Meaning-centered pain coping skills training for patients with metastatic cancer: Results of a randomized controlled pilot trial Journal Article


Authors: Winger, J.G.; Kelleher, S. A.; Ramos, K.; Check, D. K.; Yu, J. A.; Powell, V. D.; Lerebours, R.; Olsen, M. K.; Keefe, F. J.; Steinhauser, K. E.; Porter, L. S.; Breitbart, W. S.; Somers, T. J.
Article Title: Meaning-centered pain coping skills training for patients with metastatic cancer: Results of a randomized controlled pilot trial
Abstract: Objective For patients with advanced cancer, pain is a common and debilitating symptom that can negatively impact physical, emotional, and spiritual well-being. This trial examined the feasibility and initial effects of Meaning-Centered Pain Coping Skills Training (MCPC), a cognitive-behavioral pain management intervention with an emphasis on enhancing meaning (i.e., a personal sense of purpose, worth, and significance) and peace. Methods We enrolled 60 adults with stage IV solid tumor cancers and moderate-severe pain between February 2021 and February 2022. Participants were randomized 1:1 to MCPC + usual care or usual care alone. Meaning-Centered Pain Coping Skills Training consisted of four weekly 60-min individual sessions via videoconference or telephone, delivered by a trained therapist using a manualized protocol. Participants completed validated measures of pain severity, pain interference, pain self-efficacy, spiritual well-being (i.e., meaning, peace, and faith), and psychological distress at baseline and 5-week and 10-week follow-ups. Results All feasibility metrics exceeded prespecified benchmarks. Fifty-eight percent of screened patients were eligible, and 69% of eligible patients consented. Of those assigned to MCPC, 93% completed all sessions and 100% of those who completed follow-ups reported using coping skills weekly. Retention was strong at 5-week (85%) and 10-week (78%) follow-ups. Meaning-Centered Pain Coping Skills Training participants reported better scores than control participants across outcome measures, including moderate-to-large sized differences at 10-week follow-up in pain severity (Cohen's d = -0.75 [95% confidence interval: -1.36, -0.14]), pain interference (d = -0.82 [-1.45, -0.20]), and pain self-efficacy (d = 0.74 [0.13, 1.35]). Conclusions MCPC is a highly feasible, engaging, and promising approach for improving pain management in advanced cancer. Future efficacy testing is warranted. Trial registration ClinicalTrials.gov Identifier: NCT04431830, registered 16 June 2020. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Keywords: palliative care; oncology; psycho-oncology; spirituality; pain management; psychosocial intervention; cognitive behavioral therapy; cancer
Journal Title: Psycho-Oncology
Volume: 32
Issue: 7
ISSN: 1057-9249
Publisher: John Wiley & Sons  
Date Published: 2023-07-01
Start Page: 1096
End Page: 1105
ACCESSION: 2023-73829-001
DOI: 10.1002/pon.6151
PROVIDER: Ovid Technologies
PROVIDER: psycinfo
PMCID: PMC10330450
PUBMED: 37173865
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Source: APA PsycInfo
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  1. William S Breitbart
    505 Breitbart