The efficacy of Life Review Therapy combined with Memory Specificity Training (LRT-MST) targeting cancer patients in palliative care: A randomized controlled trial

Gitta Kleijn, Birgit I Lissenberg-Witte, Ernst T Bohlmeijer, Bas Steunenberg, Kitty Knipscheer-Kuijpers, Vincent Willemsen, Annemarie Becker, Egbert F Smit, Corien M Eeltink, Anna M E Bruynzeel, Maurice van der Vorst, Remco de Bree, C René Leemans, Michiel W M van den Brekel, Pim Cuijpers, Irma M Verdonck-de Leeuw, Gitta Kleijn, Birgit I Lissenberg-Witte, Ernst T Bohlmeijer, Bas Steunenberg, Kitty Knipscheer-Kuijpers, Vincent Willemsen, Annemarie Becker, Egbert F Smit, Corien M Eeltink, Anna M E Bruynzeel, Maurice van der Vorst, Remco de Bree, C René Leemans, Michiel W M van den Brekel, Pim Cuijpers, Irma M Verdonck-de Leeuw

Abstract

Background: The aim of this study was to evaluate the efficacy of an intervention combining Life Review Therapy (LRT) and Memory Specificity Training (MST) (LRT-MST) to improve ego-integrity and despair among cancer patients in palliative care.

Methods: In this multicentre randomized controlled trial, cancer patients in palliative care were randomized to the intervention group (LRT-MST; n = 55) or waiting-list control group (n = 52). LRT-MST is a 4-session home-based psychological intervention that aims to retrieve specific positive memories, to re-evaluate life events and to reconstruct the story of a patient's life, including the diagnosis of incurable cancer. Outcome measures were ego-integrity and despair (NEIS), psychological distress, anxiety and depression (HADS), quality of life (EORTC QLQ-C15-PAL), and specificity of the autobiographical memory (AMT). NEIS, HADS and EORTC QLQ-C15-PAL were assessed at baseline (T0), 1 month later (post-treatment; T1), and at 1 month follow-up (T2). AMT was assessed at T0 and T1. Linear mixed models (intention to treat) were used to assess group differences in changes over time. Independent samples t-tests were used to assess group differences at T0, T1, and T2, and effect sizes (ES) were calculated at T1 and T2.

Results: The course of ego-integrity (not despair) improved significantly over time (p = .007) in the intervention group compared to the waiting-list control group, with moderate, but insignificant, effect sizes at T1 (ES = .42) and T2 (ES = .48). Compliance rate was 69% and total dropout rate was 28%, both primarily related to disease progression and death.

Conclusions: LRT-MST seems effective among cancer patients in palliative care to improve the course of ego-integrity.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Consort flow diagram of study…
Fig 1. Consort flow diagram of study population.
ITT, intention to treat.
Fig 2. Course of NEIS: Ego-integrity scale.
Fig 2. Course of NEIS: Ego-integrity scale.

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Source: PubMed

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