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

Published online by Cambridge University Press:  27 May 2021

Guida da Ponte Open the ORCID record for Guida da Ponte [Opens in a new window] ,
Sílvia Ouakinin ,
Jorge Espírito Santo ,
Afolabi Ohunakin ,
Domingos Prata ,
Inês Amorim ,
Zita Gameiro ,
Estêvão Soares dos Santos  and
William Breitbart
Guida da Ponte*
Affiliation:
Department of Psychiatry and Mental Health, Centro Hospitalar Barreiro-Montijo, EPE, Barreiro, Portugal Medical School of Lisbon, University of Lisbon, Lisbon, Portugal
Sílvia Ouakinin
Affiliation:
University Clinic of Medical Psychology and Psychiatry, Medical School of Lisbon, University of Lisbon, Lisbon, Portugal
Jorge Espírito Santo
Affiliation:
Oncology Unit, Centro Hospitalar Barreiro-Montijo, EPE, Barreiro, Portugal
Afolabi Ohunakin
Affiliation:
Department of Family Medicine, Ekiti State University Teaching Hospital, Ado-ekiti, Nigeria
Domingos Prata
Affiliation:
Faculty of Economics, University of Algarve, Faro, Portugal
Inês Amorim
Affiliation:
Algarve Cancer Association, Faro, Portugal
Zita Gameiro
Affiliation:
Department of Psychiatry and Mental Health, Centro Hospitalar Barreiro-Montijo, EPE, Barreiro, Portugal
Estêvão Soares dos Santos
Affiliation:
Public Health Center, Leiria, Portugal
William Breitbart
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
*
Author for correspondence: Guida da Ponte, Department of Psychiatry and Mental Health, Centro Hospitalar Barreiro-Montijo, EPE, Barreiro, Portugal; Medical School of Lisbon, University of Lisbon, Lisbon, Portugal. E-mail: [email protected]
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Abstract

Objective

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 (QoL) 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), McGill 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 QoL, 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 QoL, 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 QoL (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 QoL, 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 QoL and psychologic well-being. More studies are necessary to address the limitations of this pilot exploratory trial, as its small sample size.

Keywords

CancerMeaning-centered group psychotherapy adaptationPortugueseQuality-of-life benefits
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 4 , August 2021 , pp. 464 - 473
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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