Dignity Therapy (DT) is a brief, individualized, narrative psychotherapy developed to reduce psychosocial and existential distress, and promote dignity, meaning, and hope in end of life patients. Previous studies have shown that DT was effective in reducing anxiety and depression, and improving dignity-related distress. However, less is known about its efficacy on spiritual well-being. The aim of this study is to contribute to the existing literature by investigating the effects of DT on specific dimensions of spiritual well-being, demoralization and dignity-related distress in a sample of terminally ill patients. A randomized, controlled trial was conducted with 64 terminally ill patients who were randomly assigned to the intervention group (DT + standard palliative care) or the control group (standard palliative care alone). The primary outcome measures were Meaning, Peace, and Faith whereas the secondary outcome measures were (loss of) Meaning and purpose, Distress and coping ability, Existential distress, Psychological distress, and Physical distress. All measures were assessed at baseline (before the intervention), 7-10 and 15-20 days after the baseline assessment. The trial was registered with ClinicalTrials.gov (Protocol Record NCT04256239). The MANOVA yielded a significant effect for the Group X Time interaction. ANOVA with repeated measures showed a significant effect of time on peace and a significant Group X Time interaction effect on peace. comparisons revealed that, while there was a decrease in peace from pre-treatment to follow-up and from post-treatment to follow-up in the control group, there was no such trend in the intervention group. This study provides initial evidence that patients in the DT intervention maintained similar levels of peace from pre-test to follow-up, whereas patients in the control group showed a decrease in peace during the same time period. We did not find significant longitudinal changes in measures of meaning, faith, loss of meaning and purpose, distress and coping ability, existential, psychological and physical distress. The findings of our study are of relevance in palliative care and suggest the potential clinical utility of DT, since they offer evidence for the importance of this intervention in maintaining peace of mind for terminally ill patients.
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http://dx.doi.org/10.3389/fpsyg.2020.01468 | DOI Listing |
Nutrients
January 2025
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, 1870 Frederiksberg, Denmark.
: Nutritional risks in older adults, such as malnutrition and sarcopenia, are often underdiagnosed. Screening practices frequently rely on Unplanned Weight Loss (UPWL), potentially overlooking at-risk individuals. This study aims to assess the prevalence of nutritional risk, identified by UPWL and sarcopenia, across different body mass index categories in a nursing home (NH) population.
View Article and Find Full Text PDFJ Immunother Cancer
December 2024
Center for Regenerative Medicine, Kathmandu, Nepal
Low- and middle-income countries (LMICs) face a significant burden of cancer prevalence and incidence. However, the survival rates for patients with cancer in these regions are notably lower than those in high-income countries, primarily due to late diagnosis and limited access to advanced treatments. Chimeric antigen receptor (CAR) T-cell therapy has demonstrated promising outcomes in certain terminally ill patients with cancer, yet access to this treatment remains limited in LMICs, including Nepal.
View Article and Find Full Text PDFAm J Hosp Palliat Care
January 2025
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Objectives: To explore American Muslims' perceptions and experiences regarding hospice care within the United States.
Methods: A qualitative descriptive study of 11 participants, including one patient and ten family caregivers. Data was collected through semi-structured interviews and analyzed using a framework approach to identify key themes related to perceptions, ethical concerns, and experiences with hospice care.
Truth-telling for terminally ill patients is a challenging ethical and social issue for Chinese health care professionals. However, despite the existence of ethical and moral standards for nurses, they frequently encounter moral dilemmas when making decisions about truth-telling to patients with end-stage diseases in China. This article aims to provide ethical strategies for clinical nurses in China regarding truth-telling decisions for terminally ill patients on the basis of their individual autonomy.
View Article and Find Full Text PDFJ Pain Symptom Manage
January 2025
Department of Psychology, Indiana University Indianapolis, Indianapolis, Indiana, USA. Electronic address:
Context: While prognostic awareness has been commonly assessed as perceived illness terminality in patients with advanced cancer, both perceptions of illness severity and terminality may be correlated with symptom burden and quality of life.
Objectives: The present study examined physical and psychological symptoms, quality of life, and smoking status in relation to perceived illness severity and terminality in patients with advanced, inoperable lung and prostate cancer.
Methods: Patients (N=198) were recruited from hospitals in the midwestern U.
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