An assisted structured reflection on life events and life goals in advanced cancer patients: Outcomes of a randomized controlled trial (Life InSight Application (LISA) study)

Palliat Med. 2019 Feb;33(2):221-231. doi: 10.1177/0269216318816005. Epub 2018 Dec 5.

Abstract

Background:: Diagnosis and treatment of incurable cancer as a life-changing experience evokes difficult existential questions.

Aim:: A structured reflection could improve patients’ quality of life and spiritual well-being. We developed an interview model on life events and ultimate life goals and performed a randomized controlled trial to evaluate the effect thereof on quality of life and spiritual well-being.

Design:: The intervention group had two consultations with a spiritual counselor. The control group received care as usual. EORTC QLQ-C15-PAL and the FACIT-sp were administered at baseline and 2 and 4 months after baseline. Linear mixed model analysis was performed to test between-group differences over time.

Participants:: Adult patients with incurable cancer and a life expectancy ⩾6 months were randomized in a 1:1 ratio to the intervention or control group.

Results:: A total of 153 patients from six different hospitals were included: 77 in the intervention group and 76 in the control group. Quality of life and spiritual well-being did not significantly change over time between groups. The experience of Meaning/Peace was found to significantly influence quality of life (β = 0.52, adj. R2 = 0.26) and satisfaction with life (β = 0.61, adj. R2 = 0.37).

Conclusion:: Although our newly developed interview model was well perceived by patients, we were not able to demonstrate a significant difference in quality of life and spiritual well-being between groups. Future interventions by spiritual counselors aimed at improving quality of life, and spiritual well-being should focus on the provision of sources of meaning and peace.

Trial registration: ClinicalTrials.gov NCT01830075.

Keywords: Oncology; palliative care; randomized controlled trials; spiritual care; spiritual care givers; spirituality.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attitude to Death*
  • Female
  • Goals*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Palliative Care / psychology*
  • Patient Satisfaction*
  • Quality of Life / psychology*
  • Spiritual Therapies / psychology*
  • Surveys and Questionnaires

Associated data

  • ClinicalTrials.gov/NCT01830075