Implementation and Evaluation of Dignity Therapy in Denmark
- Conditions
- Cancer
- Interventions
- Other: Dignity Therapy
- Registration Number
- NCT01507571
- Lead Sponsor
- Bispebjerg Hospital
- Brief Summary
The purpose of the study is to investigate whether Danish patients with incurable cancer have a need of, interest in and benefit from Dignity Therapy.
- Detailed Description
Research in palliative care has primarily focused on physical and psychological symptoms. Research in other psychosocial and existential problems has been sparse. Loss of dignity as a consequence of serious illness may be an important cause of suffering. The research team of the Canadian psychiatrist and professor, Harvey Chochinov has investigated the concept of dignity and developed the psychosocial intervention 'Dignity Therapy' (DT). The preliminary research results were promising.
Research questions: Do Danish cancer patients have a need of, interest in, and benefit from DT? Methods: DT consists of an interview revolving around the patient's life, values, and accomplishments and is also an opportunity to leave messages and words of hope and compassion for friends and family. The interview is audio taped, transcribed, and edited together with the patient, and made into a tangible document, which the patient can give to his/her relatives. The project consists of three parts: (1) a cross-sectional investigation of the prevalence of loss of dignity and related symptoms/problems among at least 200 incurable cancer patients. (2) A feasibility study, testing the intervention in terms of relevance and the need of any modifications in relation to Danish patients. (3) An evaluation study testing the effect of and satisfaction with DT.
At least 80 patients are planned for the feasibility and evaluation studies. Questionnaires are used for detection of loss of dignity and as measures of effect. These will be administered before the intervention and, along with a semi-structured evaluation questionnaire, right after the intervention, when the document is received and again approximately two weeks later.
The duration of the intervention (DT) varies markedly between patients. In some cases the process (interview, transcription, editing of document, and the final meeting where the document is given back to the patient) is completed urgently in a few days, whereas in other cases, the patient prefers a slower pace, and may want to sub-divide the interview into two or more parts. Also, when presented with the document, some patients want to have something changed or they want add material. This variation is seen as intentional, as it illustrates that the process is tailored to the patient's wishes.
As stated, the effect of the DT intervention is evaluated at completion of the intervention, i.e. when the final document is given back to the patient, and about two weeks later. Due to process described above, the time from the first measurement (before intervention) to the second measurement (which takes places at completion of the intervention) therefore varies considerably (median 36 days after baseline, range 7-121 days).
Perspective: If Danish patients have a need of, an interest in and benefit from DT, it can be offered to Danish patients admitted to palliative care.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 80
- diagnosis of incurable cancer,
- 18 years or older,
- informed of diagnosis and the incurable prognosis.
- dementia and other cognitive impairment,
- physical limitations,
- sufficient to preclude participation.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Dignity Therapy Dignity Therapy -
- Primary Outcome Measures
Name Time Method Sense of dignity Pre-post intervention (when the document was recieved by the patient), and again two weeks later. Measured with the Structured Interview for Symptoms and Concerns (SISC)
- Secondary Outcome Measures
Name Time Method Hopelessness Pre-post intervention (when the document was recieved by the patient), and again two weeks later. Measured with the Structured Interview for Symptoms and Concerns (SISC)
Anxiety Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the Hospital anxiety and depression scale
Depression Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured with the Structured Interview for Symptoms and Concerns
Not able to perform tasks of daily living Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the Patient Dignity Inventory
Suffering Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured with the Structured Interview for Symptoms and Concerns
performance status Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the Palliative Performance Scale v2
Communication Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the Structured Interview for Symptoms and Concerns
Social Contact Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the Structured Interview for Symptoms and Concerns
Not able to attend to bodily functions Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Physically distressing symptoms Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling how I look has changed Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Pain Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Feeling depressed Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling anxious Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling uncertain Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Worried about future Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Not able to think clearly Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Not able to continue usual routines Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling no longer who I was Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Not feeling worthwhile or valued Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Not able to carry out important roles Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling life no longer has meaning or purpose Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling of not having made a meaningful contribution Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling of unfinished business Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Concerns regarding spiritual life Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling like a burden to others Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling of not having control Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Feeling of reduced privacy Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Not feeling supported by friends or family Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Not feeling supported by health care providers Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Not feeling able to mentally fight illness Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Not being able to accept things as they are Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Not being treated with respect Pre-post intervention (when the document was received by the patient), and again two weeks later. Item from the Patient Dignity Inventory
Physical function Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Emotional function Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Overall quality of life Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Fatigue Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Nausea / Vomiting Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Dyspnoea Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Insomnia Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Appetite loss Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Constipation Pre-post intervention (when the document was received by the patient), and again two weeks later. Measured on the EORTC QLQ-C15-PAL
Trial Locations
- Locations (2)
Sankt Lukas Hospice
🇩🇰Hellerup, Denmark
Department of Palliative Medicine
🇩🇰Copenhagen, Denmark