Stöckle Helena S, Haarmann-Doetkotte Sigrid, Bausewein Claudia, Fegg Martin J
Department of Palliative Medicine, Ludwig-Maximilians-University, Marchioninistr. 15, 81377, Munich, Germany.
BMC Palliat Care. 2016 Oct 24;15(1):88. doi: 10.1186/s12904-016-0160-1.
Existential behavioural therapy (EBT) is a recently developed intervention to support informal caregivers of patients in a specialist palliative care unit and was initially established as a six-session group programme. This pilot study aimed to test the feasibility and acceptability of an adapted short-term, individual approach of EBT in preparation for a randomized controlled trial (RCT).
The study was conducted in a prospective, mixed methods design including four quantitiative assessments with embedded qualitative interviews at one assessment. The intervention offered two one-hour therapeutic sessions focusing on (1) mindfulness and (2) existential meaning-in-life as a source of strength provided by a trained psychotherapist. To test the feasibility of the intervention, doubling of the participation rate, compared to the previous group study (13,6 %) as well as an attrition rate of less than 30 % were set as thresholds. To test the acceptability of the intervention, self-rated usefulness of individual aspects of the intervention and the frequency of implementing therapeutic elements by the carers were set as criteria. Acceptability testing also included the number of participants who completed both sessions, where we expected more than 75 % as a criterion for acceptability. Return rates of quantitative questionnaires were set as criteria for the feasibility of data collection (<33 % loss expected within the study period). Qualitative interviews were used to collect additional data on feasibililty and acceptability and to explore potential harms and benefits of the intervention.
44/102 (43,1 %) of eligible informal caregivers agreed to participate in the study. Due to attrition of 13 caregivers (attrition rate: 29,5 %), 31 caregivers were included in the trial. Self-rated usefulness showed sufficiant results for all but one individual aspect. Frequency of implementing therapeutic elements showed wide inter-item as well as inter-participant ranges and decreased over the study period. All participants completed both sessions. Return rates of the questionnaires were within the expected range. According to the interviews, the intervention was associated with several participant-identified benefits. No severe adverse effects were observed.
Findings suggest that the short-term, individual EBT proved feasible and mostly acceptable.
存在主义行为疗法（EBT）是最近开发的一种干预措施，用于支持专科姑息治疗病房中患者的非正式照护者，最初是作为一个六节的团体项目设立的。这项试点研究旨在测试一种经过调整的短期、个体化EBT方法的可行性和可接受性，为随机对照试验（RCT）做准备。
该研究采用前瞻性混合方法设计，包括四次定量评估，并在一次评估中嵌入定性访谈。干预提供了两次一小时的治疗课程，重点关注（1）正念和（2）作为力量源泉的存在主义生活意义，由一名经过培训的心理治疗师提供。为了测试干预的可行性，将参与率比之前的团体研究（13.6%）提高一倍以及损耗率低于30%设定为阈值。为了测试干预的可接受性，将干预各方面的自评有用性以及照护者实施治疗要素的频率设定为标准。可接受性测试还包括完成两节课程的参与者人数，我们期望超过75%作为可接受性的标准。定量问卷的回收率设定为数据收集可行性的标准（研究期间预期损失<33%）。定性访谈用于收集关于可行性和可接受性的额外数据，并探索干预的潜在危害和益处。
102名符合条件的非正式照护者中有44名（43.1%）同意参与研究。由于13名照护者退出（损耗率：29.5%），31名照护者被纳入试验。自评有用性在除一个方面外的所有方面都显示出足够的结果。实施治疗要素的频率在项目间和参与者间差异很大，且在研究期间有所下降。所有参与者都完成了两节课程。问卷回收率在预期范围内。根据访谈，该干预与参与者确定的多项益处相关。未观察到严重不良反应。
研究结果表明，短期、个体化的EBT被证明是可行的，并且大多是可接受的。
