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Comparative Study
. 2019 Feb;33(2):221-231.
doi: 10.1177/0269216318816005. Epub 2018 Dec 5.

An assisted structured reflection on life events and life goals in advanced cancer patients: Outcomes of a randomized controlled trial (Life InSight Application (LISA) study)

Renske Kruizinga  1 , Michael Scherer-Rath  2 , Johannes Bam Schilderman  2 , Iris D Hartog  3 , Jacoba Pm Van Der Loos  4 , Hantie P Kotzé  5 , Anneke M Westermann  1 , Heinz-Josef Klümpen  1 , Francesco Kortekaas  6 , Cecile Grootscholten  7 , Frans Bossink  8 , Jolanda Schrama  9 , Willem Van De Vrande  10 , Natascha Awp Schrama  11 , Willem Blokland  12 , Filip Yfl De Vos  13 , Annemieke Kuin  14 , Wim G Meijer  15 , Martijn Gh Van Oijen  1 , Mirjam Ag Sprangers  3 , Hanneke Wm Van Laarhoven  1
Affiliations
Comparative Study

An assisted structured reflection on life events and life goals in advanced cancer patients: Outcomes of a randomized controlled trial (Life InSight Application (LISA) study)

Renske Kruizinga et al. Palliat Med. 2019 Feb.

Abstract

Background:: Diagnosis and treatment of incurable cancer as a life-changing experience evokes difficult existential questions.

Aim:: A structured reflection could improve patients’ quality of life and spiritual well-being. We developed an interview model on life events and ultimate life goals and performed a randomized controlled trial to evaluate the effect thereof on quality of life and spiritual well-being.

Design:: The intervention group had two consultations with a spiritual counselor. The control group received care as usual. EORTC QLQ-C15-PAL and the FACIT-sp were administered at baseline and 2 and 4 months after baseline. Linear mixed model analysis was performed to test between-group differences over time.

Participants:: Adult patients with incurable cancer and a life expectancy ⩾6 months were randomized in a 1:1 ratio to the intervention or control group.

Results:: A total of 153 patients from six different hospitals were included: 77 in the intervention group and 76 in the control group. Quality of life and spiritual well-being did not significantly change over time between groups. The experience of Meaning/Peace was found to significantly influence quality of life (β = 0.52, adj. R2 = 0.26) and satisfaction with life (β = 0.61, adj. R2 = 0.37).

Conclusion:: Although our newly developed interview model was well perceived by patients, we were not able to demonstrate a significant difference in quality of life and spiritual well-being between groups. Future interventions by spiritual counselors aimed at improving quality of life, and spiritual well-being should focus on the provision of sources of meaning and peace.

Trial registration: ClinicalTrials.gov NCT01830075.

Keywords: Oncology; palliative care; randomized controlled trials; spiritual care; spiritual care givers; spirituality.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
CONSORT 2010 flow diagram.
Figure 2.
Figure 2.
Conceptual model of the relationship between QoL, SWB, and relevant variables. Background variables significantly influencing Meaning/Peace are displayed on the left. In the middle, Meaning/Peace is placed as an intermediate factor influencing QoL and SwL. On the right side the two dependent variables as influenced by Meaning/Peace. Linear regression analysis was used for this conceptual model.
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