1 Department of Medical Oncology, University of Amsterdam and Academic Medical Center, Amsterdam, The Netherlands.
2 Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands.
Palliat Med. 2019 Feb;33(2):221-231. doi: 10.1177/0269216318816005. Epub 2018 Dec 5.
: Diagnosis and treatment of incurable cancer as a life-changing experience evokes difficult existential questions.
: 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.
: 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.
: Adult patients with incurable cancer and a life expectancy ⩾6 months were randomized in a 1:1 ratio to the intervention or control group.
: 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 ( = 0.52, adj. = 0.26) and satisfaction with life ( = 0.61, adj. = 0.37).
: 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.
绝症的诊断和治疗是一种改变生活的经历，会引发艰难的存在主义问题。
结构化反思可以提高患者的生活质量和精神幸福感。我们开发了一种关于生活事件和最终生活目标的访谈模型，并进行了一项随机对照试验，以评估其对生活质量和精神幸福感的影响。
干预组与精神顾问进行了两次咨询。对照组接受常规护理。在基线和基线后 2 和 4 个月时，使用 EORTC QLQ-C15-PAL 和 FACIT-sp 进行评估。采用线性混合模型分析来检验组间随时间的差异。
预期寿命 ⩾6 个月的绝症成年患者被随机分为干预组和对照组，比例为 1:1。
共有来自六家不同医院的 153 名患者入组：干预组 77 名，对照组 76 名。组间随时间的生活质量和精神幸福感没有显著变化。意义/平静的体验被发现对生活质量（ = 0.52，调整后 = 0.26）和对生活的满意度（ = 0.61，调整后 = 0.37）有显著影响。
尽管我们新开发的访谈模型得到了患者的良好评价，但我们未能证明组间生活质量和精神幸福感存在显著差异。未来由精神顾问进行的旨在提高生活质量和精神幸福感的干预措施应侧重于提供意义和宁静的来源。
