Ageing: in need of care Not Applicable
Conditions
Interventions
Dignity Therapy: This is a brief psychotherapy to foster a sense of dignity and reduce psychological and spiritual distress in people reaching the end of life. The therapy involves a therapist conduct
Sponsors
King's College London (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Residents (males and females) aged 65 years old or over, living in one of six care homes for older people, are included. Not all residents have a "terminal" illness and they are not selected on the basis of receiving palliative care. However, all residents in nursing homes are frail and could be considered as reaching the end of life. Participants are not screened for spiritual or psychological distress, or loss of dignity, however, these are assessed at baseline, to explore the potential moderating effects of these variables on the impact of the intervention.
Exclusion criteria
Exclusion criteria: 1. Residents who are considered by the care home managers to be too ill to be interviewed 2. Unable to provide informed consent either due to cognitive problems, or to the severity of their illness, or because they are unable to understand English
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Residents' sense of dignity, assessed using the Patient Dignity Inventory at baseline, 1 and 8 weeks post-intervention, and the equivalent in the control group. Themes covered by this questionnaire include physical, psychosocial, existential and spiritual domains of concern or distress. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Potential effectiveness, assessed at baseline, 1 and 8 weeks post-intervention, and the equivalent in the control group, by the following: 1.1. Geriatric Depression Scale 1.2. Herth Hope Index 1.3. Euroqol EQ-5D 1.4. A two-item measure of quality of life specifically designed to assess the effectiveness of the Dignity Therapy 2. Feasibility, recruitment (residents and their family and friends), assessed at the end of the trial: 2.1. Exclusions, drop-out rates 2.2. Time taken to obtain informed consent and organise and conduct the dignity therapy sessions, transcribe and edit narratives and collect outcomes 2.3. Deviations from the therapy protocol and uncompleted interventions and the reasons for this 2.4. Therapist's perceptions of competence as a result of training 3. Acceptability, assessed by semi-structured interviews with residents to obtain their views on Dignity Therapy (intervention group only) and on taking part in the study (both groups). These qualitative interviews will be conducted before quantitative measures are collected, 1 and 8 weeks post-intervention, and the equivalent in the control group. The therapist records her experiences of delivering the therapy and observations of resident's responses. Case reports will be produced for any difficult cases and, with the consent of participants, a detailed qualitative analysis of the therapy transcripts will be carried out. The latter might provide insight into concerns which might impact on the effectiveness of the intervention. | — |
Countries
United Kingdom
Outcome results
None listed