Achieving Dignity for the Dying
Tue, August 2, 2011 at 02:00AM Death from a prolonged cause, such as cancer, is often accompanied by pain, incontinence, and mental confusion, and consequently there’s considerable distress. A short-term individual psychotherapy program was designed to help patients with this sort of problem, and it’s been tested in a Canadian study. The findings were reported in the journal Lancet Oncology.
The dignity therapy program was compared to client-centered care and standard palliative care in over 440 patients in Canada, USA, and Australia. Over 95% of the patients had cancer. The patients, who were not expected to live more than 6 months, were randomly assigned to one of the three programs.
In dignity therapy, a trained therapist engages the patient in a conversation about the important aspects of their lives and what they want remembered after they’ve gone. The conversation is recorded and a transcription given to the patient, who decides whether it will be shared with friends and family members. ‘Client-centered care’ focuses on the patient’s illness and not on his or her legacy. And all 3 groups received palliative care throughout. Outcomes were assessed by research staff who had had no previous contact with the participant. Although the primary aim of the study was to lower distress levels, a whole battery of tests, including quality-of-life scales and a 25-item Patient Dignity Inventory, were included in the assessment.
No significant differences were noted in distress levels before and after finishing the study in the three groups. However, the secondary outcomes showed that dignity therapy was significantly more likely than either of the other therapies to have been considered helpful, and to have improved quality-of-life and sense of dignity; it also changed how patient’s families saw and appreciated them.
Although dignity therapy was unable to mitigate outright distress, such as depression, in this study, its benefits were sufficient to justify its clinical use for patients nearing death.
Reader Comments (1)
Interesting post