RESUMO
PURPOSE: Life review interventions aim to support individuals facing an incurable disease accompanied by existential concerns and health-related challenges. Based on encouraging feasibility results, this study assessed the effects of Revie â life review intervention on the self-esteem of patients with advanced cancer, and the effects on well-being, post-traumatic growth, life satisfaction, symptom burden and interaction with nurses. METHOD: The study consisted of a two-arm parallel-group, waitlist-controlled trial (WCT) in the oncology division of a Swiss-French University Hospital. Revie â was composed of nurse-led meeting with the patient to address and document significant life events using a strengths-focused approach and targeting the life project. RESULTS: Due to Covid-19 pandemic, adjustments were made regarding study duration and participant's allocation: Fifty-eight patients received Revie â, 39 completed all the measurements. Self-esteem was high at baseline and maintained stability over time. The social well-being decreased in the intervention group before-after Revie â (-1.7 (3.9), p = 0.044) while emotional and functional well-being showed stability. The intensity of symptoms decreased in the intervention group before-after Revie â: 4.9 (9.4), p = 0.020. CONCLUSIONS: This study suggests that patients living with an advanced cancer and who received Revie â intervention may have maintained their self-esteem high over time. Observed results are promising, particularly considering the influence of the pandemic. Nevertheless, these findings do not allow us to draw definitive conclusions regarding the efficacy of the intervention on self-esteem. WCT seems not to be the appropriate design to highlight the added value of Revie â for this particularly vulnerable population. CLINICAL TRIAL REGISTRATION NUMBER: NCT04254926.
Assuntos
COVID-19 , Neoplasias , Humanos , Neoplasias/psicologia , PandemiasRESUMO
BACKGROUND: Aging is one of the most important public health issues. The World Health Organization (WHO) expects the number of older adults aged 65 and above to triple from 2010 to 2050. A major challenge would be to consider how functional ability and quality of life could be enhanced in older age. Reminiscence-based interventions are widely reported as having positive effects on psychological outcomes among older adults with dementia, but its effects on cognitively intact older adults have not been clearly evaluated. OBJECTIVES: The aim of the current systematic review is to evaluate the existing evidence on the effects of reminiscence-based intervention on psychological outcomes in cognitively intact older adults. REVIEW METHODS: Commonly used English databases, including CINAHL, EMBASE, MEDLINE and PsycINFO, were searched from inception till 31 Mar 2020. Studies were included if they examined the effects of reminiscence-based intervention on psychological outcomes among cognitively intact older adults aged 60 and above. Meta-analysis was conducted to synthesise the effects on different psychological outcomes. RESULTS: Thirty-one studies involving 1,829 older adults were included. The pooled standardized mean difference for depressive symptoms and life satisfaction were -0.38 (95% CI: -0.69--0.07) and 0.33 (95% CI: 0.14-0.52) respectively. Positive effects were observed on self-esteem, psychological well-being and happiness, though meta-analysis could not be conducted. CONCLUSION: Significant reduction of depressive symptoms and improvement of life satisfaction were revealed from the reminiscence-based intervention among cognitively intact older adults. In addition, reminiscence-based intervention has been effective in enhancing self-esteem, and promoting psychological well-being and happiness. Our results suggest that reminiscence-based intervention could be an effective solution to improve psychological well-being among cognitively intact older adults. Such non-pharmacological approach can be recommended for older adults at the community level.
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Memória , Qualidade de Vida , Atividades Cotidianas , Idoso , Envelhecimento , Humanos , AutoimagemRESUMO
PURPOSE: The dignity of patients is a major concern among health professionals engaged in the care of individuals with advanced cancer. Although several dignity promoting interventions have been developed, none of them have focused on a positive, resource-based approach. The aim of our study, entitled Revie â, was to assess the feasibility and acceptability of a theory-guided life-review intervention, focusing on strength and resources, for patients with advanced cancer and for nurses delivering the intervention. METHOD: Our 2015-2016 study was conducted with patients with advanced cancer in an ambulatory and an inpatient setting of a Swiss university hospital. An embedded concurrent mixed method design was used. The feasibility and acceptability of Revie â was explored, as were changes in the sense of dignity, posttraumatic growth, and satisfaction with life. RESULTS: A total of 41 patients received the intervention. The level of attrition was low (26%). Administering the Revie â intervention proved to be feasible. Participants (patients and nurses) considered the intervention helpful with a high level of satisfaction. A merged data analysis highlighted the need to address the patients' existential concerns. The majority of the participants found that the intervention helped them, and they recommend it for other patients. CONCLUSIONS: This study indicates that the Revie â intervention, which focuses on a resource-based approach, was perceived favorably by all of the participants. A change in the nurse-patient relationship was noted and it was deemed to be beneficial.
Assuntos
Neoplasias/psicologia , Respeito , Idoso , Existencialismo , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Neoplasias/terapia , Relações Enfermeiro-Paciente , Percepção , Suíça , Assistência TerminalRESUMO
BACKGROUND: It is generally recognized that existential concerns must be addressed to promote the dignity of patients with advanced cancer. A number of interventions have been developed in this regard, such as dignity therapy and other life review interventions (LRI). However, so far, none have focused on a positive approach or evaluated its effects on dignity and personal growth. This study aims to explore the feasibility of Revie â, a life review intervention comprising a positive, patient-centered approach, and to determine potential changes of patients' sense of dignity, posttraumatic growth, and satisfaction with life. METHODS: A mixed method study will be performed, which includes specialized nurses and 40 patients with advanced cancer in an ambulatory and in-patient setting of a Swiss university hospital. Quantitative methods involve a single group, pre- and post-intervention, and outcome measurements include the Patient Dignity Inventory, the Posttraumatic Growth Inventory, and the Satisfaction with Life Scale. Feasibility data relating to process, resource, and scientific elements of the trial will also be collected. A semi-directed interview will be used to collect qualitative data about the process and the participants' experiences of the intervention. In this way, enhanced quantitative-qualitative evidence can be drawn from outcome measures as well as individual, contextualized personal views, to help inform researchers about the plausibility of this complex intervention before testing its effectiveness in a subsequent full trial. DISCUSSION: Patient dignity is a goal of quality end-of-life care. To our knowledge, this is the first trial to evaluate the role of a life review intervention that is focused on personal growth and on changes relating to the experience of having cancer. This study will evaluate the feasibility of a novel intervention, Revie â, which we hope will contribute to promote the dignity, personal growth, and overall life satisfaction of patients with advanced cancer. TRIAL REGISTRATION: ISRCTN, ISRCTN12497093.