Meaning-Centered Psychotherapy at Home

Study Overview
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Brief Summary
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The purpose of this study is to train nurses from the VNS Health Visiting Nurse Service to deliver Meaning-Centered Psychotherapy for Palliative Care Patients (MCP-PC) to homebound people, and to evaluate how effective MCP-PC is for people with cancer.

Official Title
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A Pragmatic Randomized Control Trial of Nurse-Delivered Brief Meaning Centered Psychotherapy for Homebound Palliative Care Patients

Conditions
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Nurse-Patient Relations, Psychology, Social

Intervention / Treatment
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* Behavioral: Meaning-Centered Psychotherapy/MCP-PC Training
* Behavioral: Meaning-Centered Psychotherapy/MCP-PC
* Behavioral: Treatment As Usual/TAU


Participation Criteria
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Eligibility Criteria
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Participant Inclusion Criteria: Nurses (all phases): Per self-report, providing direct care services at VNS Health Per self-report, fluent in English** Per self-report, is age 18 or older Patients (all phases): Per health record and/or self-report, is a patient in the VNS Health home health agency division (post-acute care) Per health record and/or self-report, is age 18 or older Per health record, has a cancer diagnosis and a rating of ≥ 2 on Symptom Control Scale Per health record and/or self-report, fluent in English** Has a score of ≥ 4 on Callahan cognitive screener Has a score of ≥ 4 on Distress Thermometer (N/A for Training Case Participants) Language verification: For both nurses and patients, prior to enrollment, all will be asked the following two questions by a Clinical Research Coordinator (CRC) to verify English fluency necessary for participation in the study: How well do you speak English? (must respond very well or well when given the choices of Very well, Well, Not well, Not at all, Don't know, or Refused) What is your preferred language for healthcare? (must respond English) Participant Exclusion Criteria: Nurses (all phases): Per self-report, planning to leave position at VNS Health in the next 6 months Patients (all phases): Per health record and/or self-report, has a diagnosis of Alzheimer's, dementia, or other organic brain disorder and in the judgment of the PIs is unable to meaningfully participate. Per health record, has impaired decision-making capacity Per health record and/or self-report, is permanently placed in a nursing home Per health record and/or self-report, is currently receiving Hospice care

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Phase 1: Nurse Participants<br>n=8-10 nurses | Behavioral: Meaning-Centered Psychotherapy/MCP-PC Training<br>* Two-Day MCP-PC Training for Nurses (including mock patient/simulation with actor) with a Pre- and Post-Training Assessment<br>|
| Phase 1: Patient Participants<br>n=8-10 patients | Behavioral: Meaning-Centered Psychotherapy/MCP-PC<br>* 3 sessions, completed over the course of 3-6 weeks in the participant's home<br>|
| Phase 2: Nurse Participants<br>n=8-10 nurses | Behavioral: Meaning-Centered Psychotherapy/MCP-PC Training<br>* Two-Day MCP-PC Training for Nurses (including mock patient/simulation with actor) with a Pre- and Post-Training Assessment<br>|
| Phase 2: Patient Participants Meaning-Centered Psychotherapy/MCP-PC Intervention Arm<br>n=30 | Behavioral: Meaning-Centered Psychotherapy/MCP-PC<br>* 3 sessions, completed over the course of 3-6 weeks in the participant's home<br>|
| Phase 2: Patient Participants Treatment As Usual/TAU Intervention Arm<br>n=30 | Behavioral: Treatment As Usual/TAU<br>* Research team will provide: feedback about level of distress at time of screening local referral for psychological care<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MPI Competency Ratings | Phase I portion: To refine the MCP-PC training and study procedures for homecare delivery by nurse interventionists as determined by providers' MPI Competency Ratings | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Meaning Centered Psychotherapy, Meaning Centered Psychotherapy for Palliative Patients, 22-019, Memorial Sloan Kettering Cancer Center