin; Feeling hopeless; Feeling suicidal; Grant; Group Psychotherapy; Healthcare; Intervention; Left; Life; Life Expectancy; Link; Malignant Neoplasms; Measures; Mediating; National Center for Complementary and Alternative Medicine; Pain; Palliative Care; Patient Self-Report; Patients; Personal Satisfaction; Population; Principal Investigator; Psychotherapy; Quality of life; Race; Randomized; Randomized Controlled Trials; Relative (related person); Religion; Religion and Spirituality; Research; Role; Sampling; Severity of illness; Social support; Solid Neoplasm; Spirituality; Staging; Symptoms; Terminally Ill; Testing; United States National Institutes of Health; Upper arm; Well in self; base; comparative efficacy; depression; design; end of life; end of life care; follow-up; group intervention; improved; innovation; novel; peace; post intervention; programs; psychologic; psychological distress; response; treatment response; trial comparing

Spirituality and it's role in end-of-life care has emerged as a central issue in palliative care. There have been several recent studies of terminally ill cancer and AIDS patients by our research group demonstrating the central role of spiritual well being, and "meaning" in particular, in buffering against depression, hopelessness, and desire for hastened death. We have developed, manualized and piloted an 8-week Meaning-Centered Group Psychotherapy, designed to help patients with advanced cancer sustain or enhance a sense of meaning, peace, purpose, spiritual well-being and hope as they approach the end-of-life. Preliminary findings, based on an R21 grant, suggest that our Meaning-Centered intervention significantly reduced psychological distress and desire of hastened death, and significantly increased spiritual well-being and sense of meaning and purpose in life in a sample of advanced cancer patients. This project's overall aim is to conduct a randomized controlled trial of the efficacy of this new and-unique spiritually-based psychotherapy intervention for advanced cancer patients in enhancing psychological and spiritual well-being and quality of life. Specifically, we will examine the efficacy of Meaning-Centered Group Psychotherapy, compared to a standardized Supportive Group Psychotherapy, in enhancing spiritual well being and quality of life, and reducing psychological distress (anxiety and depression) and end-of-life despair (conceptualized as hopelessness, desire for hastened death, and suicidal ideation). In additon, we will examine clinical and demographic variables that may mediate or moderate treatment response to Meaning-Centered Group Psychotherapy in this population. 320 patients with stage IV solid tumor cancers will be randomized to receive one of these two interventions(160 patients randomized to each arm, anticipating an attrition rate of 40% would thus leave 96 patients per arm who complete the entire trial). Subjects will be assessed with a battery of self-report measure at 3 points: baseline/pre- intervention, post-intervention, and at 2 months post-intervention follow-up. This study will provide essential efficacy data on a novel and innovative psychotherapy intervention for patients with advanced cancer, incorporating spiritual (meaning-centered) elements, which holds great promise in the treatment of spiritual suffering at the end-of-life

灵性及其在临终关怀中的作用已成为姑息治疗的中心问题。有 我们的研究小组最近对绝症癌症和艾滋病患者进行的几项研究表明， 精神健康的核心作用，特别是"意义"，在缓冲抑郁，绝望， 欲速则不达，欲速则不达。我们已经开发，手动化和试点8周的意义为中心， 团体心理治疗，旨在帮助晚期癌症患者维持或增强一种感觉， 意义、和平、目的、精神福祉和希望，因为他们接近生命的尽头。初步 基于R21补助金的研究结果表明，我们以意义为中心的干预显著减少了 心理困扰和加速死亡的愿望，并显着增加精神福祉， 对晚期癌症患者的生命意义和目的感。该项目的总体目标是 进行一项随机对照试验，检验这种新的、独特的以精神为基础的心理疗法的疗效。 对晚期癌症患者进行心理和精神健康干预， 生活具体来说，我们将研究意义中心团体心理治疗的疗效，与一个 标准化的支持性团体心理治疗，提高精神健康和生活质量， 减少心理困扰（焦虑和抑郁）和临终绝望（概念化为 绝望、渴望加速死亡和自杀意念）。此外，我们将检查临床和 可能介导或调节治疗对意义中心组的反应的人口统计学变量 心理治疗在这个人群中。320例IV期实体瘤癌症患者将被随机分配至 接受这两种干预措施之一（每组随机分配160名患者，预计损耗率为 因此，40%将使每组96名患者完成整个试验）。将对受试者进行评估， 3个点的自我报告测量组合：基线/干预前、干预后和2个月 干预后的后续行动。这项研究将为一种新的创新药物提供必要的疗效数据。 晚期癌症患者的心理治疗干预，包括精神（以意义为中心） 元素，这在治疗临终时的精神痛苦方面有很大的希望