• Sue Hall, Cassie Goddard, Diana Opio, Peter Speck, and Irene J Higginson.
• King's College London, Department of Palliative Care, Policy & Rehabilitation, Cicely Saunders Institute, London, UK. sue.hall@kcl.ac.uk
• Palliat Med. 2012 Jul 1;26(5):703-12.

BackgroundA pilot study of Dignity Therapy conducted with hospice patients reported high levels of self-reported benefits of the psychotherapy.AimTo assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce distress in older people in care homes.DesignA randomized controlled open-label trial (ISRCTN37589515).Setting And Participants60 residents aged 65+ with no major cognitive impairment living in care homes in London, UK.InterventionDignity Therapy, a brief palliative care psychotherapy.OutcomesPotential effectiveness (dignity-related distress, depression, hopefulness, quality of life at baseline and 1 and 8-week follow-up); acceptability (residents' views on self-reported benefits of Dignity Therapy/the Dignity Therapy study); and feasibility (time taken to deliver the intervention).ResultsWe randomized 60/755 (8%) residents: 29 - control, 31 - intervention. We found no significant differences between groups on measures of potential effectiveness at any time. There was a reduction in dignity-related distress across both groups (p = 0.026). The intervention group outperformed the control group on all the acceptability items at both follow-ups. Effect sizes (Cohen's d) ranged from small (0.25) to large (0.85). These were significant for feeling that Dignity Therapy/the Dignity Therapy study had made their life more meaningful at 2-week follow-up (p = 0.04), and that it would help their families at both follow-ups (p = 0.02 and p = 0.01, respectively). Although it was feasible to deliver the intervention in this setting, it took longer to complete than anticipated.ConclusionsAlthough Dignity Therapy took longer to deliver than expected, this intervention may be a way of enhancing the end-of-life experiences of residents.

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