Effect of dignity therapy on end-of-life psychological distress in terminally ill Portuguese patients: A randomized controlled trial
Effect of dignity therapy on end-of-life psychological distress in terminally ill Portuguese patients: A randomized controlled trial
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DOI：
10.1017/s1478951516001140
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发表时间：
2017-12-01
影响因子：
2.2
通讯作者：
Barbosa, Antnio
中科院分区：
文献类型：
--
作者：
Juliao, Miguel;Oliveira, Fatima;Barbosa, Antnio
目的：尊严疗法（DT）是一种简短的心理治疗形式，为患有生命限制性疾病的患者开发，已证明在治疗临终心理困扰的几个方面有效。我们的目的是确定DT对士气低落综合征（DS），死亡欲望（DfD）和尊严感（SoD）的影响，在临终病人经历了高水平的痛苦在姑息治疗unit.Method：一个非盲II期随机对照试验进行了80例患者谁被随机分配到两组之一：干预组（DT +标准姑息治疗[SPC]）或对照组（仅SPC）。主要结局为DS、DfD和SoD，分别根据DS标准、死亡愿望评定量表和患者尊严量表（PDI）进行测量。在基线（第1天）和随访第4天评估所有量表。该研究在http://www.controlled-trials.com/ISRCTN34354086.Results上注册：在80名参与者中，41名随机分配至DT组，39名随机分配至SPC组。两组的基线特征相似。与SPC相比，DT与DS显著降低相关（DT DS患病率= 12.1%; SPC DS患病率= 60.0%; p < 0.001）。同样，DT与DfD患病率显著降低相关（DT DfD患病率= 0%; SPC DfD患病率= 14.3%; p = 0.054）。与分配到对照组的参与者相比，那些谁收到DT显示在25个PDI items.Significance的19个统计学显着减少结果：尊严治疗有一个有益的影响，对患者遇到的心理困扰接近生命的尽头。我们的研究表明，DT是一种重要的心理治疗方法，应纳入临床护理计划，它可以帮助更多的患者科普他们的临终体验。
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 http://www.controlled-trials.com/ISRCTN34354086.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.