title: Feasibility, acceptability and potential effectiveness of Dignity Therapy for older people in care homes: a phase II randomized controlled trial of a brief palliative care psychotherapy.
abstract: BACKGROUND
  A pilot study of Dignity Therapy conducted with hospice patients reported high levels of self-reported benefits of the psychotherapy.
  
  
  OBJECTIVE
  To assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce distress in older people in care homes.
  
  
  METHODS
  A randomized controlled open-label trial (ISRCTN37589515).
  
  
  METHODS
  60 residents aged 65+ with no major cognitive impairment living in care homes in London, UK.
  
  
  METHODS
  Dignity Therapy, a brief palliative care psychotherapy.
  
  
  RESULTS
  Potential effectiveness (dignity-related distress, depression, hopefulness, quality of life at baseline and 1 and 8-week follow-up); acceptability (residents' views on self-reported benefits of Dignity Therapy/the Dignity Therapy study); and feasibility (time taken to deliver the intervention).
  
  
  RESULTS
  We randomized 60/755 (8%) residents: 29 - control, 31 - intervention. We found no significant differences between groups on measures of potential effectiveness at any time. There was a reduction in dignity-related distress across both groups (p = 0.026). The intervention group outperformed the control group on all the acceptability items at both follow-ups. Effect sizes (Cohen's d) ranged from small (0.25) to large (0.85). These were significant for feeling that Dignity Therapy/the Dignity Therapy study had made their life more meaningful at 2-week follow-up (p = 0.04), and that it would help their families at both follow-ups (p = 0.02 and p = 0.01, respectively). Although it was feasible to deliver the intervention in this setting, it took longer to complete than anticipated.
  
  
  CONCLUSIONS
  Although Dignity Therapy took longer to deliver than expected, this intervention may be a way of enhancing the end-of-life experiences of residents.
authors.affiliation: King's College London, Department of Palliative Care, Policy & Rehabilitation, Cicely Saunders Institute, London, UK. sue.hall@kcl.ac.uk
authors.forename: Sue
authors.initials: S
authors.lastname: Hall
authors.forename: Cassie
authors.initials: C
authors.lastname: Goddard
authors.forename: Diana
authors.initials: D
authors.lastname: Opio
authors.forename: Peter
authors.initials: P
authors.lastname: Speck
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Higginson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008131:London; D008297:Male; D010166:Palliative Care / Q000379:methods; D010342:Patient Acceptance of Health Care; D028723:Personhood; D011614:Psychotherapy, Brief / Q000379:methods*