Effects of a gratitude intervention on palliative patients and their caregivers: A pilot study
E. Poncin1, M. Bernard1, E. Bovet1, G. D. Borasio1 (1Lausanne)
In the end of life context, family and social relations are the most important contributors to quality of life and meaning in life. Gratitude, an other-oriented emotion and personality trait, also has significant associations with quality of life and spiritual distress for palliative patients. However, gratitude interventions have mostly unfolded in non-clinical settings, and relationship quality has never been investigated as a possible intervention outcome.
This pilot study examined whether performing a gratitude intervention (writing and sharing a gratitude letter) impacts upon the quality of the relationship, quality of life, psychological distress and feeling of burden of palliative patients and their caregivers.
This study applied pre-posttest validated questionnaires on relationship’s quality (Couples Satisfaction Index), quality of life (McGill Quality of Life Scale and Quality of Life in Life-Threatening Illness–Family Carer), psychological distress (Hospital Anxiety and Depression Scale and Brief Symptom Inventory-18) and feeling of burden (Self-Perceived Burden Scale and Burden Scale for Family Caregivers). Semi-structured interviews further explored participants’ experiences of the intervention and other potential effects.
19 patient-caregiver dyads and 12 single patients were included (patients’ mean age= 64; caregivers’= 61). Preliminary quantitative results reveal no effect in patients. By contrast, caregivers underwent a significant reduction in psychological distress (median T0= 11, median T1= 7, p=.026) and depression (median T0= 3, median T1= 1, p= .020). Qualitative analysis of interview data further highlights that 27 out of 30 participants experienced positive intervention effects, in terms of positive emotions (e.g. feeling good, moved and more serene) and improved relationship. One participant reported no effect in interview, and two reported negative effects in the form of negative emotions (anxiety, sadness and fear).
Whilst this study encountered a number of issues (ceiling effect, selection bias, social desirability bias), qualitative analysis shows that the gratitude intervention had positive effects for most participants, promoting positive emotions and, for some, improving relationships. Semi-structured interviews proved key to make sense of patients’ experiences of the intervention and of its effects, beyond pre-determined, quantitatively assessed dimensions.