Estudio comparativo de la eficacia del counselling y de la terapia de la dignidad en pacientes paliativos

Abstract

AimMany works contemplate patient needs at the end of life, with many integral models for palliative care interventions. The most commonly used methodology for meeting these needs is Counselling therapy, although recently there has been an increase in the international use of the Dignity therapy. This study aims to identify and quantify differences in emotional distress, quality of life, and preservation of dignity after both of these types of interventions. MethodA study of quasi-experimental design was developed in the Home Hospitalization Service (HHS) of University General Hospital of Valencia. After applying inclusion and exclusion criteria, 30 patients with an advanced oncology diagnosis were randomly assigned to the two intervention groups. Data were collected on sociodemographic, clinical, emotional distress (EVA), anxiety (HADS), depression (HADS), dignity (PDI) and quality of life (EORT-QLQ-30). Following intervention guides, patients received psychological treatment of 2-3 sessions per week at home. The statistics tests t and χ2 were used to compare the baseline characteristics of both groups, t tests for repeated measures to assess treatments efficacy, and t tests for independent groups to compare differences between interventions. ResultsThere were no differences between the groups at baseline, except for gender. The Counselling group improved in suffering, quality of life, and in two of the dignity dimensions (existential and dependence anguish). The Dignity group results were similar, except for anxiety, which did not improve after the intervention. The comparison of efficacy showed no differences between the interventions. ConclusionsBoth interventions were beneficial for patients, to the same extent, improving their quality of life, emotional well-being, and distress. Future research should study this situation taking into account one of the limitations of this study, the small sample size, and studying the repeatability of the results found in this ground-breaking work on Dignity Therapy in the Spanish context.