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Psychological intervention in patients with advanced cancer at home through Individual Meaning-Centered Psychotherapy-Palliative Care: a pilot study

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Abstract

Objective

To compare Individual Meaning-Centered Psychotherapy-Palliative Care (IMCP-PC) to counselling-based psychotherapy in patients receiving home palliative care (PC).

Methods

Fifty-one patients with advanced-stage cancer receiving home PC were recruited for this. Two-arm (individual meaning-centered psychotherapy-palliative—IMCP-PC—care vs. counselling) randomized feasibility trial. Anxiety, depression, demoralization, and emotional distress were evaluated before and after three psychotherapy sessions. Patient perceptions of the treatment were assessed after completion of therapy.

Results

Thirty-two patients (16 in each group) completed all three sessions as well as the pre- and post-therapy questionnaires and were therefore included in the final analysis. All patients in the IMCP-PC group showed a significant decrease in levels of demoralization (despair), anxiety, depression, and emotional distress. By contrast, the only variable that significantly improved in the counselling group was demoralization. The post-treatment questionnaire revealed no significant between-group differences regarding patient perception of the structure, focus, or length of treatment. However, the IMCP-PC group rated the treatment more highly with regard to its value in helping them to find meaning in life.

Conclusions

IMCP-PC is a specific psychotherapy tailored to the needs of patients with advanced cancer. The results of the present study indicate that this treatment is suitable for patients at end of life that are not able to attend outpatient sessions. Although more research is needed, the findings of this feasibility trial suggest that the IMCP-PC merits consideration for patients receiving home palliative care (PC).

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Acknowledgements

Our sincere gratitude to the patients who voluntarily participated in the study, to our colleagues who helped to recruit the patient sample, and to the team at Mutuam that have facilitated this research study. We also would like to thank Bradley Londres for professional English language editing.

Funding

This study was supported in part by a grant (number PSI2017-85134-R) from the Spanish Ministry of Economy, Industry and Competitiveness (MINECO).

Author information

Correspondence to Joaquín T. Limonero.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Fraguell-Hernando, C., Limonero, J.T. & Gil, F. Psychological intervention in patients with advanced cancer at home through Individual Meaning-Centered Psychotherapy-Palliative Care: a pilot study. Support Care Cancer (2020). https://doi.org/10.1007/s00520-020-05322-2

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Keywords

  • Advanced cancer
  • Home care
  • Individual psychotherapy
  • Meaning
  • Palliative care
  • Psychotherapy