Kelly Claire, Kynoch Kathryn, Ramis Mary-Anne
Mater Health, Raymond Terrace, South Brisbane, Australia.
Mater Health and Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Newstead, Brisbane, Australia.
J Palliat Care. 2023 Oct;38(4):456-464. doi: 10.1177/08258597231154221. Epub 2023 Feb 5.
Dignity therapy is a short-term psychotherapy used to help patients at end of life through addressing distress and enhancing dignity. The objective of this study was to assess the effectiveness and feasibility of introducing dignity therapy into a hospital-based cancer care service. A feasibility study was undertaken using a randomised controlled trial design. Participants were adult patients receiving systemic treatment for cancer or haematological malignancy with palliative intent, within an Australian ambulatory cancer treatment centre. Outcomes of interest were patient distress levels and feasibility of intervention delivery. Participants completed two self-reported distress scales at recruitment and four weeks following (control group) or one month after intervention delivery (intervention group). Patients receiving the intervention also completed the dignity therapy patient feedback questionnaire. Feasibility was measured by collecting data on time required to implement the intervention with subsequent crude cost estimates calculated. Study procedures are reported according to CONSORT guidance. Fifteen patients were recruited for the study. Participants in the intervention group reported small but significantly different lower distress scores than those in the control group at 4 weeks. The time taken to deliver the intervention ranged from 5.5 to 11 h with subsequent cost dependent on the remuneration of the dignity therapy therapist. Findings support other studies on the benefit to patients from delivering a dignity therapy intervention at end of life. Feasibility is influenced by multidisciplinary team support, resource availability and the designated therapist delivering the intervention. Larger sample sizes are needed to ascertain effect.
尊严疗法是一种短期心理治疗方法,旨在通过缓解痛苦和提升尊严来帮助临终患者。本研究的目的是评估将尊严疗法引入以医院为基础的癌症护理服务中的有效性和可行性。采用随机对照试验设计进行了一项可行性研究。参与者为澳大利亚一家门诊癌症治疗中心内接受姑息性全身治疗的成年癌症或血液系统恶性肿瘤患者。感兴趣的结果是患者的痛苦程度和干预实施的可行性。参与者在招募时以及(对照组)四周后或干预实施后一个月完成两份自我报告的痛苦量表。接受干预的患者还完成了尊严疗法患者反馈问卷。通过收集实施干预所需时间的数据并计算随后的粗略成本估计来衡量可行性。研究程序按照CONSORT指南进行报告。该研究招募了15名患者。干预组的参与者在4周时报告的痛苦得分比对照组略低,但差异显著。实施干预所需的时间为5.5至11小时,随后的成本取决于尊严疗法治疗师的报酬。研究结果支持了其他关于临终时实施尊严疗法对患者有益的研究。可行性受到多学科团队支持、资源可用性以及实施干预的指定治疗师的影响。需要更大的样本量来确定效果。