Palliative and Supportive Care

Original Article

A cognitive–existential intervention to improve existential and global quality of life in cancer patients: A pilot study

Pierre Gagnona1a2a3a4 c1, Lise Filliona3a4a5, Marie-Anik Robitaillea3a4, Michèle Girarda6, François Tardifa3a4, Jean-Philippe Cochranea3a4a7, Joanie Le Moignan Moreaua3a4 and William Breitbarta8

a1 Faculty of Pharmacy, Laval University, Québec City, Quebec, Canada

a2 Department of Psychiatry, CHU de Québec – L'Hôtel-Dieu de Québec, Québec City, Quebec, Canada

a3 Équipe de recherche Michel-Sarrazin en Oncologie psychosociale et Soins palliatifs, Research Center, Oncology Division, CHU de Québec – L'Hôtel-Dieu de Québec, Québec City, Quebec, Canada

a4 Laval University Cancer Research Center, Québec City, Quebec, Canada

a5 Faculty of Nursing, Laval University, Québec City, Quebec, Canada

a6 Department of Palliative Care, CHU de Québec – L'Hôtel-Dieu de Québec, Québec City, Quebec, Canada

a7 School of Psychology, Laval University, Québec city, Quebec, Canada

a8 Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York

Abstract

Objective: We developed a specific cognitive–existential intervention to improve existential distress in nonmetastatic cancer patients. The present study reports the feasibility of implementing and evaluating this intervention, which involved 12 weekly sessions in both individual and group formats, and explores the efficacy of the intervention on existential and global quality of life (QoL) measures.

Method: Some 33 nonmetastatic cancer patients were randomized between the group intervention, the individual intervention, and the usual condition of care. Evaluation of the intervention on the existential and global QoL of patients was performed using the existential well-being subscale and the global scale of the McGill Quality of Life (MQoL) Questionnaire.

Results: All participants agreed that their participation in the program helped them deal with their illness and their personal life. Some 88.9% of participants agreed that this program should be proposed for all cancer patients, and 94.5% agreed that this intervention helped them to reflect on the meaning of their life. At post-intervention, both existential and psychological QoL improved in the group intervention versus usual care (p = 0.086 and 0.077, respectively). At the three-month follow-up, global and psychological QoL improved in the individual intervention versus usual care (p = 0.056 and 0.047, respectively).

Significance of results: This pilot study confirms the relevance of the intervention and the feasibility of the recruitment and randomization processes. The data strongly suggest a potential efficacy of the intervention for existential and global quality of life, which will have to be confirmed in a larger study.

(Received October 30 2013)

(Accepted May 14 2014)

Keywords

  • Cognitive–existential intervention;
  • Existential;
  • Quality of life;
  • Cancer

Correspondence

c1 Address correspondence and reprint requests to: Pierre Gagnon, CHU de Québec – L'Hôtel-Dieu de Québec, 11 Côte du Palais, Quebec City, Province of Quebec, Canada, G1R 2J6. E-mail: pierre.gagnon@crhdq.ulaval.ca