jueves, 4 de agosto de 2011

Study: Dignity Therapy Effective for Dying Patients

Study: Dignity Therapy Effective for Dying Patients
Article date: August 1, 2011

By Stacy Simon

A form of psychotherapy called “dignity therapy” may help terminally ill patients better cope with the psychological effects of dying, according to a new study.

Dignity therapy helps dying patients articulate what gave meaning to their lives and to say what they want to loved ones while they still have time, according to lead researcher, Harvey Chochinov, MD, of the University of Manitoba in Winnipeg. It helps them define their own legacy and provides them with a tangible written document they can pass down to their survivors. By contrast, standard end-of-life care is focused mainly on easing patient discomfort from pain and stress.

Chochinov and his colleagues studied 326 patients in New York City, Perth, Australia and Winnipeg, Canada, who were expected to live 6 months or less. Those who received dignity therapy were significantly more likely than those who received standard end-of-life care to say the treatment was helpful, that it improved their quality of life and sense of dignity, and that it helped their families. The therapy did not seem to have an effect on depression or other serious signs of distress, but these were not common in the study participants to begin with.

The study was published in Lancet Oncology.

Dignity therapy as administered in the study involved 3 meetings between therapist and patient, each lasting 30 to 60 minutes. Conversations focused on the most important aspects of the patient’s life, and how he or she wanted to be remembered. Examples of questions include:

• Tell me a little about your life history, particularly the parts that you either remember most or think are the most important. When did you feel most alive?

• Are there specific things that you would want your family to know about you, and are there particular things you would want them to remember?

• Are there particular things that you feel still need to be said to your loved ones or things that you would want to take the time to say once again?

Leaving a Legacy
The sessions were recorded and transcribed, then edited into a document for the patient to give to whomever he or she wanted. Some patients in the study who received dignity therapy reported that it changed how their family saw and appreciated them.

Chochinov said some patients used dignity therapy as a last opportunity to share recollections, to extend their influence after their death, and to express feelings of love and appreciation for life’s blessings. He said many also discussed things that were difficult, tragic or sad, such as expressions of remorse or regret, apologies, and requests for forgiveness. Some family members said that the only time they heard their parents say they loved them or were proud of them was in the dignity therapy document.

Chochinov says research into psychological support of patients nearing the end of their lives is increasing, but not quickly enough. He says, “There are good ways of dying and bad ways of dying. We’re not doing a good enough job of caring for people at the end of their lives.”

Dignity therapy is a relatively new approach. You can learn more about it at dignityincare.ca. For more information on coping with cancer during the last few months of life, see our information on Nearing the End of Life or call us any time at 1-800-227-2345.

Reviewed by: Members of the ACS Medical Content Staff

Study: Dignity Therapy Effective for Dying Patients

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