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Randomized Controlled Trial
. 2018 Feb;21(2):200-207.
doi: 10.1089/jpm.2017.0007. Epub 2017 Nov 14.

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

Meg Wise  1 , Lucille R Marchand  2 , Linda J Roberts  3 , Ming-Yuan Chih  4
Affiliations
Randomized Controlled Trial

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

Meg Wise et al. J Palliat Med. 2018 Feb.

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.

Keywords: cancer narratives; existential wellbeing; life review; narrative interventions.

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Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Enrollment and Retention by Random Group.
<b>FIG. 2.</b>
FIG. 2.
Within-group change between 2 and 4 months.
See this image and copyright information in PMC

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