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.

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

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.

• 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.

• Single site
• Outpatient
• United Kingdom

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

 Randomized controlled trial

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

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.

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.

• 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.

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