Piloting an abbreviated dignity therapy intervention using a legacy‐building web portal for adults with terminal cancer: a feasibility and acceptability study

Bernat, Jennifer K.; Helft, Paul R.; Wilhelm, Laura; Hook, Nancy E.; Brown, LC; Althouse, Sandra K.; Johns, Shelley A.

doi:10.1002/pon.3790

Cited by 20 publications

(45 citation statements)

References 13 publications

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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: 63%

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: 63%

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

et al. 2020

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“…A recent study in the USA asked 16 people with advanced cancer to complete an abbreviated version of DT, which included a combination of a face‐to‐face meeting as well as a web portal with follow‐up phone calls (Bernat et al, ). Participants were highly satisfied with both the abbreviated intervention as well as the final legacy documents but were generally dissatisfied with the web portal due to usability issues and lack of clear instructions.…”

Section: Resultsmentioning

confidence: 99%

A Narrative Review of Dignity Therapy Research

Bentley

O’Connor

Shaw

et al. 2017

Australian Psychologist

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Introduction Dignity therapy is an end‐of‐life psychological intervention that focuses on the creation of a legacy document to alleviate end‐of‐life distress. Dignity therapy is based on an empirical model of dignity at the end of life. Research on dignity therapy has been ongoing for over 12 years in 11 countries, which has created a solid empirical base. Objective This article presents a narrative overview of the literature on dignity therapy to provide a comprehensive narrative review and critical synthesis of published research. Method Electronic databases (PubMed, CINAHL, PsycINFO, and Scopus) were searched using the key terms “dignity therapy,” “dignity psychotherapy,” and “Chochinov” from 2000 to March 2016. Results Thirty‐nine publications were included and findings were grouped into the following areas: Efficacy; Feasibility with different study populations; Web‐assisted delivery; Impact on families; Cultural studies; Case studies; Themes found in documents; Clinical perspectives; and Implementation studies. Conclusions While dignity therapy is well accepted in most cases, it may not always be effective, therapeutically valid, or practical, and may cause family or cultural frictions. It is recommended that clinicians take into consideration each person's unique circumstances in relation to the current literature before undertaking dignity therapy. Future research is indicated to evaluate dignity therapy with different cultural groups, to investigate the views of recipients of dignity therapy documents, to discover the time and resource commitments required to deliver dignity therapy, to identify who should provide dignity therapy, and to examine the experiences of clinicians who deliver dignity therapy. More research is also needed comparing dignity therapy to other end‐of‐life interventions.

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“…After consenting, participants completed a demographic questionnaire and measures of existential well-being and dignity-related distress at baseline (Bernat et al, 2015). Participants then scheduled a 90-minute session with a DT-trained study interventionist at each participant’s preferred location—typically the participant’s home.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2018

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Qualitative methods were used to analyze postintervention interviews with 11 participants and their legacy recipients as well as the created legacy projects. Direct content analysis was used to assess feedback from the interviews about benefits, barriers, and recommendations regarding abbreviated DT. The legacy projects were coded for expression of core values.ResultFindings suggest that abbreviated DT effectively promotes (1) self-expression, (2) connection with loved ones, (3) sense of purpose, and (4) continuity of self. Participants observed that leading the development of their legacy projects promoted independent reflection, autonomy, and opportunities for family interaction when reviewing and discussing the projects. Consistent with traditional DT, participants expressed "family" as the most common core value in their legacy projects. Expression of "autonomy" was also a notable finding.Significance of resultsAbbreviated DT reduces resource barriers to conducting traditional DT while promoting similar benefits for participants and recipients, making it a promising adaptation warranting further research. The importance that patients place on family and autonomy should be honored as much as possible by those caring for adults with advanced-stage cancer.

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Piloting an abbreviated dignity therapy intervention using a legacy‐building web portal for adults with terminal cancer: a feasibility and acceptability study

Cited by 20 publications

References 13 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

A Narrative Review of Dignity Therapy Research

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

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