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Outcomes of a Dignity Therapy/Life Plan Intervention for Patients With Advanced Cancer Undergoing Chemotherapy
Ann M Dose1, Pamela J McCabe, Catherine A Krecke
1Ann M. Dose, PhD, RN, is nurse scientist, Department of Nursing, Mayo Clinic, Rochester, Minnesota. Pamela J. McCabe, PhD, RN, is nurse scientist, Department of Nursing, Mayo Clinic, Rochester, Minnesota. Catherine A. Krecke, CCRP, is clinical research coordinator, Department of Nursing, Mayo Clinic, Rochester, Minnesota. Jeff A. Sloan, PhD, is consultant, Division of Biostatistics and Informatics, Mayo Clinic, Rochester, Minnesota.
Abstract:
Dignity therapy is a psychosocial intervention provided at the end of life to improve patient outcomes, but many persons cannot complete it because of health decline. Patients also reprioritize their life plans as death becomes imminent. As part of meeting standards to provide psychosocial palliative care simultaneously with cancer treatment, we provided a dignity therapy/life plan intervention to 18 patients with advanced pancreatic or lung cancer receiving cancer treatment. The study aim was to evaluate patient-reported outcomes of dignity therapy/life plan. Dignity therapy entailed interviews during 3 outpatient oncology encounters, which then became a legacy document for family. Participants documented life goals as their life plan. Distress, quality of life, spirituality, dignity, and purpose in life were measured at baseline, immediately after intervention, and 3 months later. No variables were significantly different from baseline to postintervention and 3 months later, except for less distress between baseline and 3 months (P = .04). Although this intervention did not show improvements in outcomes, patients with advanced disease receiving active treatment typically experience worsening symptoms overall. Maintaining psychosocial outcomes may be preventing further morbidity in an advanced cancer population during treatment and bears further exploration. Given our small sample size, further research is warranted.
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