Title | Suffering in Advanced Cancer: A Randomized Control Trial of a Narrative Intervention. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Wise M, Marchand LR, Roberts LJ, Chih M-Y |
Journal | J Palliat Med |
Volume | 21 |
Issue | 2 |
Pagination | 200-207 |
Date Published | 2018 02 |
ISSN | 1557-7740 |
Keywords | Adult, Aged, Aged, 80 and over, Chronic Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Narration, Neoplasms, Quality of Life, Stress, Psychological, Surveys and Questionnaires |
Abstract | BACKGROUND: Advanced cancer can erode patients' wellbeing. Narrative interventions have improved patients' wellbeing, but might not be feasible for widespread implementation. OBJECTIVES: (1) Test the effects of miLivingStory, a telephone-based life review and illness narrative intervention with online resources and social networking, on community-dwelling advanced cancer patients' wellbeing. (2) Explore intervention use and satisfaction. PATIENTS AND SETTING: Stage III or IV cancer patients having completed initial therapy were randomized to miLivingStory or to an active control group, miOwnResources. Data and Analysis: Primary outcomes measured at baseline, two and four months included subscales for the FACIT-Sp peace and meaning and the POMS-SF depressed, anxious, and angry mood, scored on 0-4-point Likert scales. Linear mixed modeling, controlling for baseline primary outcome scores, tested for group comparisons of repeated outcome measures. Pairwise comparisons tested for within- and between-group differences. Intervention use and satisfaction data were collected automatically and by survey. RESULTS: Eighty-six primarily white, female patients with high baseline wellbeing completed the study. There were no between-group differences at baseline or at two months. At four months, miLivingStory had a direct and positive effect for peace (2.86 vs. 2.57, p = 0.029), a trend effect for lower depressed mood (0.55 vs. 0.77, p = 0.097), and appeared to protect against the control group's declining wellbeing between two and four months. miLivingStory use was low and assessed as helpful to quite helpful. CONCLUSIONS: Telephone-based narrative interventions hold promise in improving advanced cancer patients' wellbeing. Further testing of delivery and implementation strategies is warranted. |
DOI | 10.1089/jpm.2017.0007 |
Alternate Journal | J Palliat Med |
PubMed ID | 29135330 |
PubMed Central ID | PMC5797325 |
Grant List | R21 CA129890 / CA / NCI NIH HHS / United States |