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Open Access Research article

Testing the feasibility of the Dignity Therapy interview: adaptation for the Danish culture

Lise J Houmann1*, Susan Rydahl-Hansen1, Harvey M Chochinov2, Linda J Kristjanson3 and Mogens Groenvold14

Author affiliations

1 Dept. of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark

2 Manitoba Palliative Care Research Unit, Dept. of Psychiatry, University of Manitoba, Winnipeg, Canada

3 WA Centre for Cancer & Palliative Care, Curtin University of Technology, Perth, Australia

4 Institute of Public Health, Copenhagen, Denmark

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Citation and License

BMC Palliative Care 2010, 9:21  doi:10.1186/1472-684X-9-21

Published: 22 September 2010

Abstract

Background

'Dignity Therapy' (DT) is a brief, flexible intervention, which allows patients to complete an interview and create a document regarding their life, identity and what they want to leave in writing for their loved ones. DT is based on the DT Question Protocol. Developed and tested in English speaking settings, DT has proven to be a feasible and effective way to enhance patient dignity, while diminishing suffering and depression. The aim of this study was to test the acceptability and feasibility of the DT Question Protocol among Danish health professionals and cancer patients, and to obtain preliminary estimates of patient uptake for DT. These results will be used to inform a larger evaluation study.

Method

Ten professionals were interviewed about their perception of DT and the Question Protocol. It was then tested with 20 patients at two palliative care sites and one gynecologic oncology department. Data was analyzed using content analysis techniques to evaluate the protocol for relevance, acceptability and comprehension. The interest and relevance of the intervention was also determined by examining the preliminary participation rate.

Results

Overall, DT was perceived to be comprehensible and relevant. Professionals highlighted six concerns that might warrant modification. These issues were examined using patient data. Some of their concerns overlapped with those raised by the professionals (e.g. 'unacceptable self-praise' and 'interference with the lives of others'). Tailoring DT to Danish culture required easily accommodated adjustments to the procedures and the DT Question Protocol. Some concerns expressed by health professionals may have reflected protectiveness toward the patients. While the intervention was relevant and manageable for patients admitted to palliative care, DT was less easily implemented at the gynecologic oncology department.

Conclusion

Based on patients' and professionals' reaction to the DT Question Protocol, and based on the preliminary proportion of participants accepting DT, the DT question protocol - with minor adaptations - appears to be a manageable, acceptable and relevant intervention for Danish patients admitted to palliative care.