The efficacy of Life Review Therapy combined with Memory Specificity Training (LRT-MST) targeting cancer patients in palliative care: A randomized controlled trial

• Published in: PloS one 2018-05, Vol.13 (5), p.e0197277-e0197277
• Main Authors: Kleijn, Gitta, Lissenberg-Witte, Birgit I, Bohlmeijer, Ernst T, Steunenberg, Bas, Knipscheer-Kuijpers, Kitty, Willemsen, Vincent, Becker, Annemarie, Smit, Egbert F, Eeltink, Corien M, Bruynzeel, Anna M E, van der Vorst, Maurice, de Bree, Remco, Leemans, C René, van den Brekel, Michiel W M, Cuijpers, Pim, Verdonck-de Leeuw, Irma M
• Format: Article
• Language: English
• Subjects: Analysis; Anxiety; Biology and Life Sciences; Cancer; Cancer patients; Care and treatment; Clinical trials; Depression (Mood disorder); Developmental psychology; Ethical aspects; Funding; Integrity; Intervention; Management; Medicine and Health Sciences; Memory; Mental depression; Mental disorders; Mental health; Motivation; Oncology; Palliation; Palliative care; Patients; People and Places; Psychology; Quality of life; Randomization; Research and Analysis Methods; Social Sciences; Surgery; Therapy; Training
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0197277

The aim of this study was to evaluate the efficacy of an intervention combining Life Review Therapy (LRT) and Memory Specificity Training (MST) (LRT-MST) to improve ego-integrity and despair among cancer patients in palliative care. In this multicentre randomized controlled trial, cancer patients in palliative care were randomized to the intervention group (LRT-MST; n = 55) or waiting-list control group (n = 52). LRT-MST is a 4-session home-based psychological intervention that aims to retrieve specific positive memories, to re-evaluate life events and to reconstruct the story of a patient's life, including the diagnosis of incurable cancer. Outcome measures were ego-integrity and despair (NEIS), psychological distress, anxiety and depression (HADS), quality of life (EORTC QLQ-C15-PAL), and specificity of the autobiographical memory (AMT). NEIS, HADS and EORTC QLQ-C15-PAL were assessed at baseline (T0), 1 month later (post-treatment; T1), and at 1 month follow-up (T2). AMT was assessed at T0 and T1. Linear mixed models (intention to treat) were used to assess group differences in changes over time. Independent samples t-tests were used to assess group differences at T0, T1, and T2, and effect sizes (ES) were calculated at T1 and T2. The course of ego-integrity (not despair) improved significantly over time (p = .007) in the intervention group compared to the waiting-list control group, with moderate, but insignificant, effect sizes at T1 (ES = .42) and T2 (ES = .48). Compliance rate was 69% and total dropout rate was 28%, both primarily related to disease progression and death. LRT-MST seems effective among cancer patients in palliative care to improve the course of ego-integrity.