Exploring the impact of dignity therapy on distressed patients with advanced cancer: three case studies
Exploring the impact of dignity therapy on distressed patients with advanced cancer: three case studies
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DOI：
10.1002/pon.3206
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发表时间：
2013-08-01
期刊：
影响因子：
3.6
通讯作者：
Speck, Peter
中科院分区：
文献类型：
--
作者：
Hall, Sue;Goddard, Cassie;Speck, Peter
背景尊严疗法(DT)是为了减少临终病人的痛苦而发展起来的，然而，这种新的干预措施的评估主要涉及非痛苦样本。目的本研究的目的是详细探讨DT对晚期癌症痛苦患者的影响。对接受DT治疗的三名尊严相关痛苦程度最高的患者进行了深入调查。我们在基线、干预完成后1周和4周的面对面访谈中收集了患者的定量和定性结果。我们使用患者尊严问卷评估了与尊严相关的痛苦。患者在干预结束和两次随访时对DT的益处进行评分。结果这些患者在接受干预时正经历着一系列重大的或压倒性的生理和心理社会问题，其中大部分是不被期望得到帮助的。所有人都认为DT已经帮助了他们，并且已经帮助了或将帮助他们的家人；然而，患者对目前情况的担忧使得提供干预具有挑战性，当患者的病情恶化时，与DT相关的问题再次出现。结论DT可以在多大程度上帮助这些患者及其家人，无论是作为独立治疗还是作为其他治疗的辅助，需要在专注于苦恼患者的研究中确定，特别是那些有可能通过治疗帮助的问题。版权所有(C)2012 John Wiley&Sons，Ltd.
Background Dignity therapy (DT) has been developed to help reduce distress experienced by people nearing the end of life; however, evaluations of this novel intervention have largely involved non-distressed samples.Objective The objective of this study was to explore in detail the impact of DT on distressed patients with advanced cancer.Methods We used a case study approach. Three patients with the highest levels of dignity-related distress who received DT were explored in depth. We collected quantitative and qualitative outcomes from patients in face-to-face interviews at baseline and at 1 and 4weeks after completion of the intervention. We assessed dignity-related distress using the Patient Dignity Inventory. Patients rated the benefits of DT at completion of the intervention and at both follow-ups. We conducted qualitative interviews exploring experiences of DT with patients and with two recipients of generativity documents produced by patients.Results These patients were experiencing a wide range of major or overwhelming physical and psychosocial problems when they received the intervention, most of which would not be expected to be helped by DT. All felt that DT had helped them and had helped or would help their families; however, patients' concerns about their current situation made delivering the intervention challenging, and DT-relevant problems returned when a patients' condition deteriorated.Conclusions The extent to which DT can help these patients and their families, either as a stand-alone therapy or as an adjunct to other therapies, needs to be determined in studies focussing on distressed patients, particularly those with problems likely to be helped by the therapy.Copyright (c) 2012 John Wiley & Sons, Ltd.