The development of a family participatory dignity therapy programme for patients with haematologic neoplasms and their family caregivers in China: A feasibility study

Abstract

Objective To develop a communication prompt based on dignity therapy to facilitate effective conversations between patients with haematologic neoplasms and their family caregivers and to improve the programme and preliminarily explore the benefits and challenges of family participatory dignity therapy (FPDT). Methods A mixed‐methods approach was applied to develop and revise the programme. The FPDT was developed and validated using the Delphi survey, and its further improvement was explored with a simple one‐group pre‐ and post‐trial and semi‐structured in‐depth interviews. Results Most of the FPDT items were endorsed by experts and patient–family dyads. The Content Validity Index was 93.6% in the first round of the Delphi survey and 100% in the second round. The “hope level,” “spiritual well‐being” and “general health” scores of pre‐ and post‐testing increased from 33.60 ± 4.30 to 37.70 ± 5.10 (t = 3.99, p = .003); from 30.30 ± 3.65 to 38.80 ± 7.29(t = 4.13, p = .003); and from 41.67 ± 8.78 to 53.33 ± 8.05 (t = 3.50, p = .007) respectively. The qualitative data also indicated that the project was meaningful and well received. Conclusions We showed that FPDT was a valuable and feasible means of improving communication between patients with haematologic neoplasms and their family caregivers in China by raising the hope level and spiritual well‐being and promoting general health.

Prevalence and factors associated with demoralization in palliative care patients: A cross-sectional study from Hong Kong

“…Our findings highlight the possible positive effects of family support for reducing the demoralization of palliative care patients. Palliative care professionals may focus on how they may help family members to better convey their support to patients with demoralization, like facilitating family members' developing meaningful interactions with patients via legacy activities (Allen et al, 2008;Allen, 2009) and involving family members' participation in activities which aim to enhance patients' dignity in end-of-life care (Wang et al, 2020). At the same time, palliative care professionals may also need to pay attention to supporting family caregivers of palliative care patients who may be influenced by patients' demoralization and are at risk of demoralization (Hudson et al, 2012).…”

How dignity‐related distress interacts with quality of life in young adult patients with cancer during the active treatment stage: A network analysis

“…More qualitative studies and integrated cultural adaptations are needed to revise DT. Related studies have probed into this aspect 39 …”

Dignity therapists' experience of conducting dignity therapy with terminal cancer patients in mainland China: A descriptive qualitative study

“…Besides, psychological suffering is considered as a stigma due to gossip and judgements from others, resulting in poor acceptance of psychological interventions. Considering the distinctive cultural features, it is important for dignity therapists to take Chinese cultural characteristics into account when conducting DT with Chinese patients (Wang et al, 2020), such as using euphemistic expressions and avoiding taboo words to protect patients from feeling offended. In addition, patients with an implicit personality expressed superficially in answering DT questions because of Confucian introverted culture and low literacy in rural areas in mainland China (Sun & Qin, 2009); while DT benefits patients depending on the full outpouring of patients in the therapeutic process (Chochinov, 2002), therefore, how to guide patients to unburden themselves should be a critical part of DT training.…”

“…Besides, applying other digital approaches, such as interviewing by videoconferencing or creating software‐generated e‐products, may allow for decreased time and cost (Bentley et al, 2020). Moreover, unexpected events such as sudden deterioration in health during DT implementation added more difficulties to therapists (Wang et al, 2020). Thus, it was suggested that dignity therapists need to get familiar with patients' health conditions with the help of the ward staff to identify the most appropriate time to conduct DT.…”

“…In mainland China, DT has been applied to patients with advanced diseases, such as advanced liver cancer, lung cancer and haematologic malignancies, to promote their sense of dignity and reduce psychological distress (Dai, 2011; Wang et al, 2020; Wang & Zhang, 2018). However, compared with Western culture, the traditional Chinese culture has certain uniqueness.…”