Rebecca M. Saracino PhD, Ellen Y. Park BA, Hayley Pessin PhD, Nicole Onorato MPH, Margaret V. McDonald MSW, Caraline Demirjian MPH, Elizabeth Schofield PhD, Barry Rosenfeld PhD, William Breitbart MD, Allison J. Applebaum PhD
{"title":"简短意义中心心理治疗在家庭护理中的实用随机对照试验","authors":"Rebecca M. Saracino PhD, Ellen Y. Park BA, Hayley Pessin PhD, Nicole Onorato MPH, Margaret V. McDonald MSW, Caraline Demirjian MPH, Elizabeth Schofield PhD, Barry Rosenfeld PhD, William Breitbart MD, Allison J. Applebaum PhD","doi":"10.1002/cncr.70082","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Individuals with advanced cancer receiving home health care experience elevated psychosocial and existential distress, yet few interventions address these concerns. This pilot randomized controlled trial examined the feasibility, acceptability, and preliminary efficacy of brief, nurse-delivered, meaning-centered psychotherapy in patients with advanced cancer compared with treatment as usual (TAU).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Distressed patients (aged 18 years and older) were randomized 1:1 to receive either a three-session Meaning-Centered Psychotherapy for Hospitals, Hospice, and Home (MCP-H; <i>n</i> = 33) or TAU (<i>n</i> = 32). Feasibility was based on recruitment, retention, data completion, fidelity, and intervention engagement. Acceptability was based on patients’ and nurses’ ratings of MCP-H satisfaction. Preliminary efficacy was determined by changes in scores from baseline (T1) to 6 weeks (T2) and 10 weeks (T3) in meaning, and secondary outcomes were assessed using between-group analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Seventy-one patients enrolled. Feasibility was demonstrated by satisfactory recruitment (75% approach-to-consent rate; 92% enroll-to-randomize rate), retention (74% and 75% at T2 and T3, respectively), intervention engagement (94% completed 100% of the sessions), and treatment adherence (87% mean rating). Participants endorsed the intervention’s acceptability (96% satisfied or very satisfied). MCP-H participants experienced improvements in meaning using the Cohen's d (d = 0.59 at T2; d = 0.39 at T3) and most other secondary psychosocial outcomes at 6 and 10 weeks compared with TAU participants.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>MCP-H is feasible and acceptable among patients with advanced cancer in home care. This intervention demonstrated promising evidence of clinical efficacy. A larger, fully powered randomized controlled trial is needed to test the efficacy of the intervention for patients, nurses, and health system outcomes against an active control group.</p>\n </section>\n </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1000,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A pragmatic randomized controlled pilot trial of brief meaning-centered psychotherapy in home care\",\"authors\":\"Rebecca M. Saracino PhD, Ellen Y. Park BA, Hayley Pessin PhD, Nicole Onorato MPH, Margaret V. McDonald MSW, Caraline Demirjian MPH, Elizabeth Schofield PhD, Barry Rosenfeld PhD, William Breitbart MD, Allison J. Applebaum PhD\",\"doi\":\"10.1002/cncr.70082\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Individuals with advanced cancer receiving home health care experience elevated psychosocial and existential distress, yet few interventions address these concerns. This pilot randomized controlled trial examined the feasibility, acceptability, and preliminary efficacy of brief, nurse-delivered, meaning-centered psychotherapy in patients with advanced cancer compared with treatment as usual (TAU).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Distressed patients (aged 18 years and older) were randomized 1:1 to receive either a three-session Meaning-Centered Psychotherapy for Hospitals, Hospice, and Home (MCP-H; <i>n</i> = 33) or TAU (<i>n</i> = 32). Feasibility was based on recruitment, retention, data completion, fidelity, and intervention engagement. Acceptability was based on patients’ and nurses’ ratings of MCP-H satisfaction. Preliminary efficacy was determined by changes in scores from baseline (T1) to 6 weeks (T2) and 10 weeks (T3) in meaning, and secondary outcomes were assessed using between-group analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Seventy-one patients enrolled. Feasibility was demonstrated by satisfactory recruitment (75% approach-to-consent rate; 92% enroll-to-randomize rate), retention (74% and 75% at T2 and T3, respectively), intervention engagement (94% completed 100% of the sessions), and treatment adherence (87% mean rating). Participants endorsed the intervention’s acceptability (96% satisfied or very satisfied). MCP-H participants experienced improvements in meaning using the Cohen's d (d = 0.59 at T2; d = 0.39 at T3) and most other secondary psychosocial outcomes at 6 and 10 weeks compared with TAU participants.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>MCP-H is feasible and acceptable among patients with advanced cancer in home care. This intervention demonstrated promising evidence of clinical efficacy. A larger, fully powered randomized controlled trial is needed to test the efficacy of the intervention for patients, nurses, and health system outcomes against an active control group.</p>\\n </section>\\n </div>\",\"PeriodicalId\":138,\"journal\":{\"name\":\"Cancer\",\"volume\":\"131 18\",\"pages\":\"\"},\"PeriodicalIF\":5.1000,\"publicationDate\":\"2025-09-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.70082\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer","FirstCategoryId":"3","ListUrlMain":"https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.70082","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
A pragmatic randomized controlled pilot trial of brief meaning-centered psychotherapy in home care
Background
Individuals with advanced cancer receiving home health care experience elevated psychosocial and existential distress, yet few interventions address these concerns. This pilot randomized controlled trial examined the feasibility, acceptability, and preliminary efficacy of brief, nurse-delivered, meaning-centered psychotherapy in patients with advanced cancer compared with treatment as usual (TAU).
Methods
Distressed patients (aged 18 years and older) were randomized 1:1 to receive either a three-session Meaning-Centered Psychotherapy for Hospitals, Hospice, and Home (MCP-H; n = 33) or TAU (n = 32). Feasibility was based on recruitment, retention, data completion, fidelity, and intervention engagement. Acceptability was based on patients’ and nurses’ ratings of MCP-H satisfaction. Preliminary efficacy was determined by changes in scores from baseline (T1) to 6 weeks (T2) and 10 weeks (T3) in meaning, and secondary outcomes were assessed using between-group analysis.
Results
Seventy-one patients enrolled. Feasibility was demonstrated by satisfactory recruitment (75% approach-to-consent rate; 92% enroll-to-randomize rate), retention (74% and 75% at T2 and T3, respectively), intervention engagement (94% completed 100% of the sessions), and treatment adherence (87% mean rating). Participants endorsed the intervention’s acceptability (96% satisfied or very satisfied). MCP-H participants experienced improvements in meaning using the Cohen's d (d = 0.59 at T2; d = 0.39 at T3) and most other secondary psychosocial outcomes at 6 and 10 weeks compared with TAU participants.
Conclusions
MCP-H is feasible and acceptable among patients with advanced cancer in home care. This intervention demonstrated promising evidence of clinical efficacy. A larger, fully powered randomized controlled trial is needed to test the efficacy of the intervention for patients, nurses, and health system outcomes against an active control group.
期刊介绍：
The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society.
CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research
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