Providing dignity therapy to patients with advanced cancer: a feasibility study within the setting of a hospital palliative care unit.
Cancer
Dignity Therapy
Dignity-related distress
Feasibility studies
Mixed-method study
Nurses
Palliative care
Journal
BMC palliative care
ISSN: 1472-684X
Titre abrégé: BMC Palliat Care
Pays: England
ID NLM: 101088685
Informations de publication
Date de publication:
16 Aug 2021
16 Aug 2021
Historique:
received:
09
02
2021
accepted:
17
07
2021
entrez:
17
8
2021
pubmed:
18
8
2021
medline:
16
10
2021
Statut:
epublish
Résumé
Dignity is a basic principle of palliative care and is intrinsic in the daily practice of professionals assisting individuals with incurable diseases. Dignity Therapy (DT) is a short-term intervention aimed at improving the sense of purpose, meaning and self-worth and at reducing the existential distress of patients facing advanced illness. Few studies have examined how DT works in countries of non-Anglo Saxon culture and in different real-life settings. Moreover, most studies do not provide detailed information on how DT is conducted, limiting a reliable assessment of DT protocol application and of its evaluation procedure. The aim of this study was to assess the feasibility and acceptability of a nurse-led DT intervention in advanced cancer patients receiving palliative care. This is a mixed-method study using before and after evaluation and semistructured interviews. Cancer patients referred to a hospital palliative care unit were recruited and provided with DT. The duration of sessions, and timeframes concerning each step of the study, were recorded, and descriptive statistical analyses were performed. The patients' dignity-related distress and feedback toward the intervention were assessed through the Patient Dignity Inventory and the Dignity Therapy Patient Feedback Questionnaire, respectively. Three nurses were interviewed on their experience in delivering the intervention, and the data were analyzed qualitatively. A total of 37/50 patients were enrolled (74.0%), of whom 28 (75.7%) completed the assessment. In 76.7% of cases, patients completed the intervention in the time limit scheduled in the study. No statistically significant reduction in the Patient Dignity Inventory scores was observed at the end of the intervention; most patients found DT to be helpful and satisfactory. Building opportunities for personal growth and providing holistic care emerged among the facilitators to DT implementation. Nurses also highlighted too great of a time commitment and a difficult collaboration with ward colleagues among the barriers. Our findings strongly support the acceptability, but only partially support the feasibility, of nurse-led DT in advanced cancer patients in a hospital setting. Further research is needed on how to transfer the potential benefits of DT into clinical practice. Retrospectively registered on ClinicalTrial.gov NCT04738305 .
Sections du résumé
BACKGROUND
BACKGROUND
Dignity is a basic principle of palliative care and is intrinsic in the daily practice of professionals assisting individuals with incurable diseases. Dignity Therapy (DT) is a short-term intervention aimed at improving the sense of purpose, meaning and self-worth and at reducing the existential distress of patients facing advanced illness. Few studies have examined how DT works in countries of non-Anglo Saxon culture and in different real-life settings. Moreover, most studies do not provide detailed information on how DT is conducted, limiting a reliable assessment of DT protocol application and of its evaluation procedure. The aim of this study was to assess the feasibility and acceptability of a nurse-led DT intervention in advanced cancer patients receiving palliative care.
METHOD
METHODS
This is a mixed-method study using before and after evaluation and semistructured interviews. Cancer patients referred to a hospital palliative care unit were recruited and provided with DT. The duration of sessions, and timeframes concerning each step of the study, were recorded, and descriptive statistical analyses were performed. The patients' dignity-related distress and feedback toward the intervention were assessed through the Patient Dignity Inventory and the Dignity Therapy Patient Feedback Questionnaire, respectively. Three nurses were interviewed on their experience in delivering the intervention, and the data were analyzed qualitatively.
RESULTS
RESULTS
A total of 37/50 patients were enrolled (74.0%), of whom 28 (75.7%) completed the assessment. In 76.7% of cases, patients completed the intervention in the time limit scheduled in the study. No statistically significant reduction in the Patient Dignity Inventory scores was observed at the end of the intervention; most patients found DT to be helpful and satisfactory. Building opportunities for personal growth and providing holistic care emerged among the facilitators to DT implementation. Nurses also highlighted too great of a time commitment and a difficult collaboration with ward colleagues among the barriers.
CONCLUSIONS
CONCLUSIONS
Our findings strongly support the acceptability, but only partially support the feasibility, of nurse-led DT in advanced cancer patients in a hospital setting. Further research is needed on how to transfer the potential benefits of DT into clinical practice.
TRIAL REGISTRATION
BACKGROUND
Retrospectively registered on ClinicalTrial.gov NCT04738305 .
Identifiants
pubmed: 34399737
doi: 10.1186/s12904-021-00821-3
pii: 10.1186/s12904-021-00821-3
pmc: PMC8369621
doi:
Banques de données
ClinicalTrials.gov
['NCT04738305']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
129Informations de copyright
© 2021. The Author(s).
Références
Med Health Care Philos. 2013 Nov;16(4):945-52
pubmed: 22791296
Palliat Med. 2012 Jul;26(5):768-9
pubmed: 22733965
BMJ. 2000 Jan 8;320(7227):114-6
pubmed: 10625273
Palliat Support Care. 2017 Dec;15(6):628-637
pubmed: 28166861
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
Front Psychol. 2020 Jun 25;11:1468
pubmed: 32670169
Tumori. 2012 Jul-Aug;98(4):491-500
pubmed: 23052167
ANS Adv Nurs Sci. 2001 Sep;24(1):17-35
pubmed: 11554531
Nurs Educ Perspect. 2007 Jul-Aug;28(4):196-202
pubmed: 17715804
BMC Palliat Care. 2015 Mar 21;14:8
pubmed: 25844066
J Community Support Oncol. 2014 Dec;12(12):446-53
pubmed: 25866895
BMC Palliat Care. 2010 Sep 22;9:21
pubmed: 20860786
Lancet Oncol. 2011 Aug;12(8):753-62
pubmed: 21741309
J Palliat Med. 2015 Jan;18(1):31-7
pubmed: 25314244
Psychooncology. 2019 Sep;28(9):1791-1802
pubmed: 31243850
Am J Hosp Palliat Care. 2018 Nov;35(11):1417-1420
pubmed: 29793345
Int J Older People Nurs. 2016 Jun;11(2):107-20
pubmed: 26710890
Adv Respir Med. 2019;87(3):135-145
pubmed: 31058308
BMC Med Res Methodol. 2013 Sep 18;13:117
pubmed: 24047204
Palliat Support Care. 2012 Mar;10(1):3-15
pubmed: 22329932
Palliat Support Care. 2019 Jun;17(3):262-268
pubmed: 30039777
Palliat Med. 2017 Jun;31(6):492-509
pubmed: 27566756
JAMA. 2002 May 1;287(17):2253-60
pubmed: 11980525
JMIR Res Protoc. 2019 Apr 17;8(4):e12213
pubmed: 30994466
BMC Palliat Care. 2018 May 10;17(1):73
pubmed: 29747631
J Palliat Med. 2013 Sep;16(9):1118-20
pubmed: 23937061
Qual Health Res. 2015 Jan;25(1):40-50
pubmed: 25189536
Palliat Med. 2012 Jul;26(5):703-12
pubmed: 21859743
J Clin Oncol. 2005 Aug 20;23(24):5520-5
pubmed: 16110012
PLoS One. 2014 May 09;9(5):e96888
pubmed: 24816742
J Pain Symptom Manage. 2008 Dec;36(6):559-71
pubmed: 18579340
Palliat Med. 2014 May;28(5):448-58
pubmed: 24311296
BMC Palliat Care. 2014 Mar 19;13(1):12
pubmed: 24646211
BMJ Support Palliat Care. 2011 Dec;1(3):315-21
pubmed: 24653477
Omega (Westport). 2013;67(1-2):135-45
pubmed: 23977789