Adapting Meaning-Centered Group Psychotherapy for Chinese Immigrant Patients with

描述(由申请人提供)：灵性及其在临终关怀中的作用已成为姑息关怀的中心问题。我们的研究小组和其他人最近对绝症癌症患者进行了几项研究，证明了精神健康的核心作用，特别是在缓冲抑郁、绝望和加速死亡的欲望方面，特别是对“意义”的感觉。我们已经开发了一种新的干预方法--以意义为中心的心理治疗(MCP)，并对其进行了初步测试。MCP在为期8周的小组形式下进行试点测试，基于Viktor Frankl的工作原理，旨在帮助晚期癌症患者在生命即将结束时维持或增强意义。我们的试点随机对照试验的初步结果表明，MCP显著减少了晚期癌症患者的心理痛苦(例如，抑郁、绝望、焦虑和加速死亡的欲望)，并显著提高了精神幸福感以及对生活的意义和使命感。当前提案的总体目标是调整针对中国移民癌症患者的以意义为中心的团体心理治疗(MCGP)干预(MCGP-CH)，这是一个庞大的、服务不足和被忽视的少数民族群体。我们将调整MCGP干预措施，使其在文化和语言上针对这一人群，所产生的干预措施将被用于申请随后的拨款，以试点测试MCGP-CH的可行性、可接受性和满意度。事实证明，适应文化的治疗比未适应的治疗更有效，文化适应次数更多的治疗往往最有效，针对特定族裔群体的干预措施比向不同背景的患者提供的干预更有效。为了告知干预措施的适应情况，我们将进行社区需求评估以及15-20次对患有晚期癌症的中国移民的深入访谈，使用伯纳尔等人的生态有效性模型(EVM)。Domeech-Rodriquez和Weling的文化适应过程(CAP)模型。

DESCRIPTION (provided by applicant): Spirituality and its 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 patients, both by our research group and others, demonstrating the central role of spiritual well being, and sense of "meaning" in particular, in buffering against depression hopelessness, and desire for hastened death. We have developed, manualized, and pilot-tested just such a novel intervention - Meaning-Centered Psychotherapy (MCP). MCP, pilot-tested in an 8-week group format, is based on the principles of Viktor Frankl's work, and is designed to help patients with advanced cancer sustain or enhance a sense of meaning as they approach the end-of-life. Preliminary findings from our pilot randomized controlled trials demonstrate MCP significantly reduces psychological distress (e.g., depression, hopelessness, anxiety, and desire for hastened death), and significantly increase spiritual well-being and a sense of meaning and purpose in life in advanced cancer patients. The overall aim of the current proposal is to adapt the Meaning-Centered Group Psychotherapy (MCGP) intervention for Chinese immigrant cancer patients (MCGP-Ch), a large, underserved and understudied ethnic minority group. We will adapt the MCGP intervention to be culturally and linguistically targeted for this population, the resulting intervention will be used to apply for a subsequent grant to pilot test MCGP-Ch for feasibility, acceptability, and satisfaction. Culturally adapted treatments have been demonstrated to be more effective than those that have not been adapted, treatments with greater numbers of cultural adaptations tend to be most effective, and interventions targeted for a specific ethnic group are more effective than those delivered to patients from a variety of backgrounds. To inform the adaptation of the intervention, we will conduct a community needs assessment as well as 15-20 in-depth interviews with Chinese immigrants with advanced cancer, using the Ecological Validity Model (EVM) of Bernal et al. and the Cultural Adaptation Process (CAP) model of Domenech-Rodriquez and Weiling.