Frontiers in public health · 2026
Multimedia-assisted narrative intervention for existential distress among patients with advanced cancer: a one-group pre-post study.
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He Qiaoxue, Huang Xi, Liu Yang, Li Xiaoqi, Huang Lihong, Park In Hye, Guo Yiqiang, Chen Yingchun
Аннотация
PURPOSE: Patients with advanced cancer often experience challenges related to life meaning, coping confidence, and death-related concerns, which may impair quality of life. This preliminary one-group quasi-experimental pre-post study examined whether meaning in life, terminal self-efficacy, and death anxiety changed after a multimedia-assisted narrative psychosocial intervention. The uncontrolled design was intended to identify preliminary within-participant signals and cannot establish intervention efficacy.
METHODS: A one-group quasi-experimental pre-post study was conducted in three hospice care facilities. Of 50 recruited patients, 43 completed the 4-week program and post-intervention assessment. The intervention integrated weekly group storytelling sessions, individual interviews, daily educational dissemination, multimedia-supported reflection, and structured legacy-oriented activities. Outcomes were assessed using validated scales and analyzed with paired-samples t-tests, mean differences, 95% confidence intervals, Cohen's dz, and Holm-adjusted P values.
RESULTS: Meaning in life increased from 2.28 ± 0.65 to 2.70 ± 0.52 (mean difference = 0.42, 95% CI 0.33 to 0.51, dz = 1.49), and terminal self-efficacy increased from 2.38 ± 0.58 to 2.88 ± 0.47 (mean difference = 0.50, 95% CI 0.40 to 0.59, dz = 1.62). After scale-keying the T-DAS scores so that higher scores indicated greater death anxiety, death anxiety decreased from 3.11 ± 0.27 to 2.97 ± 0.29 (mean difference = -0.13, 95% CI -0.22 to -0.05, dz = -0.49). All Holm-adjusted P values for the three primary outcomes were < 0.01.
CONCLUSION: This preliminary one-group pre-post study observed favorable changes in meaning in life, terminal self-efficacy, and death anxiety following a multimedia-assisted narrative intervention. Because the study lacked a control group and used a small convenience sample, the findings should be interpreted as hypothesis-generating rather than evidence of intervention efficacy.
METHODS: A one-group quasi-experimental pre-post study was conducted in three hospice care facilities. Of 50 recruited patients, 43 completed the 4-week program and post-intervention assessment. The intervention integrated weekly group storytelling sessions, individual interviews, daily educational dissemination, multimedia-supported reflection, and structured legacy-oriented activities. Outcomes were assessed using validated scales and analyzed with paired-samples t-tests, mean differences, 95% confidence intervals, Cohen's dz, and Holm-adjusted P values.
RESULTS: Meaning in life increased from 2.28 ± 0.65 to 2.70 ± 0.52 (mean difference = 0.42, 95% CI 0.33 to 0.51, dz = 1.49), and terminal self-efficacy increased from 2.38 ± 0.58 to 2.88 ± 0.47 (mean difference = 0.50, 95% CI 0.40 to 0.59, dz = 1.62). After scale-keying the T-DAS scores so that higher scores indicated greater death anxiety, death anxiety decreased from 3.11 ± 0.27 to 2.97 ± 0.29 (mean difference = -0.13, 95% CI -0.22 to -0.05, dz = -0.49). All Holm-adjusted P values for the three primary outcomes were < 0.01.
CONCLUSION: This preliminary one-group pre-post study observed favorable changes in meaning in life, terminal self-efficacy, and death anxiety following a multimedia-assisted narrative intervention. Because the study lacked a control group and used a small convenience sample, the findings should be interpreted as hypothesis-generating rather than evidence of intervention efficacy.