Dignity Therapy: A Novel Psychotherapeutic Intervention for Patients Near the End of Life

尊严 医学 干预(咨询) 社会心理的 感觉 苦恼 缓和医疗 意义(存在) 心理治疗师 萧条(经济学) 精神科 护理部 临床心理学 心理学 社会心理学 宏观经济学 经济 法学 政治学
作者
Harvey Max Chochinov,Thomas F. Hack,Thomas Hassard,Linda J. Kristjanson,Susan McClement,Mike Harlos
出处
期刊:Journal of Clinical Oncology [American Society of Clinical Oncology]
卷期号:23 (24): 5520-5525 被引量:871
标识
DOI:10.1200/jco.2005.08.391
摘要

Purpose This study examined a novel intervention, dignity therapy, designed to address psychosocial and existential distress among terminally ill patients. Dignity therapy invites patients to discuss issues that matter most or that they would most want remembered. Sessions are transcribed and edited, with a returned final version that they can bequeath to a friend or family member. The objective of this study was to establish the feasibility of dignity therapy and determine its impact on various measures of psychosocial and existential distress. Patients and Methods Terminally ill inpatients and those receiving home-based palliative care services in Winnipeg, Canada, and Perth, Australia, were asked to complete pre- and postintervention measures of sense of dignity, depression, suffering, and hopelessness; sense of purpose, sense of meaning, desire for death, will to live, and suicidality; and a postintervention satisfaction survey. Results Ninety-one percent of participants reported being satisfied with dignity therapy; 76% reported a heightened sense of dignity; 68% reported an increased sense of purpose; 67% reported a heightened sense of meaning; 47% reported an increased will to live; and 81% reported that it had been or would be of help to their family. Postintervention measures of suffering showed significant improvement (P = .023) and reduced depressive symptoms (P = .05). Finding dignity therapy helpful to their family correlated with life feeling more meaningful (r = 0.480; P = .000) and having a sense of purpose (r = 0.562; P = .000), accompanied by a lessened sense of suffering (r = 0.327; P = .001) and increased will to live (r = 0.387; P = .000). Conclusion Dignity therapy shows promise as a novel therapeutic intervention for suffering and distress at the end of life.
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