Managing Cancer And Living Meaningfully (CALM): randomised feasibility trial in patients with advanced cancer

Lo, Chris; Hales, Sarah; Chiu, Aubrey; Panday, Tania; Malfitano, Carmine; Jung, Judy; Rydall, Anne; Li, Madeline; Nissim, Rinat; Zimmermann, Camilla; Rodin, Gary

doi:10.1136/bmjspcare-2015-000866

Cited by 64 publications

(67 citation statements)

References 40 publications

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“…We included, in this category, 11 studies that examined psychotherapeutic interventions that emerged from existential theories and that seek to enhance life meaning in the face of terminal diagnosis. These interventions included meaning‐centred psychotherapy, supportive‐expressive therapy, and other therapies that emphasise meaning making …”

Section: Resultsmentioning

confidence: 99%

“…We included, in this category, 11 studies that examined psychotherapeutic interventions that emerged from existential theories [32][33][34][35] and that seek to enhance life meaning in the face of terminal diagnosis.…”

Section: Meaning-enhancing Interventionsmentioning

confidence: 99%

“…These interventions included meaning-centred psychotherapy, 32,[36][37][38] supportive-expressive therapy, 34,[39][40][41] and other therapies that emphasise meaning making. 33…”

Section: Meaning-enhancing Interventionsmentioning

confidence: 99%

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Psychosocial interventions for advanced cancer patients: A systematic review

2019

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Objective Psychosocial care for advanced cancer encompasses a wide range of interventions that help patients make life‐changing decisions, manage debilitating symptoms, confront impending mortality, and improve other patient outcomes. Psychosocial care is becoming increasingly available to advanced cancer patients; however, an overview of the various types of interventions is lacking. Methods The current review systematically examined randomised‐controlled trials of psychosocial interventions for advanced cancer patients from January 2007 to June 2018. MEDLINE, CINAHL Plus, PsycINFO, and Scopus databases were searched, and a total of 68 studies were included in the review. Results We found a range of psychosocial interventions studies and grouped them based on six theoretical/clinical approaches: cognitive behavioural therapy based; meaning enhancing; dignity, life review, and narrative; other counselling; education only; and music, writing, and others. The different psychosocial interventions had significantly varied characteristics (eg, format, duration, and resources used) to address issues faced by advanced cancer patients. There is compelling evidence for the use of meaning‐centred psychotherapy to improve meaning and quality of life and use of question prompt lists and communication skills training to improve communication with health care providers. Conclusions Some psychosocial interventions are further along in establishing evidence for effectiveness. Our findings demonstrate a growing capacity within the field to meet the psychosocial needs of advanced cancer patients. Lessons and direction in clinical practice and future research endeavours are discussed.

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Section: Resultsmentioning

confidence: 99%

Section: Meaning-enhancing Interventionsmentioning

confidence: 99%

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Psychosocial interventions for advanced cancer patients: A systematic review

2019

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“…This structure of care limits caregivers' timely access to information and support. Indeed, in our ongoing intervention for patients with ambulatory advanced cancer, CALM (Lo et al, ; Nissim et al, ), we encourage patients to invite their informal caregivers to at least one session. However, caregivers cannot access this resource on their own or when the patient does not wish them to be involved.…”

Section: Discussionmentioning

confidence: 99%

Supporting Family Caregivers of Advanced Cancer Patients: A Focus Group Study

et al. 2017

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Objective As the first stage in developing an intervention for family caregivers of individuals with advanced cancer, we conducted a focus group study to understand their needs. Background Family caregivers play an important role in the care of advanced cancer patients. Despite substantial burden and distress experienced by family caregivers of individuals with advanced cancer, their needs are not addressed systematically. Method The study took place at a large urban cancer center in Canada. We conducted 2 focus groups: one with 7 current family caregivers, the other with 7 bereaved caregivers. Participants were asked about their support needs while providing care, how and when they preferred to receive support, and the perceived barriers and facilitators to addressing their support needs. Responses were analyzed using the conventional content analysis method. Results Family caregivers wished for support in relation to 3 domains: decision‐making in the face of uncertainty, information about death and dying, and current and anticipated emotional distress. They identified 3 barriers to receiving support: the organization of cancer care around the patient, rather than the family; the timing of information provision; and caregivers' tendency to dismiss their own needs. Caregivers expressed a strong need for caregiver‐specific support. Conclusion This study allowed us to identify caregiver‐perceived intervention needs, barriers to access and continuity of intervention, and suggestions for intervention design. Implications This information is of value to inform the design of interventions for this population.

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“…Although randomised controlled trials (RCTs) are slowly amassing, four of these interventions have been subject to a higher degree of evaluation and hold particular promise for use with people nearing end-of-life. These psychotherapies include: supportive-expressive group therapy (SEGT) (Classen et al, 2001); dignity therapy (DT) (Chochinov et al, 2005); meaningcentred group psychotherapy (MCGP) and individual meaningcentred psychotherapy (IMCP) format (Breitbart, Applebaum, & Masterson, 2016;Breitbart et al, 2015); and managing cancer and living meaningfully (CALM) (Lo et al, 2016). As described in Table 1, these interventions have a range of aims such as enhancing meaning, reducing symptom burden and distress, improve quality of life, and assisting people with advanced disease and their families adjust to death and dying (LeMay & Wilson, 2008;Rodin, 2013).…”

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confidence: 99%

Psychosocial Interventions for End‐of‐Life Care: An Invited Commentary

Ftanou

Pascoe

Ellen

2017

Australian Psychologist

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End‐of‐life care impacts on emotional, physical, spiritual, and social wellbeing for both the individual and their family. Despite remarkable medical advances in the field, the empirical evidence regarding the development and efficacy of psychosocial interventions at end‐of‐life care is lagging behind. A number of psychosocial interventions are promising and represent important progress in the field. Psychologists have a range of suitable skills and knowledge, however, the profession is underutilised in end‐of‐life care. This special issue on end‐of‐life care highlights the need for more research into this area and could act as a call to action to accelerate our understanding of the role of Psychology in end‐of‐life care.

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Managing Cancer And Living Meaningfully (CALM): randomised feasibility trial in patients with advanced cancer

Cited by 64 publications

References 40 publications

Psychosocial interventions for advanced cancer patients: A systematic review

Psychosocial interventions for advanced cancer patients: A systematic review

Supporting Family Caregivers of Advanced Cancer Patients: A Focus Group Study

Psychosocial Interventions for End‐of‐Life Care: An Invited Commentary

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