An assisted structured reflection on life events and life goals in advanced cancer patients: Outcomes of a randomized controlled trial (Life InSight Application (LISA) study)

Renske Kruizinga, Michael Scherer-Rath, Johannes B. AM Schilderman, Iris D. Hartog, Jacoba P. M. van der Loos, Hantie P. Kotzé, Anneke M. Westermann, Heinz-Josef Klümpen, Francesco Kortekaas, Cecile Grootscholten, Frans Bossink, Jolanda Schrama, Willem van de Vrande, Natascha A. WP Schrama, Willem Blokland, Filip Y. FL de Vos, Annemieke Kuin, Wim G. Meijer, Martijn G. H. van Oijen, Mirjam A. G. SprangersHanneke W. M. van Laarhoven

Research output: Contribution to journalArticleAcademicpeer-review


Background: Diagnosis and treatment of incurable cancer as a life-changing experience evokes difficult existential questions. Aim: 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. Design: 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. Participants: Adult patients with incurable cancer and a life expectancy ⩾6 months were randomized in a 1:1 ratio to the intervention or control group. Results: 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 (β = 0.52, adj. R 2 = 0.26) and satisfaction with life (β = 0.61, adj. R 2 = 0.37). Conclusion: 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.
Original languageEnglish
Pages (from-to)221-231
Number of pages11
JournalPalliative Medicine
Issue number2
Publication statusPublished - 1 Feb 2019
Externally publishedYes

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