A Portuguese trial using dignity therapy for adults who have a life-threatening disease: Qualitative analysis of generativity documents

Abstract

Objectives Dignity therapy (DT) is a brief, individualized intervention, which provides terminally ill patients with an opportunity to convey memories, essential disclosures, and prepare a final generativity document. DT addresses psychosocial and existential issues, enhancing a sense of meaning and purpose. Several studies have considered the legacy topics most frequently discussed by patients near the end of life. To date, no Portuguese study has done that analysis. Method We conducted a qualitative analysis of 17 generativity documents derived from a randomized controlled trial (RCT). Inductive content analysis was used to identify emerging themes. Results From the 39 RCT participants receiving DT, 17 gave consent for their generativity document to undergo qualitative analysis. Nine patients were female; mean age of 65 years, with a range from 46 to 79 years. Seven themes emerged: “Significant people and things”; “Remarkable moments”; “Acknowledgments”; “Reflection on the course of life”; “Personal values”; “Messages left to others”; and “Requests and last wishes”. Significance of results Generativity document analysis provides useful information for patients nearing death, including their remarkable life moments and memories, core values, concerns, and wishes for their loved ones. Being conscious of these dominant themes may allow health providers to support humanized and personalized care to vulnerable patients and their families, enhancing how professionals perceive and respond to personhood within the clinical setting.

Patients' experiences and perceptions of dignity in end‐of‐life care in emergency departments: A qualitative study

“…From the point of view of the participants, dignity implies accepting the situation and the ability to continue making decisions, thus maintaining a sense of fulfilment and serenity in achieving their life objectives. Conserving dignity also relates to what we leave behind (our legacy) (Julião et al, 2022 ), acceptance and resilience, as well as how those around us respond to our situation and whether we are treated with respect and given independence. The definition of dignity in the last stages of life in EDs not only requires recognizing the inherent value of an individual, a notion supported by healthcare professionals (Fernández‐Sola et al, 2017 ), but also social and individual acceptance of death.…”

Manejo Da Dor

“…Essa terapia busca promover significado e propósito em pacientes que enfrentam o fim da vida, além de abordar temas como importância das relações, expressões de gratidão, reflexões sobre a trajetória de vida, valores pessoais e pedidos finais. Esses temas permitem uma abordagem mais humanizada e personalizada no cuidado de saúde, aprimorando a atenção às necessidades individuais dos pacientes (JULIÃO M, et al, 2022).…”

Effectiveness of dignity therapy in the context of culturally competent care in people with palliative care needs: a systematic review of systematic reviews

“…During the last two decades, there has been a growing number of papers regarding DT concerning psychosocial and spiritual outcomes for people with palliative care needs. Studies have found various benefits, such as decreased anxiety and depression and an improved sense of dignity, meaning and purpose among people approaching the end of their life 1–17▪,18–23▪,24 . DT is a well-accepted, tested and effective intervention; nevertheless, there needs to be a clear cultural understanding of the effectiveness of DT, particularly since it was developed and tested in Western countries.…”