Volume 8, Issue 4, August 2020, Page: 100-107
Cultural Adaptation and Open Pilot of Meaning-Centered Psychotherapy for Puerto Rican Patients with Advanced Cancer
Normarie Torres-Blasco, Ponce Research Institute, School of Behavioural and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
Eida Castro-Figuero, Ponce Research Institute, School of Behavioural and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico; Department of Psychiatry, School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico
Olga Garduño-Ortega, Department of Psychiatry and Behavioural Sciences, Memorial Sloan Kettering Cancer Center, New York, United States
Rosario Costas-Muñiz, Department of Psychiatry and Behavioural Sciences, Memorial Sloan Kettering Cancer Center, New York, United States; Department of Psychiatry, Weill Cornell Medical College, New York, United States
Received: Jun. 29, 2020;       Accepted: Jul. 15, 2020;       Published: Aug. 25, 2020
DOI: 10.11648/j.sjedu.20200804.12      View  152      Downloads  65
Abstract
In Puerto Rico, cancer incidence increases significantly, and is accompanied with a greater risk of experiencing high levels of depressive symptoms, emotional distress, and reduced quality of life when compared to other minority ethnic groups. Studies suggest that interventions to attend distress in Latino patient population would benefit from including components that seek to improve patients' spiritual well-being. The purpose of this study is to identify the level of comprehension and acceptance of Meaning-Centered Psychotherapy (MCP) concepts. A mixed method design was conducted with in-depth interviews and open pilot data. A total of nine participants with advanced or metastatic cancer were sampled from an Oncology Clinic in the south of Puerto Rico. Six semi-structured interviews and six ethnographic notes with audiotape sessions were selected and transcribed. All material was analyzed, resulting in a sample of six semi-structured interview and six ethnographic note peer sessions. Patients showed low comprehension of the MCP concepts of meaning, the finite, and legacy. Patients showed low acceptance of death and its related concepts. They also reported high acceptance of integrating family members to their therapy. In order to tailor the intervention and improve comprehension, the content should include examples, shorter questions, and brief definitions. Additionally, there is a need to address death and its related concepts in end of life.
Keywords
Puerto Ricans, Cultural Adaptation, Advanced Cancer, Meaning Centered
To cite this article
Normarie Torres-Blasco, Eida Castro-Figuero, Olga Garduño-Ortega, Rosario Costas-Muñiz, Cultural Adaptation and Open Pilot of Meaning-Centered Psychotherapy for Puerto Rican Patients with Advanced Cancer, Science Journal of Education. Vol. 8, No. 4, 2020, pp. 100-107. doi: 10.11648/j.sjedu.20200804.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Bishaw A, Fontenot K. Poverty: 2012 and 2013, American community survey briefs. Washington, DC: US Census Bureau. 2014.
[2]
O’Neil ME, Henley SJ, Singh SD, Wilson RJ, Ortiz-Ortiz KJ, Ríos NP, Cintrón CR, Luna GT, Zegarra DE, Ryerson AB. Invasive Cancer Incidence—Puerto Rico, 2007–2011. MMWR. Morbidity and mortality weekly report. 2015 Apr 17; 64 (14): 389.
[3]
Costas R, Gany F. Depressive symptoms in a sample of Afro-Caribbean and Latino immigrant cancer patients: a comparative analysis. Support Care Cancer. 2013; 21 (9): 2461-2468.
[4]
Luckett T, Goldstein D, Butow PN, et al. Psychological morbidity and quality of life of ethnic minority patients with cancer: a systematic review and meta-analysis. Lancet Oncol. 2017; 12 (13): 1240-1248. doi: 10.1016/S1470-2045(11)70212-1.
[5]
Breitbart W, Poppito S, Rosenfeld B, Vickers AJ, Li Y, Abbey J, Olden M, Pessin H, Lichtenthal W, Sjoberg D, Cassileth BR. Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. Journal of Clinical Oncology. 2012 Apr 20; 30 (12): 1304.
[6]
Lo C, Hales S, Jung J, Chiu A, Panday T, Rydall A, Nissim R, Malfitano C, Petricone-Westwood D, Zimmermann C, Rodin G. Managing Cancer And Living Meaningfully (CALM): phase 2 trial of a brief individual psychotherapy for patients with advanced cancer. Palliative medicine. 2014 Mar; 28 (3): 234-42.
[7]
Northouse LL, Mood DW, Schafenacker A, Kalemkerian G, Zalupski M, LoRusso P, Hayes DF, Hussain M, Ruckdeschel J, Fendrick AM, Trask PC. Randomized clinical trial of a brief and extensive dyadic intervention for advanced cancer patients and their family caregivers. Psycho-Oncology. 2013 Mar; 22 (3): 555-63.
[8]
Liossi C, White P. Efficacy of clinical hypnosis in the enhancement of quality of life of terminally ill cancer patients. Contemporary Hypnosis. 2001 Sep; 18 (3): 145-60.
[9]
do Carmo TM, Paiva BS, de Oliveira CZ, de Angelis Nascimento MS, Paiva CE. The feasibility and benefit of a brief psychosocial intervention in addition to early palliative care in patients with advanced cancer to reduce depressive symptoms: a pilot randomized controlled clinical trial. BMC cancer. 2017 Dec; 17 (1): 564.
[10]
Prescott AT, Hull JG, Dionne-Odom JN, Tosteson TD, Lyons KD, Li Z, Li Z, Dragnev KH, Hegel MT, Steinhauser KE, Ahles TA. The role of a palliative care intervention in moderating the relationship between depression and survival among individuals with advanced cancer. Health Psychology. 2017 Dec; 36 (12): 1140.
[11]
Triplett DP, LeBrett WG, Bryant AK, Bruggeman AR, Matsuno RK, Hwang L, Boero IJ, Roeland EJ, Yeung HN, Murphy JD. Effect of palliative care on aggressiveness of end-of-life care among patients with advanced cancer. Journal of oncology practice. 2017 Aug 22; 13 (9): e760-9.
[12]
Nottelmann L, Groenvold M, Vejlgaard TB, Petersen MA, Jensen LH. A parallel-group randomized clinical trial of individually tailored, multidisciplinary, palliative rehabilitation for patients with newly diagnosed advanced cancer: the Pal-Rehab study protocol. BMC cancer. 2017 Dec; 17 (1): 560.
[13]
Nipp RD, Greer JA, El-Jawahri A, Moran SM, Traeger L, Jacobs JM, Jacobsen JC, Gallagher ER, Park ER, Ryan DP, Jackson VA. Coping and Prognostic Awareness in Patients With Advanced Cancer. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2017 Aug; 35 (22): 2551-7.
[14]
Hoek PD, Schers HJ, Bronkhorst EM, Vissers KC, Hasselaar JG. The effect of weekly specialist palliative care teleconsultations in patients with advanced cancer–a randomized clinical trial. BMC medicine. 2017 Dec; 15 (1): 119.
[15]
Epstein AS, O’Reilly EM, Shuk E, Breitbart W, Shah MA, Ly M, Tayler R, Volandes AE. Development of an advance care planning paradigm for advanced cancer: person-centered oncologic care and choices (P-COCC). Psycho-oncology. 2017 Jun; 26 (6): 866.
[16]
Kissane DW, Zaider TI, Li Y, Hichenberg S, Schuler T, Lederberg M, Lavelle L, Loeb R, Del Gaudio F. Randomized controlled trial of family therapy in advanced cancer continued into bereavement. Journal of clinical oncology. 2016 Jun 1; 34 (16): 1921.
[17]
Breitbart W, Pessin H, Rosenfeld B, Applebaum AJ, Lichtenthal WG, Li Y, Saracino RM, Marziliano AM, Masterson M, Tobias K, Fenn N. Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: A randomized controlled trial in patients with advanced cancer. Cancer. 2018 Aug 1; 124 (15): 3231-9.
[18]
Greer JA, Jacobs JM, El-Jawahri A, Nipp RD, Gallagher ER, Pirl WF, Park ER, Muzikansky A, Jacobsen JC, Jackson VA, Temel JS. Role of Patient Coping Strategies in Understanding the Effects of Early Palliative Care on Quality of Life and Mood. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2018 Jan; 36 (1): 53-60.
[19]
Serfaty M, King M, Nazareth I, Tookman A, Wood J, Gola A, Aspden T, Mannix K, Davis S, Moorey S, Jones L. The clinical and cost effectiveness of cognitive behavioural therapy plus treatment as usual for the treatment of depression in advanced cancer (CanTalk): study protocol for a randomised controlled trial. Trials. 2016 Dec; 17 (1): 113.
[20]
Chambers SK, Occhipinti S, Foley E, Clutton S, Legg M, Berry M, Stockler MR, Frydenberg M, Gardiner RA, Lepore SJ, Davis ID. Mindfulness-based cognitive therapy in advanced prostate cancer: a randomized controlled trial. Journal of Clinical Oncology. 2016 Nov 21; 35 (3): 291-7.
[21]
Feldstain A, Lebel S, Chasen MR. An interdisciplinary palliative rehabilitation intervention bolstering general self-efficacy to attenuate symptoms of depression in patients living with advanced cancer. Supportive Care in Cancer. 2016 Jan 1; 24 (1): 109-17.
[22]
Rosenfeld B, Cham H, Pessin H, Breitbart W. Why is Meaning-Centered Group Psychotherapy (MCGP) effective? Enhanced sense of meaning as the mechanism of change for advanced cancer patients. Psycho-Oncology. 2018 Feb; 27 (2): 654-60.
[23]
Hunter-Hernández M, Costas-Muñíz R, Gany F. Missed opportunity: spirituality as a bridge to resilience in Latinos with cancer. Journal of religion and health. 2015 Dec 1; 54 (6): 2367-75.
[24]
Page AE, Adler NE, editors. Cancer care for the whole patient: Meeting psychosocial health needs. National Academies Press; 2008 Apr 19.
[25]
Carlson LE, Waller A, Mitchell AJ. Screening for distress and unmet needs in patients with cancer: review and recommendations. Journal of Clinical Oncology. 2012 Mar 12; 30 (11): 1160-77.
[26]
Molina Y, Yi JC, Martinez-Gutierrez J, Reding KW, Yi-Frazier JP, Rosenberg AR. Resilience among patients across the cancer continuum: diverse perspectives. Clin J Oncol Nurs. 2014; 18 (1): 93–101. doi: 10.1188/14.CJON.93-101.
[27]
Yanez B, Thompson EH, Stanton AL. Quality of life among Latina breast cancer patients: a systematic review of the literature. Journal of Cancer Survivorship. 2011 Jun 1; 5 (2): 191-207.
[28]
Lee MS, Tyson DM, Gonzalez BD, Small BJ, Lechner SC, Antoni MH, Vinard A, Krause M, Meade C, Jacobsen PB. Anxiety and depression in Spanish-speaking Latina cancer patients prior to starting chemotherapy. Psycho-oncology. 2018 Jan; 27 (1): 333-8.
[29]
Bai M, Lazenby M. A systematic review of associations between spiritual well-being and quality of life at the scale and factor levels in studies among patients with cancer. Journal of palliative medicine. 2015 Mar 1; 18 (3): 286-98.
[30]
Breitbart W, Rosenfeld B, Gibson C, Pessin H, Poppito S, Nelson C, Tomarken A, Timm AK, Berg A, Jacobson C, Sorger B. Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psycho-oncology. 2010 Jan 1; 19 (1): 21-8.
[31]
Breitbart W, Rosenfeld B, Pessin H, Applebaum A, Kulikowski J, Lichtenthal WG. Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. Journal of Clinical Oncology. 2015 Mar 1; 33 (7): 749.
[32]
Bernal G, Bonilla J, Bellido C. Ecological validity and cultural sensitivity for outcome research: Issues for the cultural adaptation and development of psychosocial treatments with Hispanics. Journal of abnormal child psychology. 1995 Feb 1; 23 (1): 67-82.
[33]
Bernal G, Sáez-Santiago E. Culturally centered psychosocial interventions. Journal of Community Psychology. 2006 Mar; 34 (2): 121-32.
[34]
Bernal GE, Domenech Rodríguez MM. Cultural adaptations: Tools for evidence-based practice with diverse populations. American Psychological Association; 2012.
[35]
Rosselló J, Bernal G. The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents. Journal of Consulting and clinical Psychology. 1999 Oct; 67 (5): 734.
[36]
Matos M, Torres R, Santiago R, Jurado M, Rodríguez IX. Adaptation of parent–child interaction therapy for Puerto Rican families: A preliminary study. Family Process. 2006 Jun; 45 (2): 205-22.
[37]
Creswell JW, Klassen AC, Plano Clark VL, Smith KC. Best practices for mixed methods research in the health sciences. Bethesda (Maryland): National Institutes of Health. 2011 Aug 1; 2013: 541-5.
[38]
Almanza-Muñoz JD, Juárez IR, Pérez S. Traducción, adaptación y validación del Termómetro de Distrés en una muestra de pacientes mexicanos con cáncer. Revista De Sanidad Militar. 2008; 62 (5): 209-17.
[39]
Murphy PE, Canada AL, Fitchett G, Stein K, Portier K, Crammer C, Peterman AH. An examination of the 3-factor model and structural invariance across racial/ethnic groups for the FACIT-Sp: a report from the American Cancer Society's Study of Cancer Survivors-II (SCS-II). Psycho-Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer. 2010 Mar; 19 (3): 264-72.
[40]
Dapueto JJ, Francolino C, Servente L, Chang CH, Gotta I, Levin R, del Carmen Abreu M. Evaluation of the Functional Assessment of Cancer Therapy-General (FACT-G) Spanish Version 4 in South America: classic psychometric and item response theory analyses. Health and quality of life outcomes. 2003 Dec; 1 (1): 32.
[41]
Schaffler J, Leung K, Tremblay S, Merdsoy L, Belzile E, Lambrou A, Lambert SD. The effectiveness of self-management interventions for individuals with low health literacy and/or low income: a descriptive systematic review. Journal of general internal medicine. 2018 Apr 1; 33 (4): 510-23.
[42]
Thorn BE, Day MA, Burns J, Kuhajda MC, Gaskins SW, Sweeney K, McConley R, Ward LC, Cabbil C. Randomized trial of group cognitive behavioral therapy compared with a pain education control for low-literacy rural people with chronic pain. Pain. 2011 Dec 1; 152 (12): 2710-20.
[43]
Davis TC, Williams MV, Marin E, Parker RM, Glass J. Health literacy and cancer communication. CA: a cancer journal for clinicians. 2002 May; 52 (3): 134-49.
[44]
Wolf MS, Davis TC, Osborn CY, Skripkauskas S, Bennett CL, Makoul G. Literacy, self-efficacy, and HIV medication adherence. Patient education and counseling. 2007 Feb 1; 65 (2): 253-60.
[45]
Biedrzycki BA. Factors and outcomes of decision making for cancer clinical triaparticipation. InOncology nursing forum 2011 Sep 1 (Vol. 38, No. 5).
[46]
Applebaum AJ, Breitbart W. Care for the cancer caregiver: a systematic review. Palliative & supportive care. 2013 Jun; 11 (3): 231-52.
[47]
Applebaum AJ, Kulikowski JR, Breitbart W. Meaning-centered psychotherapy for cancer caregivers (MCP-C): Rationale and overview. Palliative & supportive care. 2015 Dec; 13 (6): 1631-41.
[48]
Lim SM, Kim HC, Lee S. Psychosocial impact of cancer patients on their family members. Cancer research and treatment: official journal of Korean Cancer Association. 2013 Sep; 45 (3): 226.
[49]
Peppercorn JM, Smith TJ, Helft PR, DeBono DJ, Berry SR, Wollins DS, Hayes DM, Von Roenn JH, Schnipper LE. American society of clinical oncology statement: toward individualized care for patients with advanced cancer. J Clin Oncol. 2011 Feb 20; 29 (6): 755-60.
[50]
Harding R, Higginson IJ. What is the best way to help caregivers in cancer and palliative care? A systematic literature review of interventions and their effectiveness. Palliative medicine. 2003 Jan; 17 (1): 63-74.
[51]
McCorkle R, Siefert ML, Dowd MF, Robinson JP, Pickett M. Effects of advanced practice nursing on patient and spouse depressive symptoms, sexual function, and marital interaction after radical prostatectomy. Urologic Nursing. 2007 Feb 1; 27 (1): 65.
[52]
Northouse LL, Mood D, Templin T, Mellon S, George T. Couples' patterns of adjustment to colon cancer. Social science & medicine. 2000 Jan 1; 50 (2): 271-84.
[53]
Powell RA, Mwangi-Powell FN, Radbruch L, Yamey G, Krakauer EL, Spence D, Ali Z, Baxter S, De Lima L, Xhixha A, Rajagopal MR. Putting palliative care on the global health agenda. The Lancet Oncology. 2015 Feb 1; 16 (2): 131-3.
[54]
Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM, Ferrell BR, Loscalzo M, Meier DE, Paice JA, Peppercorn JM. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. Journal of clinical oncology. 2012 Feb 6; 30 (8): 880-7.
[55]
Levit LA, Balogh E, Nass SJ, Ganz P, editors. Delivering high-quality cancer care: charting a new course for a system in crisis. Washington, DC: National Academies Press; 2013 Sep.
Browse journals by subject