Feasibility, acceptability and potential effectiveness of Dignity Therapy for older people in care homes: A phase II randomized controlled trial of a brief palliative care psychotherapy

2011 ◽  
Vol 26 (5) ◽  
pp. 703-712 ◽  
Author(s):  
Sue Hall ◽  
Cassie Goddard ◽  
Diana Opio ◽  
Peter Speck ◽  
Irene J Higginson
2017 ◽  
Vol 15 (6) ◽  
pp. 628-637 ◽  
Author(s):  
Miguel Julião ◽  
Fátima Oliveira ◽  
Baltazar Nunes ◽  
António Vaz Carneiro ◽  
António Barbosa

ABSTRACTObjective:Dignity therapy (DT) is a brief form of psychotherapy developed for patients living with a life-limiting illness that has demonstrated efficacy in treating several dimensions of end-of-life psychological distress. Our aim was to determine the influence of DT on demoralization syndrome (DS), the desire for death (DfD), and a sense of dignity (SoD) in terminally ill inpatients experiencing a high level of distress in a palliative care unit.Method:A nonblinded phase II randomized controlled trial was conducted with 80 patients who were randomly assigned to one of two groups: the intervention group (DT + standard palliative care [SPC]) or the control group (SPC alone). The main outcomes were DS, DfD, and SoD, as measured according to DS criteria, the Desire for Death Rating Scale, and the Patient Dignity Inventory (PDI), respectively. All scales were assessed at baseline (day 1) and at day 4 of follow-up. This study is registered with http://www.controlled-trials.com/ISRCTN34354086.Results:Of the 80 participants, 41 were randomized to DT and 39 to SPC. Baseline characteristics were similar between the two groups. DT was associated with a significant decrease in DS compared with SPC (DT DS prevalence = 12.1%; SPC DS prevalence = 60.0%; p < 0.001). Similarly, DT was associated with a significant decrease in DfD prevalence (DT DfD prevalence = 0%; SPC DfD prevalence = 14.3%; p = 0.054). Compared with participants allocated to the control group, those who received DT showed a statistically significant reduction in 19 of 25 PDI items.Significance of results:Dignity therapy had a beneficial effect on the psychological distress encountered by patients near the end of life. Our research suggests that DT is an important psychotherapeutic approach that should be included in clinical care programs, and it could help more patients to cope with their end-of-life experiences.


2015 ◽  
Vol 14 (1) ◽  
Author(s):  
Lori P. Montross-Thomas ◽  
Scott A. Irwin ◽  
Emily A. Meier ◽  
Jarred V. Gallegos ◽  
Shahrokh Golshan ◽  
...  

2017 ◽  
Vol 53 (2) ◽  
pp. 162-170.e1 ◽  
Author(s):  
Dean Vuksanovic ◽  
Heather J. Green ◽  
Murray Dyck ◽  
Shirley A. Morrissey

2013 ◽  
Vol 11 (6) ◽  
pp. 481-489 ◽  
Author(s):  
Miguel Julião ◽  
António Barbosa ◽  
Fátima Oliveira ◽  
Baltazar Nunes ◽  
António Vaz Carneiro

AbstractObjective:Dignity therapy (DT) is a short-term psychotherapy developed for patients living with a life-limiting illness. Our aim was to determine the influence of DT on symptoms of depression and anxiety in people with a life-threatening disease with high level of distress, referred to an inpatient palliative care unit.Method:This was an open-label randomized controlled trial. Sixty terminally ill patients were randomly assigned to one of two groups: intervention group (DT+ standard palliative care [SPC]) or control group (SPC alone). The main outcomes were symptoms of depression and anxiety, measured with the Hospital Anxiety and Depression Scale, assessed at baseline, day 4, day 15, and day 30 of follow-up.Results:Of the 60 participants, 29 were randomized to DT and 31 to SPC. Baseline characteristics were similar between the two groups. DT was associated with a significant decrease in depressive symptoms at day 4 and day 15 (mean = −4.46, 95% CI, −6.91–2.02, p = 0.001; mean= −3.96, 95% CI, −7.33 to −0.61; p = 0.022, respectively), but not at day 30 (mean = −3.33, 95% CI, −7.32–0.65, p = 0.097). DT was also associated with a significant decrease in anxiety symptoms at each follow-up (mean= −3.96, 95% CI, −6.66 to −1.25, p = 0.005; mean= −6.19, 95% CI, −10.49 to −1.88, p = 0.006; mean = −5.07, 95% CI, −10.22 to −0.09, p = 0.054, respectively).Significance of results:DT appears to have a short-term beneficial effect on the depression and anxiety symptoms that often accompany patients at the end of their lives. Future research with larger samples compared with other treatments is needed to better understand the potential benefits of this psychotherapy.


10.2196/12213 ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. e12213
Author(s):  
Sheri Kittelson ◽  
Lisa Scarton ◽  
Paige Barker ◽  
Joshua Hauser ◽  
Sean O'Mahony ◽  
...  

2001 ◽  
Vol 49 (11) ◽  
pp. 1448-1455 ◽  
Author(s):  
Margaret Stevens ◽  
C. D'Arcy J. Holman ◽  
Nicole Bennett ◽  
Nick De Klerk

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