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Perspectives of newly diagnosed advanced cancer patients receiving dignity therapy during cancer treatment

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Abstract

Purpose

Dignity therapy is a psychosocial intervention that has been used primarily at the end of life to improve quality of life and other patient outcomes, but many individuals are unable to complete it due to health decline and death. The purpose of this study was to identify what individuals with advanced pancreatic or lung cancer with limited life expectancy, undergoing active cancer treatment describe during the dignity therapy intervention as important to them when not immediately facing end of life.

Methods

Twenty patients undergoing chemotherapy for advanced cancer participated in a dignity therapy intervention study. Initial interviews were analyzed using descriptive content analysis.

Results

Family provided the overall context and background for emerging themes of defining events, accomplishments, and God’s plan, which led to lessons learned, and resulted in messages of hope. Interviews were often autobiographical in nature and contained much reminiscence, consistent with dignity therapy’s intent. Few participants spoke about their cancer diagnoses during the interview.

Conclusions

This study adds unique insight into the use of dignity therapy for those still receiving active cancer treatment, different from work by others in which it was offered only at end of life. As part of supportive care, clinicians need to validate the importance of family to those with advanced cancer and to provide opportunities for patients to share what they have learned throughout life and to impart messages of hope to those closest to them.

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References

  1. Pinquart M, Silbereisen RK, Frohlich C (2009) Life goals and purpose in life in cancer patients. Support Care Cancer: Off J Multinatl Assoc Support Care Cancer 17(3):253–259. doi:10.1007/s00520-008-0450-0

    Article  Google Scholar 

  2. Hullmann SE, Robb SL, Rand KL (2016) Life goals in patients with cancer: a systematic review of the literature. Psycho-Oncology 25(4):387–399. doi:10.1002/pon.3852

    Article  PubMed  Google Scholar 

  3. Oechsle K, Wais MC, Vehling S, Bokemeyer C, Mehnert A (2014) Relationship between symptom burden, distress, and sense of dignity in terminally ill cancer patients. J Pain Symptom Manag 48(3):313–321. doi:10.1016/j.jpainsymman.2013.10.022

    Article  Google Scholar 

  4. Sun V, Ferrell B, Juarez G, Wagman LD, Yen Y, Chung V (2008) Symptom concerns and quality of life in hepatobiliary cancers. Oncol Nurs Forum 35(3):E45–E52. doi:10.1188/08.onf.e45-e52

    Article  PubMed  Google Scholar 

  5. Clark KL, Loscalzo M, Trask PC, Zabora J, Philip EJ (2010) Psychological distress in patients with pancreatic cancer—an understudied group. Psycho-Oncology 19(12):1313–1320. doi:10.1002/pon.1697

    Article  PubMed  Google Scholar 

  6. Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psycho-Oncology 10(1):19–28

    Article  CAS  Google Scholar 

  7. Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M (2005) Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life. J Clin Oncol: Off J Am Soc Clin Oncol 23(24):5520–5525. doi:10.1200/jco.2005.08.391

    Article  Google Scholar 

  8. Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M (2002) Dignity in the terminally ill: a cross-sectional, cohort study. Lancet 360(9350):2026–2030. doi:10.1016/s0140-6736(02)12022-8

    Article  PubMed  Google Scholar 

  9. Wagland R, Richardson A, Ewings S, Armes J, Lennan E, Hankins M, Griffiths P (2016) Prevalence of cancer chemotherapy-related problems, their relation to health-related quality of life and associated supportive care: a cross-sectional survey. Support Care Cancer: Off J Multinatl Assoc Support Care Cancer 24:4901–4911

    Article  Google Scholar 

  10. Keall RM, Clayton JM, Butow PN (2015) Therapeutic life review in palliative care: a systematic review of quantitative evaluations. J Pain Symptom Manag 49(4):747–761. doi:10.1016/j.jpainsymman.2014.08.015

    Article  Google Scholar 

  11. Chochinov HM (2002) Dignity-conserving care—a new model for palliative care: helping the patient feel valued. JAMA 287(17):2253–2260

    Article  Google Scholar 

  12. Chochinov HM, Hack T, McClement S, Kristjanson L, Harlos M (2002) Dignity in the terminally ill: a developing empirical model. Soc Sci Med 54(3):433–443

    Article  Google Scholar 

  13. McClain-Jacobson C, Rosenfeld B, Kosinski A, Pessin H, Cimino JE, Breitbart W (2004) Belief in an afterlife, spiritual well-being and end-of-life despair in patients with advanced cancer. Gen Hosp Psychiatry 26(6):484–486. doi:10.1016/j.genhosppsych.2004.08.002

    Article  PubMed  Google Scholar 

  14. Chochinov HM, Kristjanson LJ, Breitbart W, McClement S, Hack TF, Hassard T, Harlos M (2011) Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial. Lancet Oncol 12(8):753–762. doi:10.1016/s1470-2045(11)70153-x

    Article  PubMed  PubMed Central  Google Scholar 

  15. Juliao M, Oliveira F, Nunes B, Vaz Carneiro A, Barbosa A (2014) Efficacy of dignity therapy on depression and anxiety in Portuguese terminally ill patients: a phase II randomized controlled trial. J Palliat Med 17(6):688–695. doi:10.1089/jpm.2013.0567

    Article  PubMed  Google Scholar 

  16. Vergo MT, Nimeiri H, Mulcahy M, Benson A, Emmanuel L (2014) A feasibility study of dignity therapy in patients with stage IV colorectal cancer actively receiving second-line chemotherapy. J Commun Support Oncol 12(12):446–453. doi:10.12788/jcso.0096

    Article  CAS  Google Scholar 

  17. Vuksanovic D, Green HJ, Dyck M, Morrissey SA (2017) Dignity therapy and life review for palliative care patients: a randomized controlled trial. J Pain Symptom Manag 53(2). doi:10.1016/j.jpainsymman.2016.09.005

    Article  Google Scholar 

  18. Hack TF, McClement SE, Chochinov HM, Cann BJ, Hassard TH, Kristjanson LJ, Harlos M (2010) Learning from dying patients during their final days: life reflections gleaned from dignity therapy. Palliat Med 24(7):715–723. doi:10.1177/0269216310373164

    Article  PubMed  Google Scholar 

  19. Montross L, Winters KD, Irwin SA (2011) Dignity therapy implementation in a community-based hospice setting. J Palliat Med 14(6):729–734. doi:10.1089/jpm.2010.0449

    Article  PubMed  PubMed Central  Google Scholar 

  20. Hall S, Goddard C, Speck PW, Martin P, Higginson IJ (2013) “It makes you feel that somebody is out there caring”: a qualitative study of intervention and control participants’ perceptions of the benefits of taking part in an evaluation of dignity therapy for people with advanced cancer. J Pain Symptom Manag 45(4):712–725. doi:10.1016/j.jpainsymman.2012.03.009

    Article  Google Scholar 

  21. Houmann LJ, Chochinov HM, Kristjanson LJ, Petersen MA, Groenvold M (2014) A prospective evaluation of dignity therapy in advanced cancer patients admitted to palliative care. Palliat Med 28(5):448–458. doi:10.1177/0269216313514883

    Article  PubMed  Google Scholar 

  22. Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM, Ferrell BR, Loscalzo M, Meier DE, Paice JA, Peppercorn JM, Somerfield M, Stovall E, Von Roenn JH (2012) American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol: Off J Am Soc Clin Oncol 30(8):880–887. doi:10.1200/jco.2011.38.5161

    Article  Google Scholar 

  23. Dose AM, Hubbard JM, Mansfield AS, McCabe PJ, Krecke CA, Sloan JA (in press) Feasibility and acceptability of dignity therapy/life plan for patients with advanced cancer. Oncology nursing forum

  24. Chochinov HM (2012) Dignity therapy: final words for final days. Oxford university press, Oxford

    Book  Google Scholar 

  25. Graneheim UH, Lundman B (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 24(2):105–112. doi:10.1016/j.nedt.2003.10.001

    Article  CAS  PubMed  Google Scholar 

  26. Giannantonio C (2010) Book review: Krippendorff, K. (2004). Content analysis: an introduction to its methodology (2nd ed.). Thousand oaks, CA: sage. Organ Res Methods 13(2):392–394

    Article  Google Scholar 

  27. Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care: J Int Soc Qual Health Care / ISQua 19(6):349–357. doi:10.1093/intqhc/mzm042

    Article  Google Scholar 

  28. Piderman KM, Egginton JS, Ingram C, Dose AM, Yoder TJ, Lovejoy LA, Swanson SW, Hogg JT, Lapid MI, Jatoi A, Remtema MS, Tata BS, Radecki-Breitkopf C (2016) I’m still me: inspiration and instruction from individuals with brain cancer. Journal of Health Care Chaplaincy. http://www.Tandfonline.Com/action/showCitFormats?Doi=10.1080/08854726.2016.1196975

  29. Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363(8):733–742. doi:10.1056/NEJMoa1000678

    Article  CAS  Google Scholar 

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Acknowledgements

People: The authors would like to acknowledge Catherine Krecke for expert coordination of this study.

Grants: This publication was made possible by CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) and by the Saint Marys Hospital Sponsorship Board. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH or Saint Marys Hospital.

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Authors and Affiliations

  1. Department of Nursing, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Ann Marie Dose & Lori M. Rhudy

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  1. Ann Marie Dose
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  2. Lori M. Rhudy
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Corresponding author

Correspondence to Ann Marie Dose.

Ethics declarations

The study was approved by the Mayo Clinic institutional review board.

Conflict of interest

The authors declare that they have no conflict of interest.

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Dose, A.M., Rhudy, L.M. Perspectives of newly diagnosed advanced cancer patients receiving dignity therapy during cancer treatment. Support Care Cancer 26, 187–195 (2018). https://doi.org/10.1007/s00520-017-3833-2

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  • DOI: https://doi.org/10.1007/s00520-017-3833-2

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