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4. Engaging Mortality: Effective Implementation of Dignity Therapy.

Author

Wilkie, Diana J., Fitchett, George, Yao, Yingwei, Schoppee, Tasha, Delgado Guay, Marvin O., Hauser, Joshua, Kittelson, Sheri, O'Mahony, Sean, Rabow, Michael, Quest, Tammie, Solomon, Sheldon, Handzo, George, Chochinov, Harvey Max, and Emanuel, Linda L.

Subjects
CANCER patient psychology, MULTIPLE regression analysis, DIGNITY therapy, HEALTH outcome assessment, HUMAN services programs, HOSPITAL mortality, PRE-tests & post-tests, QUALITY of life, DESCRIPTIVE statistics, HOSPITAL nursing staff, RESEARCH funding, PALLIATIVE treatment
Abstract

Background: Patients consider the life review intervention, Dignity Therapy (DT), beneficial to themselves and their families. However, DT has inconsistent effects on symptoms and lacks evidence of effects on spiritual/existential outcomes. Objective: To compare usual outpatient palliative care and chaplain-led or nurse-led DT for effects on a quality-of-life outcome, dignity impact. Design/Setting/Subjects: In a stepped-wedge trial, six sites in the United States transitioned from usual care to either chaplain-led or nurse-led DT in a random order. Of 638 eligible cancer patients (age ≥55 years), 579 (59% female, mean age 66.4 ± 7.4 years, 78% White, 61% stage 4 cancer) provided data for analysis. Methods: Over six weeks, patients completed pretest/posttest measures, including the Dignity Impact Scale (DIS, ranges 7–35, low-high impact) and engaged in DT+usual care or usual care. They completed procedures in person (steps 1–3) or via Zoom (step 4 during pandemic). We used multiple imputation and regression analysis adjusting for pretest DIS, study site, and step. Results: At pretest, mean DIS scores were 24.3 ± 4.3 and 25.9 ± 4.3 for the DT (n = 317) and usual care (n = 262) groups, respectively. Adjusting for pretest DIS scores, site, and step, the chaplain-led (β = 1.7, p = 0.02) and nurse-led (β = 2.1, p = 0.005) groups reported significantly higher posttest DIS scores than usual care. Adjusting for age, sex, race, education, and income, the effect on DIS scores remained significant for both DT groups. Conclusion: Whether led by chaplains or nurses, DT improved dignity for outpatient palliative care patients with cancer. This rigorous trial of DT is a milestone in palliative care and spiritual health services research. clinicaltrials.gov: NCT03209440. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Competencies for quality spiritual care in palliative care in Latin America: from the Spirituality Commission of the Latin American Association for Palliative Care

Author

Espinel, Jorge, primary, Colautti, Norma, additional, Reyes Donoso, Maria M., additional, López Saca, Jose Mario, additional, Riveros Rios, Miriam Elisa, additional, Mazzotti, Umberto, additional, Espín González, Ismariel I., additional, Mas, Monica, additional, Rios, Myriam, additional, Ramos, Laura, additional, Rodríguez Paz, Marco Antonio, additional, Bonilla, Patricia, additional, and Delgado Guay, Marvin O., additional

Published
2022
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15. The Influence of Spirituality and Religiosity on US Oncologists’ Personal Use of and Clinical Practices Regarding Complementary and Alternative Medicine

Author

Powers-James, Catherine, primary, Alvarez, Adriana, additional, Milbury, Kathrin, additional, Barbo, Andrea, additional, Daunov, Katherine, additional, Lopez, Gabriel, additional, Cohen, Lorenzo, additional, Delgado-Guay, Marvin O., additional, Olopade, Olufunmilayo I., additional, and Lee, Richard T., additional

Published
2020
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18. Inequalities in Financial Distress, Symptoms, and Quality of Life Among Patients with Advanced Cancer in France and the U.S.

Author

Barbaret, Cécile, primary, Delgado-Guay, Marvin O., additional, Sanchez, Stéphane, additional, Brosse, Christelle, additional, Ruer, Murielle, additional, Rhondali, Wadih, additional, Monsarrat, Léa, additional, Michaud, Patrick, additional, Schott, Anne Marie, additional, Bruera, Eduardo, additional, and Filbet, Marilène, additional

Published
2019
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21. Reduction of Cancer-Related Fatigue With Dexamethasone: A Double-Blind, Randomized, Placebo-Controlled Trial in Patients With Advanced Cancer

Author

Yennurajalingam, Sriram, primary, Frisbee-Hume, Susan, additional, Palmer, J. Lynn, additional, Delgado-Guay, Marvin O., additional, Bull, Janet, additional, Phan, Alexandria T., additional, Tannir, Nizar M., additional, Litton, Jennifer Keating, additional, Reddy, Akhila, additional, Hui, David, additional, Dalal, Shalini, additional, Massie, Lisa, additional, Reddy, Suresh K., additional, and Bruera, Eduardo, additional

Published
2013
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