Department of Psychology, 3463University of Florida, Gainesville, FL, USA.
Department of Biobehavioral Nursing Science, 3463University of Florida, Gainesville, FL, USA.
Am J Hosp Palliat Care. 2022 Jan;39(1):54-61. doi: 10.1177/10499091211011712. Epub 2021 Apr 29.
Nearly 500,000 older Americans die a cancer-related death annually. Best practices for seriously ill patients include palliative care that aids in promoting personal dignity. Dignity Therapy is an internationally recognized therapeutic intervention designed to enhance dignity for the seriously ill. Theoretically, Dignity Therapy provides opportunity for patients to make meaning by contextualizing their illness within their larger life story. The extent to which Dignity Therapy actually elicits meaning-making from patients, however, has not been tested.
The current study examines (i) extent of patient meaning-making during Dignity Therapy, and (ii) whether baseline psychospiritual distress relates to subsequent meaning-making during Dignity Therapy.
Participants completed baseline self-report measures of psychospiritual distress (i.e., dignity-related distress, spiritual distress, quality of life), before participating in Dignity Therapy. Narrative analysis identified the extent of meaning-making during Dignity Therapy sessions.
Twenty-five outpatients ( age = 63, 5.72) with late-stage cancer and moderate cancer-related symptoms were recruited.
Narrative analysis revealed all patients made meaning during Dignity Therapy but there was wide variation (i.e., 1-12 occurrences). Patients who made greater meaning were those who, at baseline, reported significantly higher psychospiritual distress, including greater dignity-related distress ( = .46), greater spiritual distress ( = .44), and lower quality of life ( = -.56).
Meaning-making was found to be a central component of Dignity Therapy. Particularly, patients experiencing greater distress in facing their illness use the Dignity Therapy session to express how they have made meaning in their lives.
每年有近 50 万美国老年人死于与癌症相关的疾病。重病患者的最佳治疗方案包括姑息治疗，以帮助促进个人尊严。尊严疗法是一种国际公认的治疗干预措施，旨在增强重病患者的尊严。从理论上讲，尊严疗法为患者提供了通过将疾病置于其更大的生活故事中来赋予其意义的机会。但是，尊严疗法实际上是否能引起患者的意义建构尚未得到检验。
本研究考察了（i）尊严疗法中患者意义建构的程度，以及（ii）基线心理精神困扰与尊严疗法中随后的意义建构之间的关系。
参与者在参加尊严疗法之前，完成了基线自我报告的心理精神困扰（即与尊严相关的困扰，精神困扰，生活质量）的测量。叙述性分析确定了尊严疗法期间意义建构的程度。
招募了 25 名患有晚期癌症且癌症相关症状中度的门诊患者（年龄=63，5.72）。
叙述性分析表明，所有患者在尊严疗法中都找到了意义，但存在很大差异（即 1-12 次）。在基线时报告有较高心理精神困扰的患者，包括更高的与尊严相关的困扰（=0.46），更高的精神困扰（=0.44）和较低的生活质量（=-0.56），在尊严疗法中意义建构更多。
意义建构是尊严疗法的一个核心组成部分。特别是，在面对疾病时感到更大困扰的患者会利用尊严疗法来表达他们如何在生活中找到了意义。
