None listed
Conditions
Brief summary
This study aims to evaluate the effectiveness of a new intervention called Dignity Therapy in patients with advanced cancer and patients receiving palliative care. Effects on sense of dignity, distress and quality of life will be investigated. Who is it for? You can join this study if: (a) you have a diagnosis of advanced cancer with life expectancy of 12 months or less, (b) you have no significant cognitive impairment, (c) you are at least 18 years of age, and (d) have at least basic fluency in English language. Trial Details: Dignity Therapy aims to strengthen a person’s sense of worth, meaning and purpose by allowing people to create a lasting legacy document for their loved ones. A legacy document can include information about a person’s life that they see as important or meaningful, personal history that they would want others to know about, words of wisdom and life lessons, personal values, hopes and dreams for their loved ones, words of advice and things that need to be said or repeated to their loved ones. A legacy document is created when an audio recording of this discussion is transcribed and given back to participants to make any necessary changes. Additions to legacy documents can also be made at this time. A final legacy document is given back to participants in paper form and a digital copy is also included on an archival CD. Although initial evaluations of Dignity Therapy in Western Australia, Canada and the United Kingdom have yielded positive results for both participants and their families, further research is required before conclusions can be made about effectiveness of Dignity Therapy. This study also aims to evaluate a similar intervention called Life Review. This intervention also involves discussion about past life experiences, important achievements, personal values and hopes and dreams for loved ones. However, Life Review is different to Dignity Therapy in that it does not involve creation of a legacy document. This discussion also needs to be recorded in order to make sure that the two interventions were delivered in an identical way. Direct comparison of these two interventions has never been done before. This will allow for specific conclusions to be made about their effectiveness in helping patients with advanced illnesses and their families. Participants in this trial will be randomly (by chance) assigned to one of three groups. One group will receive Dignity Therapy, second group will undergo Life Review and third group will receive standard care for 1 week and then undergo Dignity Therapy. Participants will be asked to complete questionnaires before and after treatment to assess their sense of dignity, distress and quality of life.
Interventions
Dignity Therapy
Dignity Therapy is a brief individualized psychological therapy specifically intended for terminally ill patients (Chochinov et al., 2004). It provides patients with an opportunity to create a legacy document that includes aspects of their life that they see as important or meaningful, personal history that they would want others to know, words of wisdom, personal values, hopes and dreams for their loved ones and things that need to be said to their loved ones. Patients are guid
Dignity Therapy Dignity Therapy is a brief individualized psychological therapy specifically intended for terminally ill patients (Chochinov et al., 2004). It provides patients with an opportunity to create a legacy document that includes aspects of their life that they see as important or meaningful, personal history that they would want others to know, words of wisdom, personal values, hopes and dreams for their loved ones and things that need to be said to their loved ones. Patients are guided through protocol questions, and the legacy document is created when a clinician records, transcribes, edits, and presents back the transcription of the session/s back to the patient who can then choose who they would give the legacy document to. It is a relatively brief intervention in that it typically takes one to three 45-minute sessions face-to-face with patient and additional time to transcribe the sessions, make edits and present the legacy document.
Sponsors
Dean Vuksanovic
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Diagnosis of advanced cancer with life expectancy of less than 12 months (clinical consensus) 2. Minimum age of 18 years 3. English speaking 4. Commitment to up to four contacts over approximately 7 to 10 days 5. No cognitive impairment (clinical consensus) 6. Willingness to provide verbal and written consent
Exclusion criteria
1. To reduce potential bias, patients previously followed by primary investigator who also works as a psychologist in cancer services and palliative care will be excluded from this study 2. Significant cognitive impairment (clinical consensus and/or scores on cognitive screening tools) Patients with advanced non-cancer illnesses will not be excluded from the study but due to setting of this study it is highly unlikely that a significant number will be recruited.
Outcome results
None listed