Suffering in Advanced Cancer: A Randomized Control Trial of a Narrative Intervention

Meg Wise, Lucille R. Marchand, Linda J. Roberts, Ming Yuan Chih

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Background: Advanced cancer can Erode patients' wellbeing. Narrative interventions have improved patients' wellbeing, but might not be feasible for widespread implementation. Objectives: (1) Test the effects of miLivingStory, a telephone-based life review and illness narrative intervention with online resources and social networking, on community-dwelling advanced cancer patients' wellbeing. (2) Explore intervention use and satisfaction. Patients and Setting: Stage III or IV cancer patients having completed initial therapy were randomized to miLivingStory or to an active control group, miOwnResources. Data and Analysis: Primary outcomes measured at baseline, two and four months included subscales for the FACIT-Sp peace and meaning and the POMS-SF depressed, anxious, and angry mood, scored on 0-4-point Likert scales. Linear mixed modeling, controlling for baseline primary outcome scores, tested for group comparisons of repeated outcome measures. Pairwise comparisons tested for within- and between-group differences. Intervention use and satisfaction data were collected automatically and by survey. Results: Eighty-six primarily white, female patients with high baseline wellbeing completed the study. There were no between-group differences at baseline or at two months. At four months, miLivingStory had a direct and positive effect for peace (2.86 vs. 2.57, p = 0.029), a trend effect for lower depressed mood (0.55 vs. 0.77, p = 0.097), and appeared to protect against the control group's declining wellbeing between two and four months. miLivingStory use was low and assessed as helpful to quite helpful. Conclusions: Telephone-based narrative interventions hold promise in improving advanced cancer patients' wellbeing. Further testing of delivery and implementation strategies is warranted.

Original languageEnglish
Pages (from-to)200-207
Number of pages8
JournalJournal of Palliative Medicine
Volume21
Issue number2
DOIs
StatePublished - Feb 2018

Bibliographical note

Publisher Copyright:
© Copyright 2018, Mary Ann Liebert, Inc. 2018.

Keywords

  • Cancer narratives
  • Existential wellbeing
  • Life review
  • Narrative interventions

ASJC Scopus subject areas

  • General Nursing
  • Anesthesiology and Pain Medicine

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