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Published on: October 25, 2019
Cultural acceptability and potential effectiveness of dignity therapy for patients with terminal cancer in Taiwan: A
Tzu-Yun Chiu1, Wei-Shu Lai2, Sheng-Yu Fan3
1Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Purpose:
This study assessed the cultural acceptability and clinical effectiveness of dignity therapy (DT) among terminal cancer patients in Taiwan, addressing a significant gap in evidence regarding its applicability in East Asian contexts.
Methods:
A quasiexperimental, nonrandomized controlled design with integrated qualitative feedback analysis was employed. Twenty-four terminal cancer patients were assigned to either an intervention group (DT plus comfort care, n = 12) or a control group (comfort care only, n = 12). Dignity-related distress was measured using the Patient Dignity Inventory-Mandarin Version (PDI-MV) at baseline, postintervention, and at the two-week follow-up. Acceptability was assessed using the Dignity Therapy Patient and Family Feedback Questionnaires (DTPFQ/DTFFQ). Quantitative data were analyzed using t tests and repeated-measures ANOVA, while qualitative responses were analyzed thematically.
Results:
Participants in the intervention group experienced a significant reduction in dignity-related distress over time (F = 10.08, P < 0.001), whereas no significant change was observed in the control group (F = 0.70, P = 0.50). High acceptability was reported by participants who received DT (M = 4.21/5) and their family members (M = 4.28/5). Qualitative analysis revealed three overarching themes: (1) emotional catharsis and relief, (2) meaning-making and restoration, and (3) mutual understanding and reconciliation.
Conclusion:
This study provides preliminary evidence supporting the feasibility, cultural relevance, and potential efficacy of DT in Taiwan. Integrating DT into culturally responsive palliative care may preserve patient dignity, reduce existential distress, and enhance meaningful family communication at the end of life in East Asian contexts.
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