A randomized controlled trial on the efficacy of life review therapy targeting incurably ill cancer patients: do their informal caregivers benefit?

Abstract

Purpose Investigate whether Life Review Therapy and Memory Specificity Training (LRT-MST) targeting incurably ill cancer patients may also have a beneficial effect on caregiving burden, symptoms of anxiety and depression, and posttraumatic growth of the informal caregivers. Methods Data was collected in the context of a randomized controlled trial (RCT) (secondary analyses) on the effect of LRT-MST among incurably cancer patients. Informal caregivers of participating patients were asked to complete outcome measures at baseline (T0), post-intervention (T1), and 1-month follow-up (T2): caregiver burden (caregivers reaction assessment scale (CRA)), symptoms of anxiety and depression (hospital anxiety and depression scale), and posttraumatic growth (posttraumatic growth inventory). Linear mixed models (intention to treat) were used to assess group differences in changes over time. Effect size and independent samples t tests were used to assess group differences at T1 and T2. Results In total, 64 caregivers participated. At baseline, 56% of the caregivers experienced anxiety and 30% depression. No significant effect was found on these symptoms nor on posttraumatic growth or most aspects of caregiver burden. There was a significant effect of LRT-MST on the course of self-esteem (subscale CRA) (p = 0.013). Effect size was moderate postintervention (ES = − 0.38, p = 0.23) and at 3-month follow-up (ES = 0.53, p = 0.083). Conclusions Many caregivers of incurably ill cancer patients experience symptoms of anxiety and depression. LRT-MST does not improve symptoms of depression and anxiety, negative aspects of caregiver burden, or posttraumatic growth. LRT-MST may have a protective effect on self-esteem of informal caregivers (positive aspect of caregiver burden). Trial registration number Netherlands Trial Register (NTR 2256), registered on 23-3-2010.

Interventions to improve outcomes for caregivers of patients with advanced cancer: a meta-analysis

“…Of the 49 included trials, 34 (69%) included caregivers of patients with mixed solid tumor malignancies, 6 (12%) only lung cancer ( 42 , 59-62 , 69 , 72 , 81 ), 1 (2%) breast cancer ( 74 ), 1 (2%) pancreatic cancer ( 94 ), 1 (2%) high-grade glioma ( 43 ), 2 (4%) gastrointestinal cancers ( 73 , 76 ), and 4 (8%) hematological malignancies ( 44 , 49 , 80 , 84 ). A total of 32 (65%) trials were conducted in an outpatient setting ( 42-45 , 53-57 , 59-77 , 81-83 , 85 , 87 , 88 , 91 , 92 , 94 ), 5 (10%) in a home setting ( 46-48 , 51 , 78 , 79 , 86 ), 4 (8%) in an inpatient setting ( 41 , 80 , 84 , 96 ), and 8 (16%) in mixed settings ( 49 , 50 , 52 , 58 , 89 , 90 , 93 , 95 ). Of the trials, 28 were conducted in the United States ( 44 , 45 , 49-51 , 53 , 55 , 59-68 , 71-77 , 83-86 , 89 , 92 , 94 , 95 ); 4 each in Australia ( 46-48 , 52 , …”

“…A total of 32 (65%) trials were conducted in an outpatient setting ( 42-45 , 53-57 , 59-77 , 81-83 , 85 , 87 , 88 , 91 , 92 , 94 ), 5 (10%) in a home setting ( 46-48 , 51 , 78 , 79 , 86 ), 4 (8%) in an inpatient setting ( 41 , 80 , 84 , 96 ), and 8 (16%) in mixed settings ( 49 , 50 , 52 , 58 , 89 , 90 , 93 , 95 ). Of the trials, 28 were conducted in the United States ( 44 , 45 , 49-51 , 53 , 55 , 59-68 , 71-77 , 83-86 , 89 , 92 , 94 , 95 ); 4 each in Australia ( 46-48 , 52 , 87 , 88 ) and China ( 69 , 80 , 81 , 96 ); 3 in Canada ( 42 , 70 , 91 ); 2 each in the United Kingdom ( 54 , 82 ), Netherlands ( 43 , 90 ), and Denmark ( 58 , 78 , 79 ); and 1 each in Colombia ( 41 …”

“…A total of 42 (86%) trials compared 1 intervention to usual care ( 42-46 , 49 , 50 , 52-56 , 58 , 59 , 63-72 , 74 , 75 , 77-96 ), 2 (4%) compared 2 interventions to usual care ( 47 , 48 , 51 ), and 5 (10%) compared 2 or more interventions without a usual care arm ( 41 , 57 , 60-62 , 73 , 76 ). For most trials reporting on proportion of spousal caregivers, more than 50% of participants were patients’ spouses (31 of 36, 86%) ( 42 , 44-49 , 52-55 , 58 , 59 , 63-66 , 68-73 , 75-77 , 83-85 , 90-94 ); for most reporting on caregiver sex, more than 60% were female caregivers (30 of 42, 71%) ( 41-51 , 54 , 55 , 57-59 , 65-69 , 73 , 76 , 78 , 79 , 83-86 , 90-93 ); and for most conducted in the United States and western Europe reporting on race, more than 70% of caregivers were White or Caucasian (15 of 18, 83%) ( 44 , 45 , 54 , 55 , 65-67 , 71-73 , 75 , 76 , 84 , 85 , 92 , 94 ). Other aspects of the study design and outcomes are reported in Supplementary Tables 1-3 (available online).…”

“…Anxiety was assessed in 21 trials: 4 were at low risk of bias ( 42 , 44 , 84 , 85 ), 3 had some concerns ( 55 , 59 , 63 , 64 ), and 14 were at high risk ( 46 , 49 , 52 , 53 , 57 , 58 , 73 , 80-82 , 86 , 90 , 94 , 96 ). Eight trials had interventions directed at caregivers ( 42 , 44 , 46 , 49 , 52 , 53 , 55 , 57 ), 6 at the patient–caregiver dyad ( 58 , 59 , 63 , 64 , 73 , 80 , 81 ), and 7 at patients and/or their families ( 82 , 84-86 , 90 , 94 , 96 ).…”

Effects of Reminiscence Therapy combined with Memory Specificity Training (RT-MeST) on depressive symptoms in older adults: A Randomized Controlled Trial Protocol

“…Currently, reminiscence therapy combined with memory speci c training is mainly used in the psychological treatment of cancer patients in palliative care, and its effectiveness needs further validation, as randomized controlled trials Life Review Therapy combined with Memory Speci city Training (LRT-MST) by Gitta Kleijn showed that no signi cant differences were found between the two groups for anxiety, depression, quality of life and autobiographical memory in cancer patients (38,39). however, other studies have shown that reminiscence therapy based on autobiographical memory training can be used in future studies to investigate available, cost-effective, low-intensity treatment options for patients experiencing mood disorders (40,41), and therefore further investigation of this therapy is warranted.…”