Existential behavioural therapy for informal caregivers of palliative patients: a randomised controlled trial

Fegg, Martin; Brandstätter, Monika; Kögler, Monika; Hauke, Gernot; Rechenberg-Winter, Petra; Fensterer, Veronika; Küchenhoff, Helmut; Hentrich, M.; Belka, Claus; Borasio, Gian Domenico

doi:10.1002/pon.3260

Cited by 51 publications

(121 citation statements)

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“…As another example, existential therapy is an approach with obvious resonance given the proximity of death and the immediate challenge of coming to terms with a foreshortened future and impending mortality. Here again, the evidence base for these approaches is just beginning to emerge in the context of end-of-life care (e.g., Fegg et al, 2013;Spira, 2000).…”

Section: Treatment Of Psychological Distressmentioning

confidence: 98%

Contemporary Psychological Approaches toLifeat the End of Life

Carpenter

2013

Occupational Therapy In Health Care

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When people have a serious life-limiting illness, physical symptoms are often prominent, both in the experience of the illness and in its treatment. No less important, however, are psychological symptoms. A holistic, bio-psycho-social-spiritual approach to quality of life near the end of life must address psychological distress of all types, including frank psychopathology, more moderate problems with living, and existential distress. Responding to mental health issues at the end of life requires (1) systematic and careful assessment, and (2) deployment of evidence-based treatments. In recent years, standardized assessment tools have been adapted or developed for use with people who have serious illness, and the same has happened with psychological treatments. Practitioners have several resources available to them. Given their practice orientation centered on meaningful engagement, occupational therapists can play an important role in responding to mental distress in patients with serious illness whose lives are becoming more circumscribed because of their medical condition or because of the mental distress itself. High-quality end-of-life care depends on scrupulous attention to the full spectrum of thoughts, feelings, and behaviors that unfold as death draws near.

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Section: Treatment Of Psychological Distressmentioning

confidence: 98%

Contemporary Psychological Approaches toLifeat the End of Life

Carpenter

2013

Occupational Therapy In Health Care

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“…EBT was developed as a manualised group-intervention for informal caregivers, consisting of six group sessions [16]. Therapeutic approaches comprised an introduction into mindfulness and acceptance in the context of dying and bereavement, the activation of personal resources, finding meaning-in-life, reflection of existential questions as well as issues of self-care and stress management.…”

Section: Introductionmentioning

confidence: 99%

The feasibility and acceptability of short-term, individual existential behavioural therapy for informal caregivers of patients recruited in a specialist palliative care unit

et al. 2016

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BackgroundExistential behavioural therapy (EBT) is a recently developed intervention to support informal caregivers of patients in a specialist palliative care unit and was initially established as a six-session group programme. This pilot study aimed to test the feasibility and acceptability of an adapted short-term, individual approach of EBT in preparation for a randomized controlled trial (RCT).MethodsThe study was conducted in a prospective, mixed methods design including four quantitiative assessments with embedded qualitative interviews at one assessment.The intervention offered two one-hour therapeutic sessions focusing on (1) mindfulness and (2) existential meaning-in-life as a source of strength provided by a trained psychotherapist. To test the feasibility of the intervention, doubling of the participation rate, compared to the previous group study (13,6 %) as well as an attrition rate of less than 30 % were set as thresholds. To test the acceptability of the intervention, self-rated usefulness of individual aspects of the intervention and the frequency of implementing therapeutic elements by the carers were set as criteria. Acceptability testing also included the number of participants who completed both sessions, where we expected more than 75 % as a criterion for acceptability. Return rates of quantitative questionnaires were set as criteria for the feasibility of data collection (<33 % loss expected within the study period). Qualitative interviews were used to collect additional data on feasibililty and acceptability and to explore potential harms and benefits of the intervention.Results44/102 (43,1 %) of eligible informal caregivers agreed to participate in the study. Due to attrition of 13 caregivers (attrition rate: 29,5 %), 31 caregivers were included in the trial. Self-rated usefulness showed sufficiant results for all but one individual aspect. Frequency of implementing therapeutic elements showed wide inter-item as well as inter-participant ranges and decreased over the study period. All participants completed both sessions. Return rates of the questionnaires were within the expected range. According to the interviews, the intervention was associated with several participant-identified benefits. No severe adverse effects were observed.ConclusionsFindings suggest that the short-term, individual EBT proved feasible and mostly acceptable.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-016-0160-1) contains supplementary material, which is available to authorized users.

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“…Dentro de las principales afectaciones en cuidadores primarios de pacientes oncológicos están los psicológicos, se han reportado hasta un 67% con sintomatología depresiva leve y de un 2% a 35% con sintomatología severa (16,17) . Así como 40,7% con sintomatología ansiosa (17) .…”

Section: Afectaciones Del Cuidador Primario Informal Del Paciente Conunclassified

“…Así como 40,7% con sintomatología ansiosa (17) . Esto aumenta durante la fase paliativa donde aproximadamente 13% reúne criterios para un trastorno psiquiátrico (trastorno de pánico 8,0%, trastorno depresivo mayor 4,5%, trastorno de estrés post-traumático, 4,0%, a 3,5% trastorno de ansiedad generalizada); en general 25% requiere atención de un servicio de salud mental (18) .…”

Section: Afectaciones Del Cuidador Primario Informal Del Paciente Conunclassified

“…Esto aumenta durante la fase paliativa donde aproximadamente 13% reúne criterios para un trastorno psiquiátrico (trastorno de pánico 8,0%, trastorno depresivo mayor 4,5%, trastorno de estrés post-traumático, 4,0%, a 3,5% trastorno de ansiedad generalizada); en general 25% requiere atención de un servicio de salud mental (18) . Por otra parte 15,0% refieren dolor, 36,7% trastornos del dormir, 33,3% fatiga en la mañana y 30,3% fatiga (17) . Las probabilidades de presentar depresión son mayores en cuidadores mujeres, esposas o cónyuges, con mal estado de salud, con niveles de clínicos de estrés, pocas habilidades adaptativas y que el paciente presente un estado funcional pobre de acuerdo con la clasificación del ECOG (16) .…”

Section: Afectaciones Del Cuidador Primario Informal Del Paciente Conunclassified

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Guía de práctica clínica para la atención psico-oncológica del cuidador primario informal de pacientes con cáncer

Vazquez

Castillo²,

Huertas

et al. 2015

Psicooncología

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ResumenIntroducción: Los cuidadores primarios representan un papel crucial en la atención de los pacientes con cáncer, lo que comúnmente representan tareas complejas de cuidado. Los cuidadores de los pacientes pueden experimentar diversas afectaciones físicas y psicológicas, así como un funcionamiento social deficiente.Objetivo: Proporcionar a los servicios de psicooncología un algoritmo con los elementos suficientes que faciliten el diagnóstico y tratamiento psicosocial de cuidadores primarios de pacientes con cáncer.Método: Se realizó una búsqueda de la literatura en PsycInfo, LatinIndex y Medline en el período de 2005-2014.Resultados: El presente algoritmo se divide en dos momentos clave: 1). Evaluación y 2). Tratamiento del cuidador primario. Los instrumentos más empleados para ansiedad y depresión son: CES-D, BDI, IDARE, HADS y POMS. Para carga el ECCZ y CRA; las intervenciones psico-educativa, capacitación y orientación terapéutica presentan efectos benéficos para esta población.Conclusiones: El algoritmo ofrece un proceso de toma de decisiones para el diagnós-tico y tratamiento psicooncológico del cuidador primario informal.Palabras clave: Cuidador primario informal, cáncer, guía de práctica clínica, psico-oncología. Conclusions: The algorithm provides a process of decision making for the diagnosis and psychooncologic treatment of the primary caregiver.

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Existential behavioural therapy for informal caregivers of palliative patients: a randomised controlled trial

Abstract: Existential behavioural therapy appears to exert beneficial effects on distress and QOL of informal caregivers of palliative patients. Further longitudinal evidence is needed to confirm these findings.

Cited by 51 publications

References 31 publications

Contemporary Psychological Approaches toLifeat the End of Life

Contemporary Psychological Approaches toLifeat the End of Life

The feasibility and acceptability of short-term, individual existential behavioural therapy for informal caregivers of patients recruited in a specialist palliative care unit

Guía de práctica clínica para la atención psico-oncológica del cuidador primario informal de pacientes con cáncer

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