Current Status of Fear of Disease Progression in Patients with Advanced Cancer and Usefulness of Dignity Therapy Intervention

Abstract

With changes in lifestyle and an increase in bad health habits, cancer has become a noncommunicable and frequently occurring disease that poses a serious threat to human life. Cancer is associated with high rates of morbidity and mortality worldwide. As a major negative life event, advanced malignancies lead to strong mood swings in most patients. Furthermore, various internal and external factors can have a huge impact on patients’ physical and mental health and put them in a stressful situation, causing a series of psychological stress responses. To explore the degree of fear of disease progression in patients with advanced cancer and the usefulness of dignity therapy. Overall, 120 patients with advanced malignant tumors admitted to Shijiazhuang No. 1 hospital between January 2019 and January 2020 were enrolled. The selected patients were divided into the test and control groups (60 people per group) using a random number table. All patients received basic treatment. Patients in the trial group also received dignity therapy. The intervention period was 4 weeks. Simplified scales were used for assessing disease progression (FoP-Q-SF) and quality of life (QLQ-C30) before and after the intervention, and the scores were compared between the groups. After the intervention, the degree of fear in the experimental group was lower than that of the control group. Cognitive function, emotional function, and the scores of the overall health status of the experimental group were higher than those of the control group. Additionally, the scores of fatigue, insomnia, loss of appetite, and diarrhea in the experimental group were lower than those of the control group ( P < 0.05). The social support level scale scores, depression scores, hospital anxiety and depression scale scores, and patient dignity inventory scores of the experimental group were lower than those of the control group ( P < 0.05). Patients with advanced malignant tumors have fear, anxiety, and depression related to disease progression. Dignity therapy is useful for improving the patients’ quality of life, increasing dignity, and enhancing social support.

Comparative efficacy of psychological interventions on anxiety and depression in patients with cancer: A systematic review and network meta-analysis

“…The included studies [15–41,46–49] involved 3471 participants from 14 distinct countries. The psychological interventions involved include AT, CBT, DT, FT, IPT, MT, PE, and ST.…”

“…Robertson, 2016 [37] UK FT UC 21/22 Prostate cancer HADS-A HADS-D ② Ren, 2018 [38] China CBT UC 98/196 Breast cancer HAM-A HAM-D ② Savard, 2006 [39] Canada CBT UC 25/20 Breast cancer HADS-A HADS-D ② Shari, 2020 [40] Malaysia CBT UC 32/30 Breast cancer HADS-A HADS-D ② Tang, 2021 [41] China MT UC 50/50 Lung cancer SAS Wu, 2018 [42] China PE UC 20/20 Breast cancer HADS-A HADS-D ② Xiao, 2022 [43] China DT PE 60/60 Lung cancer PHQ-9 Xu, 2019 [44] China MT UC 60/60 Cancer SAS/SDS ② Yuan, 2022 [45] China MT UC 40/40 Intracranial Tumor SAS/SDS ② Zhao, 2020 [46] China PE UC 50/51 Liver Cancer HADS-D Zahedian, 2021 [47] Iran CBT UC 12/12 Breast cancer BDI ② Zhang, 2022 [48] China DT UC 60/60 Cancer HADS-A HADS-D ② Zhu, 2023 [49] China…”

Components of spirituality in older adults: A phenomenological study through interviews based on dignity therapy

“…Patients treated with DT compose a message to their loved ones through an interaction centred on nine questions, allowing them to regain their dignity and maintain it for generations to come. Effects such as increased hope [17] and decreased anxiety [18] have been observed, and patients have reported an increased sense of dignity after receiving DT [19][20][21]. Its effectiveness has been reported in patients with terminal cancer and it has been used worldwide as psychotherapy in palliative care [22][23][24].…”

Fear of progression, loneliness, and hope in patients with gastrointestinal cancer: a cross-sectional relational study

“…Therefore, we suggest that health care staff develop targeted interventions based on positive psychology theories to increase patients' level of hope and reduce patients' FoP to improve their quality of life and subjective well-being. One study showed that dignity therapy can improve the hope level of cancer patients (Zhang et al, 2022b). Clinical medical staff should evaluate and identify patients with high levels of FoP early and provide psychological counseling referral services for these patients when necessary.…”