MAIN OBJECTIVE: To assess the ability of dignity therapy to reduce distress in advanced cancer patients. DESIGN: A phase II open-label trial. SETTING: Two UK National Health Service trusts. PARTICIPANTS: 45 adults with advanced cancer. INTERVENTION: Dignity therapy: a brief palliative care psychotherapy. METHODS: Participants were randomly allocated to receive the intervention plus standard care or standard care only (control group). Outcomes were collected at baseline and at 1- and 4-week follow-up. MAIN OUTCOME MEASURES: The primary outcome was dignity-related distress (Palliative Dignity Inventory). Secondary outcomes were hope, anxiety and depression, quality of life, palliative-related outcomes, and self-reported study benefits. RESULTS: 45/188 (24%) patients responded. 27/45 (60%) participants remained at 1-week and 20/45 (44%) at 4-week follow-up. Baseline levels of distress were low. Groups did not differ in dignity-related distress at any time. An effect on only one secondary outcome was found: the intervention group reported more hope than the control group at both follow-ups. Effect sizes were medium (partial η(2)=0.20 and 0.15) and the difference was statistically significant at 1-week follow-up (difference in adjusted means 2.55; 95% CI -4.73 to 0.36; p=0.02). The intervention group was more positive than the control group on all the self-reported benefits ratings. Effect sizes (Cohen's d) ranged from 1.34 for feeling that dignity therapy had helped to 0.31 for increasing will to live. CONCLUSIONS: The effects of dignity therapy on people with advanced cancer are encouraging. Further investigation is warranted focusing on distressed patients and those earlier in the palliative care trajectory. TRIAL REGISTER NUMBER: ISRCTN29868352.
RCT Entities:
MAIN OBJECTIVE: To assess the ability of dignity therapy to reduce distress in advanced cancerpatients. DESIGN: A phase II open-label trial. SETTING: Two UK National Health Service trusts. PARTICIPANTS: 45 adults with advanced cancer. INTERVENTION: Dignity therapy: a brief palliative care psychotherapy. METHODS:Participants were randomly allocated to receive the intervention plus standard care or standard care only (control group). Outcomes were collected at baseline and at 1- and 4-week follow-up. MAIN OUTCOME MEASURES: The primary outcome was dignity-related distress (Palliative Dignity Inventory). Secondary outcomes were hope, anxiety and depression, quality of life, palliative-related outcomes, and self-reported study benefits. RESULTS: 45/188 (24%) patients responded. 27/45 (60%) participants remained at 1-week and 20/45 (44%) at 4-week follow-up. Baseline levels of distress were low. Groups did not differ in dignity-related distress at any time. An effect on only one secondary outcome was found: the intervention group reported more hope than the control group at both follow-ups. Effect sizes were medium (partial η(2)=0.20 and 0.15) and the difference was statistically significant at 1-week follow-up (difference in adjusted means 2.55; 95% CI -4.73 to 0.36; p=0.02). The intervention group was more positive than the control group on all the self-reported benefits ratings. Effect sizes (Cohen's d) ranged from 1.34 for feeling that dignity therapy had helped to 0.31 for increasing will to live. CONCLUSIONS: The effects of dignity therapy on people with advanced cancer are encouraging. Further investigation is warranted focusing on distressed patients and those earlier in the palliative care trajectory. TRIAL REGISTER NUMBER: ISRCTN29868352.
Authors: Carma L Bylund; Greenberry Taylor; Emily Mroz; Diana J Wilkie; Yingwei Yao; Linda Emanuel; George Fitchett; George Handzo; Harvey Max Chochinov; Susan Bluck Journal: Palliat Support Care Date: 2022-06
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: Marina Martínez; María Arantzamendi; Alazne Belar; José Miguel Carrasco; Ana Carvajal; María Rullán; Carlos Centeno Journal: Palliat Med Date: 2016-08-26 Impact factor: 4.762