BACKGROUND: A pilot study of Dignity Therapy conducted with hospice patients reported high levels of self-reported benefits of the psychotherapy. AIM: To assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce distress in older people in care homes. DESIGN: A randomized controlled open-label trial (ISRCTN37589515). SETTING AND PARTICIPANTS: 60 residents aged 65+ with no major cognitive impairment living in care homes in London, UK. INTERVENTION: Dignity Therapy, a brief palliative care psychotherapy. OUTCOMES: Potential effectiveness (dignity-related distress, depression, hopefulness, quality of life at baseline and 1 and 8-week follow-up); acceptability (residents' views on self-reported benefits of Dignity Therapy/the Dignity Therapy study); and feasibility (time taken to deliver the intervention). RESULTS: We randomized 60/755 (8%) residents: 29 - control, 31 - intervention. We found no significant differences between groups on measures of potential effectiveness at any time. There was a reduction in dignity-related distress across both groups (p = 0.026). The intervention group outperformed the control group on all the acceptability items at both follow-ups. Effect sizes (Cohen's d) ranged from small (0.25) to large (0.85). These were significant for feeling that Dignity Therapy/the Dignity Therapy study had made their life more meaningful at 2-week follow-up (p = 0.04), and that it would help their families at both follow-ups (p = 0.02 and p = 0.01, respectively). Although it was feasible to deliver the intervention in this setting, it took longer to complete than anticipated. CONCLUSIONS: Although Dignity Therapy took longer to deliver than expected, this intervention may be a way of enhancing the end-of-life experiences of residents.
RCT Entities:
BACKGROUND: A pilot study of Dignity Therapy conducted with hospice patients reported high levels of self-reported benefits of the psychotherapy. AIM: To assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce distress in older people in care homes. DESIGN: A randomized controlled open-label trial (ISRCTN37589515). SETTING AND PARTICIPANTS: 60 residents aged 65+ with no major cognitive impairment living in care homes in London, UK. INTERVENTION: Dignity Therapy, a brief palliative care psychotherapy. OUTCOMES: Potential effectiveness (dignity-related distress, depression, hopefulness, quality of life at baseline and 1 and 8-week follow-up); acceptability (residents' views on self-reported benefits of Dignity Therapy/the Dignity Therapy study); and feasibility (time taken to deliver the intervention). RESULTS: We randomized 60/755 (8%) residents: 29 - control, 31 - intervention. We found no significant differences between groups on measures of potential effectiveness at any time. There was a reduction in dignity-related distress across both groups (p = 0.026). The intervention group outperformed the control group on all the acceptability items at both follow-ups. Effect sizes (Cohen's d) ranged from small (0.25) to large (0.85). These were significant for feeling that Dignity Therapy/the Dignity Therapy study had made their life more meaningful at 2-week follow-up (p = 0.04), and that it would help their families at both follow-ups (p = 0.02 and p = 0.01, respectively). Although it was feasible to deliver the intervention in this setting, it took longer to complete than anticipated. CONCLUSIONS: Although Dignity Therapy took longer to deliver than expected, this intervention may be a way of enhancing the end-of-life experiences of residents.
Authors: Barry Rosenfeld; Rebecca Saracino; Kristen Tobias; Melissa Masterson; Hayley Pessin; Allison Applebaum; Robert Brescia; William Breitbart Journal: Palliat Med Date: 2016-07-21 Impact factor: 4.762
Authors: Keith Zi Yuan Chua; Elaine Li Ying Quah; Yun Xue Lim; Chloe Keyi Goh; Jieyu Lim; Darius Wei Jun Wan; Simone Meiqi Ong; Chi Sum Chong; Kennan Zhi Guang Yeo; Laura Shih Hui Goh; Ray Meng See; Alexia Sze Inn Lee; Yun Ting Ong; Min Chiam; Eng Koon Ong; Jamie Xuelian Zhou; Crystal Lim; Simon Yew Kuang Ong; Lalit Krishna Journal: BMC Palliat Care Date: 2022-07-04 Impact factor: 3.113
Authors: Adrienne Beck; Ann H Cottingham; Patrick V Stutz; Rachel Gruber; Jennifer K Bernat; Paul R Helft; Laura Wilhelm; Karen Schmidt; Madison E Stout; Claire Willard; Shelley A Johns Journal: Palliat Support Care Date: 2018-07-24
Authors: Tasha M Schoppee; Lisa Scarton; Susan Bluck; Yingwei Yao; Gail Keenan; George Handzo; Harvey M Chochinov; George Fitchett; Linda L Emanuel; Diana J Wilkie Journal: Palliat Support Care Date: 2022-04
Authors: Lisa Scarton; Sungho Oh; Ashley Sylvera; Ralph Lamonge; Yingwei Yao; Harvey Chochinov; George Fitchett; George Handzo; Linda Emanuel; Diana Wilkie Journal: Am J Hosp Palliat Care Date: 2018-05-24 Impact factor: 2.090
Authors: Harvey Max Chochinov; Wendy Johnston; Susan E McClement; Thomas F Hack; Brenden Dufault; Murray Enns; Genevieve Thompson; Mike Harlos; Ronald W Damant; Clare D Ramsey; Sara Davison; James Zacharias; Doris Milke; David Strang; Heather J Campbell-Enns; Maia S Kredentser Journal: PLoS One Date: 2016-01-25 Impact factor: 3.240