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Providing dignity therapy to patients with advanced cancer: a feasibility study within the setting of a hospital palliative care unit
被引:10
|作者:
Nunziante, Francesca
[1
]
Tanzi, Silvia
[2
,3
]
Alquati, Sara
[2
]
Autelitano, Cristina
[2
]
Bedeschi, Enrica
[4
]
Bertocchi, Elisabetta
[2
]
Dragani, Matilde
[1
]
Simonazzi, Davide
[5
]
Turola, Elena
[6
]
Braglia, Luca
[7
]
Masini, Luciano
[8
]
Di Leo, Silvia
[9
]
机构:
[1] Azienda USL IRCCS Reggio Emilia, Med Oncol Dept, Reggio Emilia, Italy
[2] Azienda USL IRCCS Reggio Emilia, Palliat Care Unit, Reggio Emilia, Italy
[3] Univ Modena & Reggio Emilia, Clin & Expt Med PhD Program, Modena, Italy
[4] Azienda USL IRCCS Reggio Emilia, Rheumatol Diabetol Week Hosp, Reggio Emilia, Italy
[5] Azienda USL IRCCS Reggio Emilia, Primary Care, Reggio Emilia, Italy
[6] Azienda USL IRCCS Reggio Emilia, Sci Directorate, Reggio Emilia, Italy
[7] Azienda USL IRCCS Reggio Emilia, Res & Stat Infrastruct, Reggio Emilia, Italy
[8] Casa Cura Villa Verde, Dept Med & Long Term Care, Reggio Emilia, Italy
[9] Azienda USL IRCCS Reggio Emilia, Psychooncol Unit, Reggio Emilia, Italy
关键词:
Dignity Therapy;
Palliative care;
Cancer;
Nurses;
Feasibility studies;
Mixed-method study;
Dignity-related distress;
TERMINALLY-ILL PATIENTS;
OF-LIFE;
QUALITATIVE RESEARCH;
FAMILY CAREGIVERS;
INTERVENTION;
END;
INVENTORY;
DISTRESS;
EFFICACY;
RESPECT;
D O I:
10.1186/s12904-021-00821-3
中图分类号:
R19 [保健组织与事业(卫生事业管理)];
学科分类号:
摘要:
Background: Dignity is a basic principle of palliative care and is intrinsic in the daily practice of professionals assisting individuals with incurable diseases. Dignity Therapy (DT) is a short-term intervention aimed at improving the sense of purpose, meaning and self-worth and at reducing the existential distress of patients facing advanced illness. Few studies have examined how DT works in countries of non-Anglo Saxon culture and in different real-life settings. Moreover, most studies do not provide detailed information on how DT is conducted, limiting a reliable assessment of DT protocol application and of its evaluation procedure. The aim of this study was to assess the feasibility and acceptability of a nurse-led DT intervention in advanced cancer patients receiving palliative care. Method: This is a mixed-method study using before and after evaluation and semistructured interviews. Cancer patients referred to a hospital palliative care unit were recruited and provided with DT. The duration of sessions, and timeframes concerning each step of the study, were recorded, and descriptive statistical analyses were performed. The patients' dignity-related distress and feedback toward the intervention were assessed through the Patient Dignity Inventory and the Dignity Therapy Patient Feedback Questionnaire, respectively. Three nurses were interviewed on their experience in delivering the intervention, and the data were analyzed qualitatively. Results: A total of 37/50 patients were enrolled (74.0%), of whom 28 (75.7%) completed the assessment. In 76.7% of cases, patients completed the intervention in the time limit scheduled in the study. No statistically significant reduction in the Patient Dignity Inventory scores was observed at the end of the intervention; most patients found DT to be helpful and satisfactory. Building opportunities for personal growth and providing holistic care emerged among the facilitators to DT implementation. Nurses also highlighted too great of a time commitment and a difficult collaboration with ward colleagues among the barriers. Conclusions: Our findings strongly support the acceptability, but only partially support the feasibility, of nurse-led DT in advanced cancer patients in a hospital setting. Further research is needed on how to transfer the potential benefits of DT into clinical practice.
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页数:12
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