A Novel Poetic Dignity Therapy Adaptation for Sexual and Gender Minority Patients With Cancer

Background

Sexual and gender minority (SGM) patients experience disproportionately poor psychosocial cancer outcomes when compared to non‐SGM patients. Psychosocial interventions specifically tailored to this population are lacking.

Aims

To assess feasibility, acceptability and preliminary efficacy of a modified Dignity Therapy (DT) intervention for sexual and gender minority (SGM) patients with cancer.

Methods

We modified DT to incorporate questions about sexual and gender identity and a novel poetic interpretation of the dignity narrative (DT‐SGM). The intervention was evaluated in a prospective pilot trial. SGM people with cancer diagnoses were recruited from a designated comprehensive cancer center. They participated in a single episode of DT‐SGM, which was recorded and transcribed. The recording was used to generate a narrative and poem, which were reviewed with the patient. Feasibility was assessed by recruitment and completion rates; acceptability through questions in the DT Feedback Questionnaire and qualitative analyses of follow‐up interviews.

Results

45 individuals were screened and 27 approached; 13/27 (55.6%) completed the study. Participants were demographically mixed in terms of age, cancer diagnosis, sexual orientation, gender identity and race.

All participants (13/13; 100%) found the intervention acceptable. Qualitative analysis revealed four themes regarding intervention acceptability: (1) timing and duration, (2) feeling connected, (3) DT as a helpful processing tool, and (4) meaningfulness of the experience. We identified 4 additional themes related to sexual and gender orientation, including: (1) charting one’s own course, (2) finding meaning, (3) lack of acceptance/ discrimination, (4) love and belonging.

Conclusions

DT‐SGM is feasible and acceptable to SGM people with cancer.