• Dean Vuksanovic, Heather J Green, Murray Dyck, and Shirley A Morrissey.
• Menzies Health Institute Queensland and School of Applied Psychology, Griffith University, Gold Coast Campus, Southport, Queensland, Australia. Electronic address: Dean.Vuksanovic@health.qld.gov.au.
• J Pain Symptom Manage. 2017 Feb 1; 53 (2): 162-170.e1.

ContextDignity therapy (DT) is a psychotherapeutic intervention with increasing evidence of acceptability and utility in palliative care settings.ObjectivesThe aim of this study was to evaluate the legacy creation component of DT by comparing this intervention with life review (LR) and waitlist control (WC) groups.MethodsSeventy adults with advanced terminal disease were randomly allocated to DT, LR, or WC followed by DT, of which 56 completed the study protocol. LR followed an identical protocol to DT except that no legacy document was created in LR. Primary outcome measures were the Brief Generativity and Ego-Integrity Questionnaire, Patient Dignity Inventory, Functional Assessment of Cancer Therapy-General, version 4, and treatment evaluation questionnaires.ResultsUnlike LR and WC groups, DT recipients demonstrated significantly increased generativity and ego-integrity scores at study completion. There were no significant changes for dignity-related distress or physical, social, emotional, and functional well-being among the three groups. There were also no significant changes in primary outcomes after the provision of DT after the waiting period in the WC group. High acceptability and satisfaction with interventions were noted for recipients of both DT and LR and family/carers of DT participants.ConclusionThis study provides initial evidence that the specific process of legacy creation is able to positively affect sense of generativity, meaning, and acceptance near end of life. High acceptability and satisfaction rates for both DT and LR and positive impacts on families/carers of DT participants provide additional support for clinical utility of these interventions. Further evaluation of specific mechanisms of change post-intervention is required given DT's uncertain efficacy on other primary outcomes.Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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