Supportive-Affective Group Experience for Persons with Life-Threatening Illness: Reducing Spiritual, Psychological, and Death-Related Distress in Dying Patients

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Abstract
Background: Attention to psycho-socio-spiritual needs is considered critical by patients with life-threatening illnesses and their caregivers. Palliative care interventions that address these needs—particularly spirituality—are lacking. Objective: To evaluate the effects of an innovative program to address psycho-socio-spiritual needs in patients with life-threatening illnesses. Design: A group intervention entitled Life-Threatening Illness Supportive-Affective Group Experience (LTI-SAGE) was developed for reducing patient spiritual, emotional, and deathrelated distress. Setting/subjects: African American and Caucasian patients (n = 69) from two hospitals in St. Louis, Missouri, with life-threatening medical conditions (cancer; human immunodeficiency virus/acquired immune deficiency syndrome [HIV/AIDS]; geriatric frailty; liver, kidney, pulmonary, or cardiovascular disease) were randomly assigned to intervention or control groups. Intervention patients participated in a maximum of 12 LTI-SAGE groups over a 12-month period. Control patients received standard care. Measurements: Outcome measures were depression symptoms, anxiety, spiritual well-being, and death-related emotional distress. Results: After attrition, 51 (73.9%) patients completed the trial. At the end of the trial, after factoring in compliance, intervention patients had significantly fewer depression symptoms and death-related feelings of meaninglessness and significantly better spiritual well-being than did control patients. Conclusions: The use of the LTI-SAGE model for enhancing the end-of-life illness experience is promising.