Meaning-Centered Psychotherapy in Advanced Cancer

描述（由申请人提供）：灵性及其在生命终结中的作用 护理最近已成为姑息治疗的中心问题。已经 我们最近对癌症晚期和艾滋病患者进行了几项研究， 研究小组展示了精神健康的核心作用， “意义”，特别是在缓冲抑郁，绝望， 渴望快速死亡。灵性可以被定义为一种结构， 信仰和/或意义的组成部分。根据《公约》 信仰/宗教的精神组成部分有有限的接受健康 护理人员和患者。基于意义成分的干预 可能会有更普遍的接受和适用性。我们有 开发和手动8周的意义为中心的团体心理治疗，基于 根据维克多·弗兰克尔的意义疗法的原则， 晚期癌症患者维持或增强意义感、和平感和目标感 当他们接近生命的尽头。该项目的总体目标是探索 这种新的和独特的心理治疗干预对晚期癌症的疗效 提高患者的心理和精神健康和质量 生活具体而言，我们将初步研究 以意义为中心的团体心理治疗，与标准支持团体相比 心理治疗，提高精神健康和生活质量， 减少心理困扰。118名晚期癌症患者将在 随机接受这两种干预措施之一。此外，我们将 探索精神健康，心理困扰， 绝望，身体症状的严重程度和痛苦，生活质量， 感知社会支持。受试者将接受一组评估， 干预前基线（累积点）的自我报告测量， 干预后和3个月随访时。这项研究将提供必要的 关于一种新型创新心理治疗干预的初步疗效数据 对于晚期癌症患者，结合精神（以意义为中心） 元素，这在精神痛苦的治疗方面有很大的希望， 生命的终结意义中心组的大型随机对照试验 未来将利用学到的见解进行心理治疗 从这个试点干预研究中。

DESCRIPTION (provided by applicant): Spirituality and its role in end-of-life care has recently 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. Spirituality can be defined as a construct involving components of both faith and/or meaning. Interventions based on the faith/religious component of spirituality have limited acceptance by health care practitioners and patients. Interventions based on the meaning component of spirituality may have more universal acceptance and applicability. We have developed and manualized an 8-week Meaning-Centered Group Psychotherapy, based on the principles of Viktor Frankl's Logotherapy, designed to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose as they approach the end-of-life. This project's overall aim is to explore the efficacy of this new and unique psychotherapy intervention for advanced cancer patients in enhancing psychological and spiritual well being and quality of life. Specifically, we will preliminarily examine the efficacy of Meaning-Centered Group Psychotherapy, compared to a standard supportive group psychotherapy, in enhancing spiritual well being and quality of life and reducing psychological distress. 118 advanced cancer patients will be randomized to receive one of these two interventions. In addition, we will explore the relationships among-spiritual well being, psychological distress, hopelessness, physical symptom severity and distress, quality of life, and perceived social support. Subjects will be assessed with a battery of self-report measures at baseline (point of accrual), prior to intervention, post-intervention, and at 3 month follow-up. This study will provide essential preliminary 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. Larger, randomized controlled trials of Meaning-Centered Group Psychotherapy will be conducted in the future utilizing the insights learned from this pilot intervention study.