An assisted structured reflection on life events and life goals in advanced cancer patients: Outcomes of a randomized controlled trial (Life InSight Application (LISA) study)
Kruizinga, Renske; Scherer-Rath, Michael; Schilderman, Johannes Bam; Hartog, Iris D; Van Der Loos, Jacoba Pm; Kotzé, Hantie P; Westermann, Anneke M; Klümpen, Heinz-Josef; Kortekaas, Francesco; Grootscholten, Cecile; Bossink, Frans; Schrama, Jolanda; Van De Vrande, Willem; Schrama, Natascha Awp; Blokland, Willem; De Vos, Filip Yfl; Kuin, Annemieke; Meijer, Wim G; Van Oijen, Martijn Gh; Sprangers, Mirjam Ag; Van Laarhoven, Hanneke Wm
(2019) Palliative Medicine, volume 33, issue 2, pp. 221 - 231
(Article)
Abstract
BACKGROUND:: Diagnosis and treatment of incurable cancer as a life-changing experience evokes difficult existential questions. AIM:: A structured reflection could improve patients' quality of life and spiritual well-being. We developed an interview model on life events and ultimate life goals and performed a randomized controlled trial to evaluate the effect
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thereof on quality of life and spiritual well-being. DESIGN:: The intervention group had two consultations with a spiritual counselor. The control group received care as usual. EORTC QLQ-C15-PAL and the FACIT-sp were administered at baseline and 2 and 4 months after baseline. Linear mixed model analysis was performed to test between-group differences over time. PARTICIPANTS:: Adult patients with incurable cancer and a life expectancy ⩾6 months were randomized in a 1:1 ratio to the intervention or control group. RESULTS:: A total of 153 patients from six different hospitals were included: 77 in the intervention group and 76 in the control group. Quality of life and spiritual well-being did not significantly change over time between groups. The experience of Meaning/Peace was found to significantly influence quality of life ( β = 0.52, adj. R2 = 0.26) and satisfaction with life ( β = 0.61, adj. R2 = 0.37). CONCLUSION:: Although our newly developed interview model was well perceived by patients, we were not able to demonstrate a significant difference in quality of life and spiritual well-being between groups. Future interventions by spiritual counselors aimed at improving quality of life, and spiritual well-being should focus on the provision of sources of meaning and peace.
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Keywords: Oncology, randomized controlled trials, spiritual care givers, spirituality, palliative care, spiritual care, Anesthesiology and Pain Medicine
ISSN: 0269-2163
Publisher: SAGE Publications Ltd
Note: Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Dutch Cancer Society/Alpe d’HuZes (grant no. UVA 2011–5311), Janssen Pharmaceutical Companies, and an anonymous beneficiary. Funding Information: We are thankful to all the patients who were willing to participate in our study and all oncologists (in training), oncology nurses, and data managers who participated in patient inclusion. We thank Simon Evers and Stephanie Verhoeven for participating in the training, Marianne Snijdewind and Alexandra Calor for their assistance, and Niek de Jonge for helping out with the statistics. H.W.M.V.L., M.S.-R., and J.B.A.M.S. conceived the study and secured funding. R.K., H.W.M.V.L. and M.S.-R. oversaw the study. A.M.W., H.-J.K., C.G., J.S., N.A.W.P.S., F.Y.F.L.D.V., W.G.M., I.D.H., and H.W.M.V.L. included patients in the study. R.K. checked and cleaned the data. R.K., M.S.-R., and M.G.H.V.O. analyzed the data. H.W.M.V.L. provided critical comments and advise in all analysis stages. R.K., H.W.M.V.L., and M.S.-R. wrote the first draft of the paper. All authors critically reviewed the manuscript and approved the final version of the manuscript. R.K. is the guarantor. Trial Registration: The study is registered at ClinicalTrials.gov: NCT01830075. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Dutch Cancer Society/Alpe d?HuZes (grant no. UVA 2011?5311), Janssen Pharmaceutical Companies, and an anonymous beneficiary. Publisher Copyright: © The Author(s) 2018.
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