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Dignity Therapy Effective For Dying Patients, Study Says

Dignity therapy, a form of psychotherapy, may help terminally ill patients better cope with the psychological effects of dying, according to a new study.

Dignity therapy helps dying patients articulate what gave meaning to their lives and to say what they want to loved ones while they still have time, according to lead researcher, Dr. Harvey Chochinov, of the University of Manitoba in Winnipeg, in a news release. “It helps them define their own legacy and provides them with a tangible written document they can pass down to their survivors. By contrast, standard end-of-life care is focused mainly on easing patient discomfort from pain and stress.”

Chochinov and his colleagues studied 326 patients in New York City, Perth, Australia and Winnipeg, Canada, who were expected to live 6 months or less.

The therapy did not seem to have an effect on depression or other serious signs of distress, but these were not common in the study participants to begin with.

Secondary outcomes of self-reported end-of-life experiences were assessed in a survey that was undertaken after the completion of the study. For the secondary outcomes, patients reported that dignity therapy was significantly more likely than the other two interventions to have been helpful, improve quality of life, increase sense of dignity, change how their family saw and appreciated them , and be helpful to their family.

Dignity therapy was significantly better than client-centered care in improving spiritual wellbeing, and was significantly better than standard palliative care in terms of lessening sadness or depression; significantly more patients who had received dignity therapy reported that the study group had been satisfactory, compared with those who received standard palliative care

Dignity therapy as administered in the study involved 3 meetings between therapist and patient, each lasting 30 to 60 minutes. Conversations focused on the most important aspects of the patient’s life, and how he or she wanted to be remembered.

The sessions were recorded and transcribed, then edited into a document for the patient to give to whomever he or she wanted. Some patients in the study who received dignity therapy reported that it changed how their family saw and appreciated them.

Chochinov said some patients used dignity therapy as a last opportunity to share recollections, to extend their influence after their death, and to express feelings of love and appreciation for life’s blessings. He said many also discussed things that were difficult, tragic or sad, such as expressions of remorse or regret, apologies, and requests for forgiveness.

Although the ability of dignity therapy to mitigate outright distress, such as depression, desire for death or suicidality, has yet to be proven, the study’s authors say its benefits in terms of self-reported end-of-life experiences support its clinical application for patients nearing death.

Chochinov says research into psychological support of patients nearing the end of their lives is increasing, but not quickly enough. He says, “There are good ways of dying and bad ways of dying. We’re not doing a good enough job of caring for people at the end of their lives.”

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