Abstract
This study focuses on the dimensions of dignity, linking Chochinov’s Dignity Therapy to Schwartz’s Theory of Values. The use of family photo albums has enriched the application of dignity therapy. Seven terminal patients in home-based palliative care participated in the therapeutic intervention. To measure the effects of the intervention, we administered the Edmonton Symptom Assessment Scale and the Patient Dignity Inventory, then, at the end of the meetings, collected the opinions of participants, available nurses, and relatives who attended the sessions. The resulting generativity documents were then analyzed through thematic analysis, which revealed three main themes linked to both fundamental values and the dimensions of dignity: The relationship between continuity of self and myriad values in the context of family relationships; personal dignity as characterized by the values of personal success, hope, and wisdom; and hope and generativity. The fourth theme reflected the participants’ final judgements on the intervention, which were highly positive and greatly encouraged further use of photographs in similar therapeutic interventions. The assessment protocol highlighted a significant decrease in tiredness amongst the participants and a trend towards a significant decrease in drowsiness after the intervention.
Highlights
Numerous studies have shown that the underlying reason for patients’ desire for euthanasia is a depreciation in life value due to the loss of dignity and hope [1,2]
On the basis of this theoretical framework, Chochinov et al, developed an innovative, brief, and individualized psychotherapy called Dignity Therapy (DT) [6], which aims to reduce psychosocial–existential suffering, increase quality of life, and support a sense of meaning, purpose, and dignity [7] amongst people approaching the end of life by offering them a final opportunity to address important issues or to talk about things they would like to remember as death approaches [8,9]
The process of construction of this document facilitates the remembrance of images of their own life and to dwell on the most significant experiences. It is based on MDTP [10] and involves three elements [11]: The first is the preparation of a concrete generativity document—effectively the transcript of the audio-recorded interview—which reflects the patient’s personal sense of dignity/identity; the second is the tenor of care, which is based on Client-Centered Therapy (CTT) [12,13]; the third is the 11-question, semi-structured interview, which addresses the preservation of dignity and is divided into eight sub-themes
Summary
Numerous studies have shown that the underlying reason for patients’ desire for euthanasia is a depreciation in life value due to the loss of dignity and hope [1,2]. The process of construction of this document facilitates the remembrance of images of their own life and to dwell on the most significant experiences. It is based on MDTP [10] and involves three elements [11]: The first is the preparation of a concrete generativity document—effectively the transcript of the audio-recorded interview—which reflects the patient’s personal sense of dignity/identity; the second is the tenor of care, which is based on Client-Centered Therapy (CTT) [12,13]; the third is the 11-question, semi-structured interview, which addresses the preservation of dignity and is divided into eight sub-themes (continuity of self; role preservation; generativity/legacy; maintenance of pride; hopefulness; autonomy/control; acceptance; resilience/fighting spirit)
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