EXISTENTIAL HEALING AT THE END OF LIFE: A CULTURALLY ADAPTED INTERVENTION FOR TURKISH WOMEN WITH ADVANCED CANCER

Abstract

This quasi experimental study assessed the effectiveness of a 12 week Existential Based Cognitive Therapy (EBCT) program for women with metastatic cancer in Türkiye. Sixty participants were allocated to either the intervention or waitlist control group. The intervention integrated meaning centered exercises, symbolic expression, self compassion, and acceptance strategies within culturally congruent therapeutic frameworks. Outcomes were evaluated using validated Turkish versions of the Ryff Psychological Well Being Scale, FACIT Sp 12, and Beck Hopelessness Scale at baseline, mid intervention, and post intervention. Results showed that the EBCT group experienced statistically and clinically significant improvements across all outcome measures—particularly in autonomy, purpose in life, spiritual meaning, and reductions in hopelessness—while the control group displayed no meaningful change. Thematic analysis of anonymized session reflections provided illustrative context for participants’ experiences, highlighting culturally embedded meanings of illness, gendered caregiving roles, and spiritual coping frameworks. Findings suggest that EBCT, when culturally adapted to integrate existential themes with local meaning systems, can promote psychological and spiritual well being among women confronting life limiting illness. This study contributes to death studies literature by demonstrating how existentially grounded psychosocial interventions may support adaptive functioning in non Western settings confronting the existential challenges of advanced cancer.

Keywords

• psycho-oncology
• existential therapy
• advanced cancer
• ; culture
• Turkish women
• spirituality

YAŞAM SONUNDA VAROLUŞSAL İYİLEŞME: İLERİ EVRE KANSERLİ TÜRK KADINLAR İÇİN KÜLTÜREL OLARAK UYARLANMIŞ BİR MÜDAHALE

Abstract

Bu yarı deneysel çalışma, Türkiye'de metastatik kanserli kadınlar için 12 haftalık Varoluşsal Temelli Bilişsel Terapi (EBCT) programının etkinliğini değerlendirdi. Altmış katılımcı, müdahale grubu veya bekleme listesi kontrol grubuna ayrıldı. Müdahale, kültürel açıdan uygun terapötik çerçeveler içinde anlam odaklı egzersizler, sembolik ifade, öz şefkat ve kabul stratejilerini birleştirdi. Sonuçlar, Ryff Psikolojik İyi Olma Ölçeği, FACIT Sp 12 ve Beck Umutsuzluk Ölçeği'nin doğrulanmış Türkçe versiyonları kullanılarak başlangıçta, müdahalenin ortasında ve müdahale sonrasında değerlendirildi. Sonuçlar, EBCT grubunun tüm sonuç ölçümlerinde, özellikle özerklik, yaşam amacı, manevi anlam ve umutsuzlukta azalma açısından istatistiksel ve klinik olarak anlamlı iyileşmeler yaşadığını gösterirken, kontrol grubunda anlamlı bir değişiklik görülmedi. Anonimleştirilmiş seans yansımalarının tematik analizi, katılımcıların deneyimlerine açıklayıcı bir bağlam sağladı ve hastalığın kültürel olarak yerleşik anlamlarını, cinsiyete dayalı bakım rollerini ve manevi başa çıkma çerçevelerini vurguladı. Bulgular, EBCT'nin, varoluşsal temaları yerel anlam sistemleriyle bütünleştirmek için kültürel olarak uyarlanması durumunda, yaşamı sınırlayan hastalıklarla karşı karşıya olan kadınlar arasında psikolojik ve manevi refahı teşvik edebileceğini göstermektedir. Bu çalışma, varoluşsal temelli psikososyal müdahalelerin, ileri evre kanserin varoluşsal zorluklarıyla karşı karşıya olan Batı dışı ortamlarda uyumsal işlevselliği nasıl destekleyebileceğini göstererek ölüm çalışmaları literatürüne katkıda bulunmaktadır.

Keywords

• psiko-onkoloji; varoluşsal terapi; ileri evre kanser; kültür; Türk kadınları; maneviyat
• psiko-onkoloji
• varoluşsal terapi
• ileri evre kanser
• kültür

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