Narrative Interview

Narrative Interview

PEP Topic 
Depression
Description 

A narrative interview is an interview in which the interviewee can tell his or her story and experience and express feelings. This approach is aimed at allowing patients to focus on issues that are of concern to them and reflect on actions that might be helpful to them. Researchers have studied the use of the narrative interview as a treatment for depression in patients with cancer.

Effectiveness Not Established

Research Evidence Summaries

Lloyd-Williams, M., Cobb, M., O'Connor, C., Dunn, L., & Shiels, C. (2012). A pilot randomised controlled trial to reduce suffering and emotional distress in patients with advanced cancer. Journal of Affective Disorders, 148(1), 141–145.

doi:10.1016/j.jad.2012.11.013
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Study Purpose:

To determine if a focused narrative-interview intervention can alleviate symptoms of suffering, anxiety, and depression in patients with advanced cancer

Intervention Characteristics/Basic Study Process:

Patients in a hospice day unit were randomized to one of two groups. In one, patients received the study intervention; in the other, usual care. The intervention was a single focused narrative interview in which a patient was encouraged to discuss his or her perspectives; sense of meaning; sense of suffering; and psychological, physical, and spiritual well-being. The emphasis was on enabling each patient to tell his or her story. Study assessments were done at baseline and at two, four, and eight weeks after the intervention.

Sample Characteristics:

  • The sample was composed of 100 participants.
  • Mean patient age was 66 years. The age range was 31–89 years.
  • Of all participants, 32% were male and 68% were female.
  • All patients had advanced disease, and the sample included various tumor types. Of types of cancer represented in the sample, breast, lung, and colon cancer were the most common.
  • Of all participants, 55% were married or cohabiting; 33.3% had been diagnosed with cancer within the last 12 months; and approximately 33.3% had, before cancer diagnosis, disorders related to depression or stress.

Setting:

  • Single site
  • Outpatient
  • United Kingdom

Phase of Care and Clinical Applications:

  • Phase of care: end-of-life care
  • Clinical applications: eldercare, palliative care

Study Design:

 Randomized controlled trial

Measurement Instruments/Methods:

  • Brief Edinburgh Depression Scale (BEDS)
  • Edmonton Symptom Assessment Scale (ESAS)
     

Results:

Baseline scores indicated, on average, probable depression. At four weeks investigators noted a slight, but nonsignificant improvement in the depression score. Authors noted no other changes or differences between groups.

Conclusions:

As result of narrative interview intervention in a hospice day program, findings did not show any substantial improvement in measures of depression or other symptoms.

Limitations:

  • The study had a small sample size, with fewer than 100 participants.
  • The study had risks of bias due to no blinding and no appropriate attentional control condition.
  • Authors did not describe usual care. Although the authors noted no significant differences as a result of the intervention, authors concluded that the intervention was effective.

Nursing Implications:

Findings do not suggest that narrative interview, used as an intervention for depression and other symptoms, had any effect in this study.


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