Cultural Adaptation and Open Pilot of Meaning-Centered Psychotherapy for Puerto Rican Patients with Advanced Cancer

Abstract

In Puerto Rico, cancer incidence increases significantly, and is accompanied with a greater risk of experiencing high levels of depressive symptoms, emotional distress, and reduced quality of life when compared to other minority ethnic groups. Studies suggest that interventions to attend distress in Latino patient population would benefit from including components that seek to improve patients' spiritual well-being. The purpose of this study is to identify the level of comprehension and acceptance of Meaning-Centered Psychotherapy (MCP) concepts. A mixed method design was conducted with in-depth interviews and open pilot data. A total of nine participants with advanced or metastatic cancer were sampled from an Oncology Clinic in the south of Puerto Rico. Six semi-structured interviews and six ethnographic notes with audiotape sessions were selected and transcribed. All material was analyzed, resulting in a sample of six semi-structured interview and six ethnographic note peer sessions. Patients showed low comprehension of the MCP concepts of meaning, the finite, and legacy. Patients showed low acceptance of death and its related concepts. They also reported high acceptance of integrating family members to their therapy. In order to tailor the intervention and improve comprehension, the content should include examples, shorter questions, and brief definitions. Additionally, there is a need to address death and its related concepts in end of life.

Psychosocial Intervention Cultural Adaptation for Latinx Patients and Caregivers Coping with Advanced Cancer

“…The semi-structured interview analyses, integration, and interpretation were completed in Spanish. A coding dictionary was developed and defined a priori, following standard deductive analysis procedures [ 5 , 6 , 16 , 17 ], which included developing a structured coding matrix with categories, codes, and definitions [ 5 , 6 , 16 , 17 ]. The qualitative codes used for the interviews included high, moderate, low, and neutral acceptance.…”

“…Using the report and query functions of ATLAS.ti, the qualitative analysts (CP, LR, and KS) independently coded the transcripts and discussed divergence and convergence points [ 5 , 6 , 16 , 17 ]. The qualitative coders then coded the remaining transcriptions using the coding dictionary, and meetings were held to reach a consensus about the applied codes.…”

“…Reliability was conducted through team-based consensus building. The team’s previous publications include more details about the methodology [ 15 , 16 , 17 , 18 ]. All investigators had expertise in qualitative analysis, and the last author moderated these discussions [ 15 , 16 , 17 , 18 ].…”

Spanish Adaptation of Meaning-Centered Psychotherapy for Participants With Cancer: Study Protocol of a Randomized Control Trial

“…The second objective of this proposed study will be to analyze the feasibility and acceptance of MCP in Spanish participants with cancer. The concepts and premises of logotherapy, such as meaning-making, vital goals, the concepts of responsibility, freedom, courage, legacy, and will to meaning, or meaning in life, are subject to cultural, religious, and social factors specific to each culture ( 19 ). Given that all the RCTs on the efficacy of MCP have been carried out in an English-speaking population, it is necessary to analyze the extent to which the Spanish participants accept the program and are comfortable with it, as well as their opinions and expectations about it, in order to improve adherence and future implementation.…”

“…The construction of meaning, vital goals, responsibility, sources of meaning, and the comprehension and acceptance of these constructs depend on cultural, social, and religious factors, etc. ( 19 ). There are studies that indicate that the construction of meaning and growth in the face of adverse situations is different for Anglo-Saxon and Spanish populations.…”