Abbreviated dignity therapy for adults with advanced-stage cancer and their family caregivers: Qualitative analysis of a pilot study

Beck, Adrienne; Cottingham, Ann H.; Stutz, Patrick V.; Gruber, Rachel; Bernat, Jennifer K.; Helft, Paul R.; Wilhelm, Laura; Schmidt, Klaus; Stout, Madison E.; Willard, Claire A.; Johns, Shelley A.

doi:10.1017/s1478951518000482

Cited by 16 publications

(26 citation statements)

References 24 publications

(46 reference statements)

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“…These studies 28 – 30 and ours indicate that integrating technology into dignity therapy delivery has the potential to create new barriers to service provision and uptake. Integrating technology could burden people with a need to learn how to use technology during an already stressful time.…”

Section: Discussionmentioning

confidence: 64%

“…Beck and colleagues researched a brief dignity therapy intervention in the United States that was part online and part face-to-face with the primary goal of reducing the therapist time. 29 In this study with 10 participants, researchers choose three questions from the ten-question dignity therapy framework to discuss face-to-face in a recorded and transcribed interview. Participants were then provided with the transcript of the interview which they edited themselves using personal computers while being supported with three follow-up 5 to 10-minute phone calls.…”

Section: Discussionmentioning

confidence: 99%

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Dignity therapy online: Piloting an online psychosocial intervention for people with terminal illness

et al. 2020

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Objective Dignity therapy is a life review intervention shown to reduce distress and enhance the quality of life for people with a terminal illness and their families. Dignity therapy is not widely used in clinical practice because it is time and cost prohibitive. This pilot study examined the feasibility and acceptability of dignity therapy delivered through therapist-supported web-based delivery to reduce costs, increase time efficiency, and promote access to treatment. Methods This study employed a one-group pre-test post-test design to pilot methods. Australian adults diagnosed with a terminal illness with a prognosis of six months or less were recruited for the study. The primary outcome measure was a Participant Feedback Questionnaire used in previous face-to-face dignity therapy studies. Data regarding therapist time and details about final documents were recorded. Results Six people were recruited; four chose to complete the intervention via videoconference and two chose email. Participants reported high levels of acceptability and efficacy comparable to face-to-face delivery; meanwhile therapist time was about 40% less and legacy documents were longer. Participants described dignity therapy online as convenient, but technological issues may create challenges. Conclusions Online delivery of dignity therapy is feasible and acceptable, reduces therapist time and clinical cost, and appears to reach people who would not otherwise receive the therapy. Dignity therapy via email may have the greatest potential to reduce time and cost barriers. This pilot study demonstrates a need for further research to determine the full benefits of online delivery of dignity therapy.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Dignity therapy online: Piloting an online psychosocial intervention for people with terminal illness

et al. 2020

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“…As reported by the nurses, in most cases the intervention steps were accomplished within the time limits only due to their availability to devote extra time and effort to the study. As a lack of institutional resource is a limit to DT implementation, an abbreviated and less resource-intensive version of DT has been developed and piloted in US [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Providing dignity therapy to patients with advanced cancer: a feasibility study within the setting of a hospital palliative care unit

et al. 2021

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Background Dignity is a basic principle of palliative care and is intrinsic in the daily practice of professionals assisting individuals with incurable diseases. Dignity Therapy (DT) is a short-term intervention aimed at improving the sense of purpose, meaning and self-worth and at reducing the existential distress of patients facing advanced illness. Few studies have examined how DT works in countries of non-Anglo Saxon culture and in different real-life settings. Moreover, most studies do not provide detailed information on how DT is conducted, limiting a reliable assessment of DT protocol application and of its evaluation procedure. The aim of this study was to assess the feasibility and acceptability of a nurse-led DT intervention in advanced cancer patients receiving palliative care. Method This is a mixed-method study using before and after evaluation and semistructured interviews. Cancer patients referred to a hospital palliative care unit were recruited and provided with DT. The duration of sessions, and timeframes concerning each step of the study, were recorded, and descriptive statistical analyses were performed. The patients' dignity-related distress and feedback toward the intervention were assessed through the Patient Dignity Inventory and the Dignity Therapy Patient Feedback Questionnaire, respectively. Three nurses were interviewed on their experience in delivering the intervention, and the data were analyzed qualitatively. Results A total of 37/50 patients were enrolled (74.0%), of whom 28 (75.7%) completed the assessment. In 76.7% of cases, patients completed the intervention in the time limit scheduled in the study. No statistically significant reduction in the Patient Dignity Inventory scores was observed at the end of the intervention; most patients found DT to be helpful and satisfactory. Building opportunities for personal growth and providing holistic care emerged among the facilitators to DT implementation. Nurses also highlighted too great of a time commitment and a difficult collaboration with ward colleagues among the barriers. Conclusions Our findings strongly support the acceptability, but only partially support the feasibility, of nurse-led DT in advanced cancer patients in a hospital setting. Further research is needed on how to transfer the potential benefits of DT into clinical practice. Trial registration Retrospectively registered on ClinicalTrial.gov NCT04738305.

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“…Through this, the core values of the patient become apparent (14). A patient who has developed the generativity documents can promote independent reflection, autonomy, and opportunities for family interaction during the review and discussion of the project (20).…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, the importance that patients place on family should not be underestimated. Nurses caring for end-of-life patients should honor their autonomy (20). The nurse as a dignity therapist may provide a better experience for the family members when they are aware of acceptance levels and quality of partner relationships (11).…”

Section: Discussionmentioning

confidence: 99%

Dignity Therapy for End-of-Life Care Patients: A Literature Review

Cuevas

Davidson

Mejilla

et al. 2021

Journal of Patient Experience

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Dignity therapy as an intervention has been used for individuals receiving palliative care. The goal of this review is to explore the current state of empirical support to its use for end-of-life care patients. Data sources were articles extracted from search engines PubMed, Cochrane, Embase, CINAHL, Web of Science, and PsycINFO. The years searched were 2009 to 2019 (10-year period). The review process was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results revealed the feasibility, acceptability, satisfaction, and effectiveness of dignity therapy for life-limiting cases/conditions of patients in different age groups. It also highlighted the importance of the therapy setting and the need to apply this in the cultural context. The meaning of dignity therapy to patients and their family care members also emerged. Findings showed most patients displayed the need to leave a legacy and from this their core values surfaced. In conclusion, this review highlighted the contribution of dignity therapy to the holistic care of patients who hope to leave a legacy. The therapy was also relevant to decrease the anxiety; depression, and burden of family members throughout the palliative care period of their loved ones.

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Abbreviated dignity therapy for adults with advanced-stage cancer and their family caregivers: Qualitative analysis of a pilot study

Cited by 16 publications

References 24 publications

Dignity therapy online: Piloting an online psychosocial intervention for people with terminal illness

Dignity therapy online: Piloting an online psychosocial intervention for people with terminal illness

Providing dignity therapy to patients with advanced cancer: a feasibility study within the setting of a hospital palliative care unit

Dignity Therapy for End-of-Life Care Patients: A Literature Review

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