Abstract
177 Background: Dignity Therapy (DT) is a psychosocial intervention used primarily at the end of life to improve quality of life and promote patient dignity, but many individuals are unable to complete it due to health decline/death. In addition, when individuals face potential mortality, they evaluate life plans to determine tasks and behaviors most important to them. Consistent with guidelines to provide palliative care interventions simultaneously with cancer treatment, the purpose of this study was to evaluate initial patient-reported outcomes of an intervention combination (Dignity Therapy + Life Plan [DT/LP]) for those with advanced pancreatic or lung cancer receiving treatment within a year of diagnosis. Methods: This was a single-arm, Phase I/II pilot study, conducted in the outpatient setting at an NCI-designated comprehensive cancer center. Dignity Therapy consisted of a focused life review intervention delivered during three outpatient oncology encounters for each patient. Interviews were audiotaped, transcribed, and edited to produce a legacy document. Participants scribed a list of 3-6 life goals for the LP intervention. Outcomes measured at baseline, immediately post DT/LP, and 3 months later were distress (Distress Thermometer), quality of life (FACT and LASA), spirituality (FaCIT-Sp-12), dignity (Patient Dignity Inventory), and purpose in life (Purpose in Life Test- Short Form). Data were analyzed with one-sample, two-sided t-tests (alternate: Wilcoxan). Results: Eighteen advanced pancreatic or lung cancer patients enrolled, mean age 64. There were no significant differences among all variables from baseline to post-DT/LP and 3 months later, with the exception of less distress experienced between baseline and 3 months after DT/LP ( p= 0.04). Conclusions: The DT/LP intervention did not show improvements in these psychosocial outcomes, but patients with advanced cancer typically experience worsening physical and psychosocial symptoms with active treatment. Therefore, maintaining these outcomes from baseline is a worthy goal, as we may be preventing further morbidity in an advanced cancer population. Further research is needed, however, given this small sample size. Clinical trial information: NCT02132325.
Published Version
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