The effect of dignity therapy on the quality of life of patients with cancer receiving palliative care

Abstract

Background: Patients with cancer deal with physical, psychosocial, spiritual, and existential problems that impact on their quality of life. This study aimed to assess the effect of dignity therapy on the quality of life of mentioned patients. Materials and Methods: In this quasi-experimental study, 50 patients with cancer hospitalized in a palliative care center in Tehran, Iran, in 2017-18 who fulfilled inclusion criteria were selected through convenience sampling. The European Organization for Research and Treatment of Cancer Quality of Life-C15-Palliative (EORTC-QLQ-C15-PAl) questionnaire was filled by patients before and 2 weeks after dignity therapy. Data were analyzed using descriptive statistics such as frequency, mean, and standard deviation, as well as inferential statistics, including independent t-test and Chi-square test. Results: Results showed that dignity-therapy led to more improvement in the quality of life of the intervention group (t 35,18 = 4.82, p = 0.001). There was also a significant difference between the two groups in terms of the physical functioning scale (t 32,96 = -2.60,p = 0.01) and emotional functioning (t 45,69 = 6.54, p < 0.001). We also found that dignity-therapy led to more improvement in nausea and vomiting (χ 2 = 5.71, p = 0.02), insomnia (χ 2 = 15.78, p < 0.001), appetite (χ 2 = 5.09, p = 0.02), and constipation (χ 2 = 12.50, p < 0.001). Conclusions: The application of new approaches like-dignity therapy could benefit patients with cancer in terms of reducing their distress, improving symptom severity, physical and emotional functioning, and total quality of life.

Current State of Palliative Care in Iran and Related Issues

“…The important components and findings of final included articles are presented in Table 2 . Results of the study showed that included studies had a focus on different patients/participants including cancer,[ 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 ] hemodialysis,[ 45 ] heart failure,[ 46 47 ] chronic disease,[ 48 ] chronic pain,[ 49 ] and with anonymous groups. [ 50 51 52 53 54 55 ] Several provinces/cities were engaged in the studies including Tehran,[ 12 13 14 15 17 20 21 24 25 26 29 30 31 32 33 34 35 37 39 40 41 42 43 48 , 51 , 52 Isfahan,[ 22 27 28 …”

“…[ 50 51 52 53 54 55 ] Several provinces/cities were engaged in the studies including Tehran,[ 12 13 14 15 17 20 21 24 25 26 29 30 31 32 33 34 35 37 39 40 41 42 43 48 , 51 , 52 Isfahan,[ 22 27 28 38 55 ] Kerman,[ 45 53 ] Tabriz,[ 16 36 ] Mashhad,[ 18 19 ] Yasouj,[ 44 ] Gorgan,[ 49 ] Neyshabour,[ 50 ] Jiroft,[ 46 47 ] Meybod/Ardakan,[ 54 ] Gorgan/Gonabad. [ 23 ] Majority of studies had quantitative approach, including interventional,[ 17 18 19 22 23 29 31 33 35 44 47 49 54 ] descriptive,[ 20 39 41 42 50 53 ] and correlational-analytical. [ 37 45 46 51 ] This was then followed by qualitative[ 12…”

“…[ 37 45 46 51 ] This was then followed by qualitative[ 12 13 14 15 16 21 24 25 26 27 30 32 34 36 40 43 48 52 ] and mixed methods. [ 28 38 55 ] In quantitative interventional PC studies, a range of medical-surgical,[ 17 18 19 23 29 31 33 37 ] educational,[ 44 49 54 ] and psycho-spiritual[ 22 35 ] managements were used as an independent variable.…”

“…PC interventions were led to a variety of positive changes in dependent variables measured including reducing in pain severity,[ 17 ] change in life pattern,[ 49 ] a good response to therapy,[ 19 ] increase life expectancy,[ 22 ] improve in dysphagia,[ 23 ] improve QoL,[ 18 31 35 44 47 ] reduce patients' metastasis,[ 33 ] and increase in nurses' self-efficacy. [ 54 ] In one study,[ 29 ] PC had no effect on the outcome (urinary symptoms).…”

“…Conducting more research with different patients' populations in several geographical areas of Iran might also reveals problems are culturally, socially, or economically context-bonded. ↱Findings of the study also showed that in quantitative studies, whether in selecting the type of intervention[ 17 19 22 23 29 31 33 35 44 47 49 54 ] or evaluating the dependent variables,[ 17 19 29 33 37 ] the main focus was on the physical aspect of the PC and other psychosocial and spiritual aspects have been neglected. PC care includes several principles, including pain relief and other uncomfortable symptoms and integration of psychological and spiritual aspects of patient care,[ 56 ] regardless of the stage of illness.…”