Abstract
For individuals with advanced cancer, quality of life (QOL) worsens due to disease and psychosocial factors, as well as cancer treatment itself. Palliative care, recommended to occur simultaneously with cancer treatment, improves outcomes, but we know little about the logistics of providing interventions and their influence on aspects of psychosocial QOL. Dignity Therapy (DT), a brief focused life review/values clarification intervention, improves outcomes at end of life. There are limited data about its feasibility during treatment and its pairing with a Life Plan (LP) intervention. This study’s purpose was to determine feasibility, acceptability and psychosocial outcomes of the DT/LP intervention for persons with advanced pancreatic cancer (PC) or non-small cell lung cancer (NSCLC) receiving treatment. DT was delivered during three outpatient cancer treatment visits. Audiotaped interviews were transcribed and edited to produce a document, which the participant kept. Life Plan is a type of ‘bucket list' of future hopes/dreams. Participant acceptability was evaluated, distress measured with the Distress Thermometer, and QOL measured with the Linear Analogue Self-Assessment (LASA) and Functional Assessment of Cancer Therapy (FACT) instruments. Baseline distress and QOL scores were compared with those after intervention completion, about 6 weeks later. Of 25 PC or NSCLC participants enrolled, seven withdrew, due to worsening disease or other life changes; 18 completed the intervention/measures. Seventy-eight percent felt it was worthwhile to participate in the study; 88% felt the timing of the DT/LG intervention was ‘just right.' Data trended toward improved emotional QOL, and lessened emotional distress and anxiety. These findings demonstrated our ability to recruit advanced cancer patients, retain them to complete the DT/LG intervention, validated that we were targeting a relevant population for DT/LG and allowed us to determine next steps in examining important outcomes and appropriate instruments to measure QOL and other important psychosocial outcomes.
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