Learning from dying patients during their final days: life reflections gleaned from dignity therapy.
Dignity therapy is a novel therapeutic approach designed to decrease suffering, enhance quality of life and bolster a sense of dignity for patients approaching death. The benefits of dignity therapy were previously documented in a sample of 100 terminally ill patients. One of the products of dignity therapy is a transcript of the edited therapy session(s). In this qualitative study, 50 of the 100 (17 from Winnipeg, Manitoba, Canada, and 33 from Perth, Australia) dignity therapy transcripts were randomly drawn, and independently coded and analysed by three investigators using a grounded theory approach. The transcripts revealed that dignity therapy serves to provide a safe, therapeutic environment for patients to review the most meaningful aspects of their lives in such a manner that their core values become apparent. The most common values expressed by the patients included 'Family', 'Pleasure', 'Caring', 'A Sense of Accomplishment', 'True Friendship', and 'Rich Experience'. Exemplars of each of these values illustrate the pervasive, defining role of values in our lives. The findings are discussed in terms of values theory, the role of dignity therapy, and consideration of values clarification in clinicians' efforts to enhance the dignity of terminally ill patients.
Hack
Thomas F
TF
Faculty of Nursing, University of Manitoba, Winnipeg, Canada. thack@sbrc.ca
McClement
Susan E
SE
Chochinov
Harvey M
HM
Cann
Beverley J
BJ
Hassard
Thomas H
TH
Kristjanson
Linda J
LJ
Harlos
Mike
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001315:Australia; D002170:Canada; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology*; D028723:Personhood; D011788:Quality of Life / Q000523:psychology*; D013727:Terminal Care / Q000379:methods; D019452:Terminally Ill / Q000523:psychology*