Abbreviated dignity therapy for adults with advanced-stage cancer and their family caregivers: Qualitative analysis of a pilot study

被引：19

作者：

Beck, Adrienne ^{[1
]}

Cottingham, Ann H. ^{[2
,3
]}

Stutz, Patrick V. ^{[3
]}

Gruber, Rachel ^{[3
]}

Bernat, Jennifer K. ^{[4
]}

Helft, Paul R. ^{[2
,5
,6
,7
]}

Wilhelm, Laura ^{[8
]}

Schmidt, Karen ^{[2
]}

Stout, Madison E. ^{[3
]}

Willard, Claire ^{[2
,5
,9
]}

Johns, Shelley A. ^{[2
,3
,5
,6
]}

机构：

[1] Univ Chicago, Chicago, IL 60637 USA

[2] Indiana Univ Sch Med, Indianapolis, IN 46202 USA

[3] Regenstrief Inst Inc, 1101 West 10th St, Indianapolis, IN 46202 USA

[4] Indiana Univ, Sch Nursing, Indianapolis, IN 46204 USA

[5] Indiana Univ Hlth, Charles Warren Fairbanks Ctr Med Eth, Indianapolis, IN USA

[6] Indiana Univ Purdue Univ, Res Palliat & End Life Commun & Training Ctr, Indianapolis, IN 46202 USA

[7] Indiana Univ, Melvin & Bren Simon Canc Ctr, Indianapolis, IN 46204 USA

[8] West Virginia Univ, Sch Med, Charleston, WV 25304 USA

[9] Eskenazi Hlth, Indianapolis, IN USA

来源：

PALLIATIVE & SUPPORTIVE CARE | 2019年 / 17卷 / 03期

基金：

美国国家卫生研究院;

关键词：

Dignity therapy; Existential; Autonomy; Palliative care; Advanced-stage cancer; TERMINALLY-ILL; OLDER-PEOPLE; CARE HOMES; OF-LIFE; INTERVENTION; FEASIBILITY; EXPERIENCE; END;

D O I：

10.1017/S1478951518000482

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

ObjectiveDignity therapy (DT) is designed to address psychological and existential challenges that terminally ill individuals face. DT guides patients in developing a written legacy project in which they record and share important memories and messages with those they will leave behind. DT has been demonstrated to ease existential concerns for adults with advanced-stage cancer; however, lack of institutional resources limits wide implementation of DT in clinical practice. This study explores qualitative outcomes of an abbreviated, less resource-intensive version of DT among participants with advanced-stage cancer and their legacy project recipients.MethodQualitative methods were used to analyze postintervention interviews with 11 participants and their legacy recipients as well as the created legacy projects. Direct content analysis was used to assess feedback from the interviews about benefits, barriers, and recommendations regarding abbreviated DT. The legacy projects were coded for expression of core values.ResultFindings suggest that abbreviated DT effectively promotes (1) self-expression, (2) connection with loved ones, (3) sense of purpose, and (4) continuity of self. Participants observed that leading the development of their legacy projects promoted independent reflection, autonomy, and opportunities for family interaction when reviewing and discussing the projects. Consistent with traditional DT, participants expressed family as the most common core value in their legacy projects. Expression of autonomy was also a notable finding.Significance of resultsAbbreviated DT reduces resource barriers to conducting traditional DT while promoting similar benefits for participants and recipients, making it a promising adaptation warranting further research. The importance that patients place on family and autonomy should be honored as much as possible by those caring for adults with advanced-stage cancer.

引用

页码：262 / 268

页数：7

共 21 条

[1] Dignity Therapy for People with Motor Neuron Disease and Their Family Caregivers: A Feasibility Study [J].