Effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers – a randomized controlled study
Abstract Background This study extended the original Dignity Therapy (DT) intervention by including partners and family caregivers (FCs) of terminally-ill cancer patients with the overall aim of evaluating whether DT can mitigate distress in both patients nearing the end of life and their FCs. Metho...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-024-01408-4 |
| _version_ | 1797258937206046720 |
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| author | Annina Seiler Manuel Amann Caroline Hertler Sebastian M. Christ Markus Schettle Barbara Meier Kaeppeli Judith Jung-Amstutz Christel Nigg Bernhard C. Pestalozzi Patrick Imesch Reinhard Dummer David Blum Josef Jenewein |
| author_facet | Annina Seiler Manuel Amann Caroline Hertler Sebastian M. Christ Markus Schettle Barbara Meier Kaeppeli Judith Jung-Amstutz Christel Nigg Bernhard C. Pestalozzi Patrick Imesch Reinhard Dummer David Blum Josef Jenewein |
| author_sort | Annina Seiler |
| collection | DOAJ |
| description | Abstract Background This study extended the original Dignity Therapy (DT) intervention by including partners and family caregivers (FCs) of terminally-ill cancer patients with the overall aim of evaluating whether DT can mitigate distress in both patients nearing the end of life and their FCs. Methods In this multicenter, randomized controlled trial (RCT), a total of 68 patients with life expectancy < 6 months and clinically-relevant stress levels (Hospital Anxiety Depression total score; HADStot ≥ 8) including their FCs were randomly assigned to DT, DT + (including their FCs), or standard palliative care (SPC) in a 1:1:1 ratio. Study participants were asked to complete a set of questionnaires pre- and post-intervention. Results The coalesced group (DT and DT +) revealed a significant increase in patients’ perceived quality of life (FACIT-Pal-14) following the intervention (mean difference 6.15, SD = 1.86, p < 0.01). We found a statistically significant group-by-time interaction effect: while the HADStot of patients in the intervention group remained stable over the pre-post period, the control group’s HADStot increased (F = 4.33, df = 1, 82.9; p < 0.05), indicating a protective effect of DT. Most patients and their FCs found DT useful and would recommend it to other individuals in their situation. Conclusions The DT intervention has been well-received and shows the potential to increase HRQoL and prevent further mental health deterioration, illness burden and suffering in terminally-ill patients. The DT intervention holds the potential to serve as a valuable tool for facilitating end-of-life conversations among terminally-ill patients and their FCs. However, the implementation of DT within the framework of a RCT in a palliative care setting poses significant challenges. We suggest a slightly modified and less resource-intensive version of DT that is to provide the DT inventory to FCs of terminally-ill patients, empowering them to ask the questions that matter most to them over their loved one’s final days. Trial registration This study was registered with Clinical Trial Registry (ClinicalTrials.gov -Protocol Record NCT02646527; date of registration: 04/01/2016). The CONSORT 2010 guidelines were used for properly reporting how the randomized trial was conducted. |
| first_indexed | 2024-04-24T23:01:28Z |
| format | Article |
| id | doaj.art-582344e38af446a19a11d1b54409936f |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-04-24T23:01:28Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-582344e38af446a19a11d1b54409936f2024-03-17T12:42:02ZengBMCBMC Palliative Care1472-684X2024-03-0123111510.1186/s12904-024-01408-4Effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers – a randomized controlled studyAnnina Seiler0Manuel Amann1Caroline Hertler2Sebastian M. Christ3Markus Schettle4Barbara Meier Kaeppeli5Judith Jung-Amstutz6Christel Nigg7Bernhard C. Pestalozzi8Patrick Imesch9Reinhard Dummer10David Blum11Josef Jenewein12Department of Radiation Oncology, Competence Center for Palliative Care, University Hospital Zurich and University of ZurichDepartment of Radiation Oncology, Competence Center for Palliative Care, University Hospital Zurich and University of ZurichDepartment of Radiation Oncology, Competence Center for Palliative Care, University Hospital Zurich and University of ZurichDepartment of Radiation Oncology, Competence Center for Palliative Care, University Hospital Zurich and University of ZurichDepartment of Radiation Oncology, Competence Center for Palliative Care, University Hospital Zurich and University of ZurichDepartment of Gynecology, University Hospital ZurichDepartment of Gynecology, University Hospital ZurichKlinik SusenbergDepartment of Medical Oncology and Hematology, University Hospital Zurich and University of ZurichDepartment of Gynecology, University Hospital ZurichDepartment of Dermatology, University Hospital Zurich and University of ZurichDepartment of Radiation Oncology, Competence Center for Palliative Care, University Hospital Zurich and University of ZurichPrivatklinik HoheneggAbstract Background This study extended the original Dignity Therapy (DT) intervention by including partners and family caregivers (FCs) of terminally-ill cancer patients with the overall aim of evaluating whether DT can mitigate distress in both patients nearing the end of life and their FCs. Methods In this multicenter, randomized controlled trial (RCT), a total of 68 patients with life expectancy < 6 months and clinically-relevant stress levels (Hospital Anxiety Depression total score; HADStot ≥ 8) including their FCs were randomly assigned to DT, DT + (including their FCs), or standard palliative care (SPC) in a 1:1:1 ratio. Study participants were asked to complete a set of questionnaires pre- and post-intervention. Results The coalesced group (DT and DT +) revealed a significant increase in patients’ perceived quality of life (FACIT-Pal-14) following the intervention (mean difference 6.15, SD = 1.86, p < 0.01). We found a statistically significant group-by-time interaction effect: while the HADStot of patients in the intervention group remained stable over the pre-post period, the control group’s HADStot increased (F = 4.33, df = 1, 82.9; p < 0.05), indicating a protective effect of DT. Most patients and their FCs found DT useful and would recommend it to other individuals in their situation. Conclusions The DT intervention has been well-received and shows the potential to increase HRQoL and prevent further mental health deterioration, illness burden and suffering in terminally-ill patients. The DT intervention holds the potential to serve as a valuable tool for facilitating end-of-life conversations among terminally-ill patients and their FCs. However, the implementation of DT within the framework of a RCT in a palliative care setting poses significant challenges. We suggest a slightly modified and less resource-intensive version of DT that is to provide the DT inventory to FCs of terminally-ill patients, empowering them to ask the questions that matter most to them over their loved one’s final days. Trial registration This study was registered with Clinical Trial Registry (ClinicalTrials.gov -Protocol Record NCT02646527; date of registration: 04/01/2016). The CONSORT 2010 guidelines were used for properly reporting how the randomized trial was conducted.https://doi.org/10.1186/s12904-024-01408-4Dignity therapyPsychological distressPatientsFamily caregiversPalliative care |
| spellingShingle | Annina Seiler Manuel Amann Caroline Hertler Sebastian M. Christ Markus Schettle Barbara Meier Kaeppeli Judith Jung-Amstutz Christel Nigg Bernhard C. Pestalozzi Patrick Imesch Reinhard Dummer David Blum Josef Jenewein Effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers – a randomized controlled study BMC Palliative Care Dignity therapy Psychological distress Patients Family caregivers Palliative care |
| title | Effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers – a randomized controlled study |
| title_full | Effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers – a randomized controlled study |
| title_fullStr | Effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers – a randomized controlled study |
| title_full_unstemmed | Effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers – a randomized controlled study |
| title_short | Effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers – a randomized controlled study |
| title_sort | effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers a randomized controlled study |
| topic | Dignity therapy Psychological distress Patients Family caregivers Palliative care |
| url | https://doi.org/10.1186/s12904-024-01408-4 |
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