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Outcomes of a Dignity Therapy/Life Plan Intervention for Patients With Advanced Cancer Undergoing Chemotherapy

Dose, Ann M., PhD, RN; McCabe, Pamela J., PhD, RN; Krecke, Catherine A., CCRP; Sloan, Jeff A., PhD

Journal of Hospice & Palliative Nursing: August 2018 - Volume 20 - Issue 4 - p 400–406
doi: 10.1097/NJH.0000000000000461
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Dignity therapy is a psychosocial intervention provided at the end of life to improve patient outcomes, but many persons cannot complete it because of health decline. Patients also reprioritize their life plans as death becomes imminent. As part of meeting standards to provide psychosocial palliative care simultaneously with cancer treatment, we provided a dignity therapy/life plan intervention to 18 patients with advanced pancreatic or lung cancer receiving cancer treatment. The study aim was to evaluate patient-reported outcomes of dignity therapy/life plan. Dignity therapy entailed interviews during 3 outpatient oncology encounters, which then became a legacy document for family. Participants documented life goals as their life plan. Distress, quality of life, spirituality, dignity, and purpose in life were measured at baseline, immediately after intervention, and 3 months later. No variables were significantly different from baseline to postintervention and 3 months later, except for less distress between baseline and 3 months (P = .04). Although this intervention did not show improvements in outcomes, patients with advanced disease receiving active treatment typically experience worsening symptoms overall. Maintaining psychosocial outcomes may be preventing further morbidity in an advanced cancer population during treatment and bears further exploration. Given our small sample size, further research is warranted.

Ann M. Dose, PhD, RN, is nurse scientist, Department of Nursing, Mayo Clinic, Rochester, Minnesota.

Pamela J. McCabe, PhD, RN, is nurse scientist, Department of Nursing, Mayo Clinic, Rochester, Minnesota.

Catherine A. Krecke, CCRP, is clinical research coordinator, Department of Nursing, Mayo Clinic, Rochester, Minnesota.

Jeff A. Sloan, PhD, is consultant, Division of Biostatistics and Informatics, Mayo Clinic, Rochester, Minnesota.

Address correspondence to Pamela J. McCabe, PhD, RN, Department of Nursing, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (

This publication was made possible by CTSA grant UL1 TR000135 from the National Center for Advancing Translational Sciences, a component of the National Institutes of Health (NIH), and by the Mayo Clinic–Saint Marys Campus Sponsorship Board. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH or Saint Marys Hospital.

The authors have no conflicts of interest to disclose.

© 2018 by The Hospice and Palliative Nurses Association.