Meaning-centered group psychotherapy in Portuguese cancer patients: A pilot exploratory trial.

OBJECTIVE: To describe the feasibility of a meaning-centered group psychotherapy (MCGP) adaptation in a sample of Portuguese cancer patients. METHOD: The study was carried out according to four steps: 1st - Transcultural adaptation and validation (focus groups); 2nd - Preliminary study with MCGP original version (to test its feasibility); 3rd - Adaptation of MCGP original version to a 4-session version (and internal pilot study); and 4th - Pilot exploratory trial (MCGP-4 session version), implemented between January 1, 2018 and December 31, 2019. Inclusion criteria were >18 years, psychological complaints, and difficulty to adapt to cancer. Allocation was according to participants' preference: MCGP vs. care as usual (CAU). Primary outcomes were: MCGP adapted version improved quality of life (QoL) and spiritual well-being; secondary outcomes were improvement of depression, anxiety, and distress. Assessments were done at baseline (T1) and 1 month after (T2), with self-report socio-demographic and clinical questionnaires, Distress Thermometer (DT), McGill Quality of Life Questionnaire (MQOL), Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), Hospital Anxiety and Depression Scale, and its subscales (HADS - HADS-D, HADS-A). RESULTS: In the 1st step, and through focus groups, the manual was reformulated and tested. The preliminary study (2nd step) with MCGP original version showed a high number of dropouts which could jeopardize the study and, after reframing the sessions content, MCGP was adapted to a 4-session version, and its feasibility was tested by an internal pilot study (3rd step). The pilot exploratory trial (4th step) had 91 participants. Most socio-demographic and clinical characteristics between the groups (51: MCGP; 40: CAU) had no statistically significant differences. A comparison between the two groups at T2 showed that the MCGP group scored significantly higher in the general (U = 552.00, P < 0.001), and existential (U = 727.50, P = 0.018) domains and total score (U = 717.50, P = 0.015) of QoL, and CAU presented statistical higher levels in DT (U = 608.50, P = 0.001). Comparing the groups between T1 and T2, the MCGP group had a statistically significant improvement in the general (Z = -3.67, P < 0.001) and psychosocial (Z = -2.89, P = 0.004) domains and total score (Z = -2.71, P = 0.007) of QoL, and a statistically significant decrease in DT (Z = -2.40, P = 0.016). In terms of group effects, the MCGP group presented increased general (b = 1.42, P < 0.001, η2p = 0.179), and support (b = 0.80, P = 0.045, η2p = 0.048) domains and total score (b = 0.81, P = 0.013, η2p = 0.073) of QoL (small to elevated dimensions), and decreased levels of depression (b = -1.14, P = 0.044, η2p = 0.048), and distress (b = -1.38, P = 0.001, η2p = 0.127) (small to medium dimensions), compared with CAU. At T2, participants who attended ≥3 sessions (n = 38) had a statistically significant higher score in the general domain (U = 130.50, P = 0.009) of QoL, comparing with those who attended 1 or 2 sessions (n = 13). SIGNIFICANCE OF RESULTS: This study supports the benefits of an MCGP adapted version in improving QoL and psychologic well-being. More studies are necessary to address the limitations of this pilot exploratory trial, as its small sample size.

Seroprevalence of Hepatitis B Surface Antigen and Occupational Risk Factors Among Health Care Workers in Ekiti State, Nigeria.

INTRODUCTION: Hepatitis B virus (HBV) infection is contracted from blood and other body fluid making healthcare workers (HCW) prone to the infection especially in the developing world. Though it is a vaccine preventable disease, the level of awareness and universal precaution among HCW is low in sub-Saharan African and Asia. AIM: The study was aimed at determining the seroprevalence of hepatitis B surface antigen and occupational risk factors among health care workers at Ekiti State University Teaching Hospital, Ado Ekiti. MATERIALS AND METHODS: One hundred and eighty-seven (187) blood samples were collected from volunteer subjects who comprised of medical doctors, nurses, health attendants, and porters who are in regular contact with blood, body fluids and patients after informed consent. Well detailed and structured questionnaires were used to obtain demographic and other relevant data from the subjects. Blood samples were tested by Enzyme Linked Immunosorbent assay (ELISA) for hepatitis B surface antigen. RESULTS: Out of the 187 HCWs there were 91 males (48.7%) and 96 (51.3%) females. Only 2 participants tested positive to hepatitis B surface antigen with a prevalence of 1.1%. Also, only 30 (16.0%) of the participants had been fully vaccinated against the infection while the remaining 157(84.0%) had no adult vaccination. CONCLUSION: It is obvious that the awareness of the infection is low among the HCWs studied thus the need to incorporate screening for HbsAg and vaccination against HBV into the periodic/pre-employment health intervention programmes by employers to help in the protection of HCWs and control the spread of the virus.