A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care

Background: Dignity Therapy is a brief, psychosocial intervention for patients with incurable disease. Aim: To investigate participation in and evaluation of Dignity Therapy and longitudinal changes in patient-rated outcomes. Design: A prospective (pre/post) evaluation design was employed. Evaluatio...

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Main Authors: Houmann, L., Chochinov, H., Kristjanson, Linda, Petersen, M., Groenvold, M.
Format: Journal Article
Published: Sage Science Press (UK) 2014
Online Access:http://hdl.handle.net/20.500.11937/45069
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author Houmann, L.
Chochinov, H.
Kristjanson, Linda
Petersen, M.
Groenvold, M.
author_facet Houmann, L.
Chochinov, H.
Kristjanson, Linda
Petersen, M.
Groenvold, M.
author_sort Houmann, L.
building Curtin Institutional Repository
collection Online Access
description Background: Dignity Therapy is a brief, psychosocial intervention for patients with incurable disease. Aim: To investigate participation in and evaluation of Dignity Therapy and longitudinal changes in patient-rated outcomes. Design: A prospective (pre/post) evaluation design was employed. Evaluation questionnaires were completed when patients received the generativity document (T1) and 2 weeks later (T2). Changes from baseline (T0) were measured in sense of dignity, Structured Interview for Symptoms and Concerns items, Patient Dignity Inventory, Hospital Anxiety and Depression Scale and European Organisation for Research and Treatment of Cancer QLQ-C15-PAL (ClinicalTrials.gov number: NCT01507571). Setting/participants: Consecutive patients with incurable cancer, =18 years, informed of prognosis and not having cognitive impairment/physical limitations precluding participation were included at a hospice and a hospital palliative medicine unit. Results: Over 2 years, 80 of 341 eligible patients completed Dignity Therapy. At T1, 55 patients completed evaluations, of whom 73%-89% found Dignity Therapy helpful, satisfactory and of help to relatives; 47%-56% reported that it heightened their sense of purpose, dignity and will to live. Quality of life decreased (mean = -9 (95% confidence interval: -14.54; -2.49)) and depression increased (mean = 0.31 (0.06; 0.57)) on one of several depression measures. At T2 (n = 31), sense of dignity (mean = -0.52 (-1.01; -0.02)) and sense of being a burden to others (mean = -0.26 (-0.49; -0.02)) improved. Patients with children and lower performance status, emotional functioning and quality of life were more likely to report benefit. Conclusions: This study adds to the growing body of evidence supporting Dignity Therapy as a valuable intervention in palliative care; a substantial subset of patients facing end of life found it manageable, relevant and beneficial.
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spelling curtin-20.500.11937-450692017-09-13T14:16:25Z A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care Houmann, L. Chochinov, H. Kristjanson, Linda Petersen, M. Groenvold, M. Background: Dignity Therapy is a brief, psychosocial intervention for patients with incurable disease. Aim: To investigate participation in and evaluation of Dignity Therapy and longitudinal changes in patient-rated outcomes. Design: A prospective (pre/post) evaluation design was employed. Evaluation questionnaires were completed when patients received the generativity document (T1) and 2 weeks later (T2). Changes from baseline (T0) were measured in sense of dignity, Structured Interview for Symptoms and Concerns items, Patient Dignity Inventory, Hospital Anxiety and Depression Scale and European Organisation for Research and Treatment of Cancer QLQ-C15-PAL (ClinicalTrials.gov number: NCT01507571). Setting/participants: Consecutive patients with incurable cancer, =18 years, informed of prognosis and not having cognitive impairment/physical limitations precluding participation were included at a hospice and a hospital palliative medicine unit. Results: Over 2 years, 80 of 341 eligible patients completed Dignity Therapy. At T1, 55 patients completed evaluations, of whom 73%-89% found Dignity Therapy helpful, satisfactory and of help to relatives; 47%-56% reported that it heightened their sense of purpose, dignity and will to live. Quality of life decreased (mean = -9 (95% confidence interval: -14.54; -2.49)) and depression increased (mean = 0.31 (0.06; 0.57)) on one of several depression measures. At T2 (n = 31), sense of dignity (mean = -0.52 (-1.01; -0.02)) and sense of being a burden to others (mean = -0.26 (-0.49; -0.02)) improved. Patients with children and lower performance status, emotional functioning and quality of life were more likely to report benefit. Conclusions: This study adds to the growing body of evidence supporting Dignity Therapy as a valuable intervention in palliative care; a substantial subset of patients facing end of life found it manageable, relevant and beneficial. 2014 Journal Article http://hdl.handle.net/20.500.11937/45069 10.1177/0269216313514883 Sage Science Press (UK) restricted
spellingShingle Houmann, L.
Chochinov, H.
Kristjanson, Linda
Petersen, M.
Groenvold, M.
A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care
title A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care
title_full A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care
title_fullStr A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care
title_full_unstemmed A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care
title_short A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care
title_sort prospective evaluation of dignity therapy in advanced cancer patients admitted to palliative care
url http://hdl.handle.net/20.500.11937/45069