THURSDAY, July 7 (HealthDay News) -- A therapeutic dialogue
known as dignity therapy helped terminally ill patients improve
their quality of life and boost their sense of dignity while
changing how their family sees and appreciates them, according to
The short-term therapy did not, however, ease those distressed
by dying, as the researchers had hoped.
But it did offer many other benefits for the end-of-life
experience, according to Dr. Harvey Max Chochinov, the lead author
of the international study, which was published online July 7 in
The Lancet Oncology.
Chochinov, from the University of Manitoba in Winnipeg, Canada,
pioneered the concept of dignity therapy, which he defines as "a
brief individualized psychotherapy designed for people nearing the
end of life."
The treatment, he said, seems to "shine a light on personhood,"
as terminal illness can often make patients feel as if the person
they were is gone.
It speaks to people's need to leave something of themselves
behind, he added.
Dignity therapy involves a conversation between patient and
therapist about the things that are important to the patient. That
information is then audio-taped, transcribed and edited into a
readable narrative that the patient can choose to share with loved
"It can include biographical information, lessons learned, or wishes, hopes or dreams for people that they are about to leave behind," Chochinov said.
For the study, the first randomized trial of the therapy,
Chochinov and his colleagues compared dignity therapy involving 108
patients to standard palliative care (making patients comfortable)
for 111 patients and client-centered care (therapy focused on the
here-and-now) for 107 patients.
While researchers found no difference in distress levels among
the groups at the end of the study, there were differences in
quality of life, feeling helpful to loved ones and an improved
sense of dignity. The dignity groups had better results in all
compared to the other two groups.
Dignity therapy also improved spiritual well-being better than
did client-centered care, the investigators found, and it worked
better than standard care to reduce sadness or depression.
One man, whose life goals had been derailed by drinking
problems, said he hoped his kids and grandkids would use him as an
example of a way not to live. Another, happily married, said he
hoped his wife could find happiness with another partner after he
There's a reason the therapy is a transcript taken from an audio
recording, rather than a video, Chochinov noted. The approach
allows the patient to focus on the words and the message, not their
appearance, which could be altered greatly from illness.
The fact that the research did not find an effect on distress
"doesn't mean it isn't effective," said Dr. Cheryl Nekolaichuk, a
psychologist in palliative care at Grey Nuns Community Hospital in
Edmonton, Canada, who wrote a commentary on the study.
Nekolaichuk is familiar with dignity therapy and called it
helpful for those who want "to put things in perspective at a very
difficult time in life."
The therapy seems to help people build a legacy, added Dr. Alexi
Wright, an instructor in medicine at Harvard Medical School and the
Dana-Farber Cancer Institute in Boston.
"When that doesn't happen, families suffer," she said, noting that dignity therapy may help make a person's death easier on loved ones.
The research, which also involved researchers from three
Australian universities and Memorial Sloan-Kettering Cancer Center
in New York City, was funded by the U.S. National Cancer
To learn more about palliative care, visit the
National Palliative Care Research Center.