Fostering human dignity during chemotherapy: An explorative study on Dignity Therapy in advanced gastric and pancreatic cancer
Federica Andreis, Chiara Deori, Fausto Meriggi, Alberto ZaniboniAbstract
Objectives
Advanced pancreatic and gastric cancers are associated with high symptom burden and psychological distress, potentially threatening patients’ sense of dignity. Although Dignity Therapy (DT) has mainly been used in end-of-life care, its potential role earlier in the disease trajectory is emerging. This exploratory study investigated the feasibility and potential impact of DT during active chemotherapy on emotional distress, dignity-related distress, and quality of life (QoL).
Methods
Thirty patients with advanced pancreatic or gastric cancer undergoing chemotherapy received a 3-session DT intervention over approximately 3 weeks. Emotional distress, dignity-related distress, and QoL were assessed at baseline (T0), post-intervention (T1), and 1-month follow-up (T2) using the Distress Thermometer, Patient Dignity Inventory, and EORTC Quality of Life Questionnaire-Core 30. Exploratory analyses assessed changes over time.
Results
Emotional distress decreased significantly from T0 (M = 6.67, SD = 1.47) to T1 (M = 3.13, SD = 1.43; p < .001) and remained lower at T2 (M = 3.50, SD = 1.53; p < .001). Dignity-related distress also decreased from T0 (M = 37.1, SD = 3.03) to T1 (M = 27.9, SD = 1.79; p < .001), with sustained improvement at T2 (M = 25.4, SD = 12.86; p < .01). QoL remained stable. Participants reported high acceptability of the intervention.
Significance of results
DT during chemotherapy appears feasible and may improve emotional and dignity-related outcomes. Results should be interpreted cautiously due to the small sample size, attrition, and lack of a control group.