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Objectives To examine the thematic features of dignity therapy generativity documents of advanced cancer patients receiving chemotherapy in mainland China from the perspective of meaning-making during dignity therapy. Methods This is a qualitative descriptive study. Content analysis was used to analyze 24 dignity therapy generativity documents derived from a quasi-experimental trial of dignity therapy for advanced cancer patients receiving chemotherapy in a daycare center at a cancer hospital in northern China. Results Among the 24 advanced cancer patients whose generativity documents were analyzed, 14 were male and ranged in age from 26 to 78 years (average = 50.3). Two dimensions emerged from the data: (1) the sources of meaning in life, which consisted of social relationships, things and circumstances providing meaning in life, and (2) the ultimate meaning in life, referring to finding one’s real self and realizing the purpose in life, including personal life goals, dignity and autonomy, and morality of patients. Significance of results The multidimensional constructs of meaning in life with distinctive traditional Chinese cultural characteristics could provide insights into dignity-conserving care for advanced cancer patients with Chinese culture and provide evidence for refining the implementation protocol of DT through intentionally addressing the ultimate meaning of patients in the therapeutic session.

Background: Palliative cancer patients and family members in China may experience difficulties in expressing their feelings, concerns, and needs to each other because of the death-taboo culture and the strong desire to protect each other from being exposed to emotional distress. Objectives: The aims of this study were to develop a nurse-led psychotherapeutic intervention aiming to facilitate meaningful conversations between palliative cancer patients and their family members, named family-based dignity therapy (FBDT), and preliminarily explore the anticipated benefits and challenges of the implementation of FBDT. Methods: A convergent parallel mixed-methods design was used. The FBDT was designed based on the dignity therapy protocol and additionally inspired by the Chinese tradition of "4 important things in life." Ten palliative cancer patients, 10 family members, and 13 oncology and hospice nurses were surveyed to evaluate the FBDT protocol both quantitatively and qualitatively. Results: The FBDT interview guide was endorsed by most palliative cancer patients and family members (>75.0%), as well as oncology and hospice nurses (>90.0%). Potential perceived benefits and challenges of FBDT were proposed by participants. The FBDT protocol was modified according to feedback from participants to make it more suitable to use in clinical practice in China. Conclusion: The FBDT was perceived to be a potentially promising