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TitleEffect of dignity therapy on end-of-life psychological distress in terminally ill Portuguese patients: A randomized controlled trial
Author(s)Fareleira, Miguel António Costa Bandeira Arez Julião
Oliveira, Fátima
Nunes, Baltazar
Carneiro, António Vaz
Barbosa, António
KeywordsDignity therapy
End-of-life psychological distress
Randomized controlled trial
Palliative care
Issue date2017
PublisherCambridge University Press
JournalPalliative & Supportive Care
CitationJulião, M., Oliveira, F., Nunes, B., Carneiro, A. V., & Barbosa, A. (2017). Effect of dignity therapy on end-of-life psychological distress in terminally ill Portuguese patients: A randomized controlled trial. Palliative & supportive care, 15(6), 628-637
Abstract(s)Objective: Dignity therapy (DT) is a brief form of psychotherapy developed for patients living with a life-limiting illness that has demonstrated efficacy in treating several dimensions of end-of-life psychological distress. Our aim was to determine the influence of DT on demoralization syndrome (DS), the desire for death (DfD), and a sense of dignity (SoD) in terminally ill inpatients experiencing a high level of distress in a palliative care unit. Method: A nonblinded phase II randomized controlled trial was conducted with 80 patients who were randomly assigned to one of two groups: the intervention group (DT + standard palliative care [SPC]) or the control group (SPC alone). The main outcomes were DS, DfD, and SoD, as measured according to DS criteria, the Desire for Death Rating Scale, and the Patient Dignity Inventory (PDI), respectively. All scales were assessed at baseline (day 1) and at day 4 of follow-up. This study is registered with Results: Of the 80 participants, 41 were randomized to DT and 39 to SPC. Baseline characteristics were similar between the two groups. DT was associated with a significant decrease in DS compared with SPC (DT DS prevalence = 12.1%; SPC DS prevalence = 60.0%; p < 0.001). Similarly, DT was associated with a significant decrease in DfD prevalence (DT DfD prevalence = 0%; SPC DfD prevalence = 14.3%; p = 0.054). Compared with participants allocated to the control group, those who received DT showed a statistically significant reduction in 19 of 25 PDI items. Significance of results: Dignity therapy had a beneficial effect on the psychological distress encountered by patients near the end of life. Our research suggests that DT is an important psychotherapeutic approach that should be included in clinical care programs, and it could help more patients to cope with their end-of-life experiences.
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AccessOpen access
Appears in Collections:ICVS - Artigos em Revistas Internacionais com Referee

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