Dignity Impact as a Primary Outcome Measure for Dignity Therapy

Area of Science:

• Palliative Care
• Psychosocial Interventions
• Spiritual Health

Background:

• Dignity Therapy (DT) is feasible in palliative care, but efficacy evidence is inconsistent.
• Previous studies may not have captured DT's primary spiritual effects.
• A new outcome measure, the Dignity Impact Scale (DIS), was developed to assess these spiritual impacts.

Purpose of the Study:

• To examine the properties of the newly developed Dignity Impact Scale (DIS).
• To analyze the impact of Dignity Therapy on spiritual well-being using the DIS.

Main Methods:

• Secondary analysis of posttest data from a 3-arm, multi-site randomized controlled trial (RCT).
• Participants (n=326) received standard palliative care, client-centered care, or DT.
• The 7-item DIS, derived from the DT Patient Feedback Questionnaire, demonstrated strong internal consistency (α = 0.85).

Main Results:

• Patients receiving DT (n=108) had significantly higher mean DIS scores (21.4 ± 5.0) compared to usual care (17.7 ± 5.5) and client-centered care (17.9 ± 4.9) groups (P < .001).
• The DIS showed strong internal consistency, indicating reliability as a measure.

Conclusions:

• DT significantly enhanced spiritual well-being, as indicated by higher DIS scores.
• The findings support the use of the DIS as a primary outcome measure for evaluating DT.
• DT's focus on meaning-making and life completion tasks aligns with the spiritual domain measured by the DIS.