Learning from dying patients during their final days: life reflections gleaned from dignity therapy

Author:

Hack Thomas F1,McClement Susan E2,Chochinov Harvey M3,Cann Beverley J4,Hassard Thomas H5,Kristjanson Linda J6,Harlos Mike7

Affiliation:

1. Faculty of Nursing, University of Manitoba, Winnipeg, Canada, Patient and Family Support Services, University of Manitoba, Winnipeg, Canada,

2. Faculty of Nursing, University of Manitoba, Winnipeg, Canada, Manitoba Palliative Care Research Unit, University of Manitoba, Winnipeg, Canada

3. Patient and Family Support Services, University of Manitoba, Winnipeg, Canada, Manitoba Palliative Care Research Unit, University of Manitoba, Winnipeg, Canada, Department of Psychiatry, University of Manitoba, Winnipeg, Canada, Department of Family Medicine, University of Manitoba, Winnipeg, Canada, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada

4. Manitoba Palliative Care Research Unit, University of Manitoba, Winnipeg, Canada

5. Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada

6. Curtin University of Technology, Perth, Australia

7. St. Boniface General Hospital, Winnipeg, Canada

Abstract

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.

Publisher

SAGE Publications

Subject

Anesthesiology and Pain Medicine,General Medicine

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