Meaning-centered group psychotherapy in Portuguese cancer patients: A pilot exploratory trial.

To describe the feasibility of a meaning-centered group psychotherapy (mcgp) adaptation in a sample of portuguese cancer patients.Method the study was carried out according to four steps: 1st - transcultural adaptation and validation (focus groups); 2nd - preliminary study with mcgp original version (to test its feasibility); 3rd - adaptation of mcgp original version to a 4-session version (and internal pilot study); and 4th - pilot exploratory trial (mcgp-4 session version), implemented between january 1, 2018 and december 31, 2019.Inclusion criteria were >18 years, psychological complaints, and difficulty to adapt to cancer.Allocation was according to participants' preference: mcgp vs.Care as usual (cau).Primary outcomes were: mcgp adapted version improved quality of life (qo l) and spiritual well-being; secondary outcomes were improvement of depression, anxiety, and distress.Assessments were done at baseline (t1) and 1 month after (t2), with self-report socio-demographic and clinical questionnaires, distress thermometer (dt), mc gill quality of life questionnaire (mqol), functional assessment of chronic illness therapy - spiritual well-being scale (facit-sp-12), hospital anxiety and depression scale, and its subscales (hads - hads-d, hads-a).Results in the 1st step, and through focus groups, the manual was reformulated and tested.The preliminary study (2nd step) with mcgp original version showed a high number of dropouts which could jeopardize the study and, after reframing the sessions content, mcgp was adapted to a 4-session version, and its feasibility was tested by an internal pilot study (3rd step).The pilot exploratory trial (4th step) had 91 participants.Most socio-demographic and clinical characteristics between the groups (51: mcgp; 40: cau) had no statistically significant differences.A comparison between the two groups at t2 showed that the mcgp group scored significantly higher in the general (u = 552.00, p < 0.001), and existential (u = 727.50, p = 0.018) domains and total score (u = 717.50, p = 0.015) of qo l, and cau presented statistical higher levels in dt (u = 608.50, p = 0.001).Comparing the groups between t1 and t2, the mcgp group had a statistically significant improvement in the general (z = -3.67, p < 0.001) and psychosocial (z = -2.89, p = 0.004) domains and total score (z = -2.71, p = 0.007) of qo l, and a statistically significant decrease in dt (z = -2.40, p = 0.016).In terms of group effects, the mcgp group presented increased general (b = 1.42, p < 0.001, η2p = 0.179), and support (b = 0.80, p = 0.045, η2p = 0.048) domains and total score (b = 0.81, p = 0.013, η2p = 0.073) of qo l (small to elevated dimensions), and decreased levels of depression (b = -1.14, p = 0.044, η2p = 0.048), and distress (b = -1.38, p = 0.001, η2p = 0.127) (small to medium dimensions), compared with cau.At t2, participants who attended ≥3 sessions (n = 38) had a statistically significant higher score in the general domain (u = 130.50, p = 0.009) of qo l, comparing with those who attended 1 or 2 sessions (n = 13).Significance of results this study supports the benefits of an mcgp adapted version in improving qo l and psychologic well-being.More studies are necessary to address the limitations of this pilot exploratory trial, as its small sample size.

Journal: Palliative & supportive care (2021)
Publication types: Journal Article