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A Portuguese trial using dignity therapy for adults who have a life-threatening disease: Qualitative analysis of generativity documents

Published online by Cambridge University Press:  23 June 2021

Miguel Julião Open the ORCID record for Miguel Julião [Opens in a new window] ,
Maria Ana Sobral ,
Bridget Johnston ,
Ana Raquel Lemos ,
Sara Almeida ,
Bárbara Antunes Open the ORCID record for Bárbara Antunes [Opens in a new window] ,
Çiğdem Fulya Dönmez  and
Harvey Max Chochinov
Miguel Julião*
Affiliation:
Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
Maria Ana Sobral
Affiliation:
Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
Bridget Johnston
Affiliation:
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK NHS Greater Glasgow and Clyde, Glasgow, UK
Ana Raquel Lemos
Affiliation:
Escola de Medicina da Universidade do Minho, Braga, Portugal
Sara Almeida
Affiliation:
Escola de Medicina da Universidade do Minho, Braga, Portugal
Bárbara Antunes
Affiliation:
Primary Care Unit, Department of Public Health and Primary care, University of Cambridge, Cambridge, UK Centro de Estudos e Investigação em Saúde da Universidade de Coimbra, Coimbra, Portugal
Çiğdem Fulya Dönmez
Affiliation:
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
Harvey Max Chochinov
Affiliation:
Department of Psychiatry, Research Institute of Oncology and Hematology, Cancer Care Manitoba, Manitoba, Canada
*
Author for correspondence: Miguel Julião, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal. E-mail: migueljuliao@gmail.com
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Abstract

Objectives

Dignity therapy (DT) is a brief, individualized intervention, which provides terminally ill patients with an opportunity to convey memories, essential disclosures, and prepare a final generativity document. DT addresses psychosocial and existential issues, enhancing a sense of meaning and purpose. Several studies have considered the legacy topics most frequently discussed by patients near the end of life. To date, no Portuguese study has done that analysis.

Method

We conducted a qualitative analysis of 17 generativity documents derived from a randomized controlled trial (RCT). Inductive content analysis was used to identify emerging themes.

Results

From the 39 RCT participants receiving DT, 17 gave consent for their generativity document to undergo qualitative analysis. Nine patients were female; mean age of 65 years, with a range from 46 to 79 years. Seven themes emerged: “Significant people and things”; “Remarkable moments”; “Acknowledgments”; “Reflection on the course of life”; “Personal values”; “Messages left to others”; and “Requests and last wishes”.

Significance of results

Generativity document analysis provides useful information for patients nearing death, including their remarkable life moments and memories, core values, concerns, and wishes for their loved ones. Being conscious of these dominant themes may allow health providers to support humanized and personalized care to vulnerable patients and their families, enhancing how professionals perceive and respond to personhood within the clinical setting.

Keywords

Dignity therapyEnd-of-life careGenerativity documentPalliative careQualitative analysisTerminal care
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 2 , April 2022 , pp. 189 - 195
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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