The Sense of Dignity at the End of Life: Reflections on Lifetime Values through the Family Photo Album

Abstract

This study focuses on the dimensions of dignity, linking Chochinov’s Dignity Therapy to Schwartz’s Theory of Values. The use of family photo albums has enriched the application of dignity therapy. Seven terminal patients in home-based palliative care participated in the therapeutic intervention. To measure the effects of the intervention, we administered the Edmonton Symptom Assessment Scale and the Patient Dignity Inventory, then, at the end of the meetings, collected the opinions of participants, available nurses, and relatives who attended the sessions. The resulting generativity documents were then analyzed through thematic analysis, which revealed three main themes linked to both fundamental values and the dimensions of dignity: The relationship between continuity of self and myriad values in the context of family relationships; personal dignity as characterized by the values of personal success, hope, and wisdom; and hope and generativity. The fourth theme reflected the participants’ final judgements on the intervention, which were highly positive and greatly encouraged further use of photographs in similar therapeutic interventions. The assessment protocol highlighted a significant decrease in tiredness amongst the participants and a trend towards a significant decrease in drowsiness after the intervention.

Reflecting on meaning in an existential-reorientation group psychotherapy approach for cancer patients: A qualitative thematic analysis

“…As indicated by other authors (Kissane et al, 1997), the process that focuses on discovering the meaning and on reflecting on the sense of the significance of the event of the disease (and its implications) is a corner-stone factor in psychotherapy. In the Italian experience, the expression of meaning came indirectly out in a different individual intervention (i.e., a modified version of Dignity Therapy, with the use of photographs) conducted in terminally ill cancer patients (Testoni et al, 2020). In that study, the continuity of self and myriad values in the context of family relationships; personal dignity as characterized by the values of personal success, hope, and wisdom; and hope and generativity.…”

“…For these reasons, group existentially oriented psychological intervention centered on giving sense and finding meaning (e.g., meaning-centered psychotherapy, MCP) have developed in the last 20 years both in palliative care (Breitbart, 2002;Breitbart et al, 2004) and other phases of illness, including survivorship (van der Spek et al, 2021).…”

Crafting Life Stories in Photocollage: An Online Creative Art-Based Intervention for Older Adults

“…Studies have shown how photographs facilitate recollection and allow for a better structuring of the narratives within the Dignity Therapy intervention [ 24 , 62 , 63 ]. Studies indicate how using photographs as therapeutic tools open up ways to recreate the life stories [ 64 ] and engage in the process of meaning making after loss [ 65 , 66 ].…”

“…Studies indicate how using photographs as therapeutic tools open up ways to recreate the life stories [ 64 ] and engage in the process of meaning making after loss [ 65 , 66 ]. The visual stimuli of the photographs can elicit themes that cannot be expressed by words alone, such as emotions, embodied expressions and muted or sensitive aspects of personal experience [ 62 , 63 ]. Moreover, the photographs, and the connections between them, can be presented in the photocollage as a visual generative document [ 24 ].…”

How People Express Grief by Sharing Photographs on Social Networks: A Comparative Study between Italy and the United States of America

“…[26]. The majority of research in this field has focused mainly on the verbal content observed or reported by the bereaved However SNSs, offer the possibility of visual manifestation of grief by publishing photographs or images related to the deceased, as photography is one of the simplest ways to remember [27][28][29]. From a historical perspective, the use of postmortem photography, also called memento mori photography, was widespread in the United States during the 19th century [30].…”