Dignity therapy: A novel psychotherapeutic intervention for patients near the end of life
Dignity therapy: A novel psychotherapeutic intervention for patients near the end of life
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DOI：
10.1200/jco.2005.08.391
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发表时间：
2005-08-20
影响因子：
45.3
通讯作者：
Harlos, M
中科院分区：
文献类型：
--
作者：
Chochinov, HM;Hack, T;Harlos, M
目的本研究探讨了一种新的干预，尊严治疗，旨在解决心理社会和存在的困扰，在绝症患者。尊严疗法邀请患者讨论最重要的问题或他们最希望记住的问题。会议被转录和编辑，并返回最终版本，他们可以遗赠给朋友或家人。本研究的目的是建立尊严治疗的可行性，并确定其对各种措施的心理社会和存在的distress.Patients和方法的影响绝症住院病人和那些接受家庭为基础的姑息治疗服务，在加拿大温尼伯，澳大利亚珀斯，被要求完成前和干预后的措施的尊严感，抑郁，痛苦，和绝望;结果91%的参与者对尊严治疗感到满意，76%的参与者报告尊严感增强，68%的参与者报告目的感增强，67%的参与者报告意义感增强，68%的参与者报告目的感增强，67%的参与者报告意义感增强。47%的人表示生活意愿增加; 81%的人表示这对他们的家庭有帮助。干预后的痛苦测量显示出显着改善（P = 0.023）和减少抑郁症状（P = 0.05）。发现尊严治疗有助于他们的家庭与生活感觉更有意义相关（r = 0.480; P =.000）和有目的感（r = 0.562; P =.000），伴随着痛苦感的减轻结论尊严疗法是一种治疗临终痛苦的有效方法。
Purpose This study examined a novel intervention, dignity therapy, designed to address psychosocial and existential distress among terminally ill patients. Dignity therapy invites patients to discuss issues that matter most or that they would most want remembered. Sessions are transcribed and edited, with a returned final version that they can bequeath to a friend or family member. The objective of this study was to establish the feasibility of dignity therapy and determine its impact on various measures of psychosocial and existential distress.Patients and Methods Terminally ill inpatients and those receiving home-based palliative care services in Winnipeg, Canada, and Perth, Australia, were asked to complete pre- and postintervention measures of sense of dignity, depression, suffering, and hopelessness; sense of purpose, sense of meaning, desire for death, will to live, and suicidality; and a postintervention satisfaction survey.Results Ninety-one percent of participants reported being satisfied with dignity therapy; 76% reported a heightened sense of dignity; 68% reported an increased sense of purpose; 67% reported a heightened sense of meaning; 47% reported an increased will to live; and 81 % reported that it had been or would be of help to their family. Postintervention measures of suffering showed significant improvement (P =.023) and reduced depressive symptoms (P =.05). Finding dignity therapy helpful to their family correlated with life feeling more meaningful (r = 0.480; P =.000) and having a sense of purpose (r = 0.562; P =.000), accompanied by a lessened sense of suffering (r = 0.327; P =.001) and increased will to live (r = 0.387; P =.000).Conclusion Dignity therapy shows promise as a novel therapeutic intervention for suffering and distress at the end of life.