緩和ケアと医学

抽象的な

A Brief Meaning-focused Intervention for Advanced Cancer Patients in Acute Oncology Setting

Lai TK Theresa, Mok Esther, Wong TP Mike, Cheung W Y, Lo CK and Yau CC

Background: A large number of advanced cancer patients are in great despair, there is no longer seen meaning or value in their life and want to hasten their death. The purpose of the study was to explore the impact of a brief, individualized meaning-focused intervention for advanced cancer patients.

Methods: This study employed a single blinded randomized controlled trial design, and measures taken at baseline, immediately after intervention, and two week after intervention. Quality-of-life concerns in the end of life questionnaire (QOLC-E) will be used as the measurement. There are 2 sessions for the intervention. The first session involves a semi-structured interview that facilitates the search for meaning. The second session is to review, verify, and clarify the findings from the first session with the patients. Qualitative data on perception of the intervention was obtained for the treatment group after completion of the intervention.

Results: The score of existential distress domain, quality of life and overall scale of QOLC-E of meaning-focused intervention group were significantly higher than the control group (p ≤ 0.05). The results showed significantly improved quality of life in existential distress domain of meaning-focused intervention group. In addition the negative emotion domain, support domain, value in life domain, existential distress domain, and quality of life and over scale of QOLC-E of intervention group improved significantly after intervention (p ≤ 0.01). Apart from the improvement in the intervention group, support domains of both groups in the third measurement were improved after the study (p ≤ 0.05). Qualitative data also supported that the intervention was effective and common meaningful events for advanced cancer patients were discovered during the processes.
Conclusion: The findings `show the brief meaning-focused on intervention helps to improve existential wellbeing and quality of life for advanced cancer patients. It represents the potential effectiveness and efficient intervention is feasible for implementation by healthcare professionals.