Date of Award

2024

Document Type

Project

College/School

College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Therry Rose Eparwa

Readers

Conor Watters

Abstract

There is considerable evidence that palliative care patients disproportionately experience anxiety, depression, and existential distress related to their chronic illnesses. Additionally, conventional therapies tend to be less effective in the treatment of this patient population. As such, research is being conducted into novel therapies. One of the promising therapies currently under active investigation is ketamine-assisted psychotherapy (KAP) which involves a combination of the administration of the dissociative anesthetic ketamine combined with psychotherapy.

Two clinical trials are being conducted at the Advanced Integrative Medical Sciences (AIMS) Institute in Seattle, WA, the purposes of which are to evaluate integrative care for patients with cancer and/or chronic medical conditions. A subset of the clinical trial participants were selected based upon palliative care criteria and their KAP-related data extracted for analysis. The study described herein used that data to assess the efficacy of KAP in ameliorating anxiety, depression, and psycho-spiritual distress experienced by participants as a consequence of their chronic medical conditions.

The results showed that, following an initial KAP session, there were downward shifts in anxiety and depression as indicated by changes in score on the PHQ-9 and GAD-7 survey instruments. These shifts were moderate in size, with a z(27) = -2.75, 90.3% CI = [-6, 0] point shift in the PHQ-9 score and a z(27) = -4.25, 90.3% CI = [-1, -7] point shift in the GAD-7 score, respectively. They were statistically significant at a fixed analysis effects size value of 0.6 with p-values of 0.033 and 0.011. The NIH-HEALS data showed smaller shifts (z(24) = 3.25, 88.6% CI = [-2, 8]) that were not statistically significant at an effects size of 0.6 and p-value of 0.363. Analysis was also conducted to see if participants’ ACES and Resiliency scores were correlated with changes in the aforementioned instrument scores. Correlation was rejected at a statistically significant level for either ACEs or Resiliency scores for any of the survey instruments.

Caution should be used in interpreting these results, as sample sizes were relatively small and there were significant integrative therapy-based covariates that were not addressed in the analysis, thus precluding any attribution of causality to KAP.

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