Comparing counseling and dignity therapies in home care patients: A pilot study.
OBJECTIVE
Several studies have successfully tested psychosocial interventions in palliative care patients. Counseling is the technique most often employed. Dignity therapy (DT) has recently emerged as a tool that can be utilized to address patients' needs at the end of life. The aims of our study were to examine the effects of DT and counseling and to offer useful information that could be put into practice to better meet patients' needs.


METHOD
We developed a pilot randomized controlled trial at the Home Care Unit of the General University Hospital of Valencia (Spain). Some 70 patients were assigned to two therapy groups. The measurement instruments employed included the Patient Dignity Inventory (PDI), the Hospital Anxiety and Depression Scale (HADS), the Brief Resilient Coping Scale (BRCS), the GES Questionnaire, the Duke-UNC-11 Functional Social Support Questionnaire, and two items from the EORTC Quality of Life C30 Questionnaire (EORTC-QLQ-C30).


RESULTS
The results of repeated-measures t tests showed statistically significant differences with respect to the dimensions of dignity, anxiety, spirituality, and quality of life for both groups. However, depression increased in the DT group after the intervention, and there were no differences with respect to resilience. Therapy in the counseling group did not negatively affect depression, and resilience did improve. When post-intervention differences between groups were calculated, statistically significant differences in anxiety were found, with lower scores in the counseling group (t(68) = -2.341, p = 0.022, d = 0.560).


SIGNIFICANCE OF RESULTS
Our study provided evidence for the efficacy of dignity therapy and counseling in improving the well-being of palliative home care patients, and it found better results in the counseling therapy group with respect to depression, resilience, and anxiety.
['Rudilla|David|D|', 'Galiana|Laura|L|', 'Oliver|Amparo|A|', 'Barreto|Pilar|P|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001007:Anxiety D001293:Attitude to Death D001294:Attitude to Health D003376:Counseling D003863:Depression D005260:Female D006699:Home Care Services D006801:Humans D008297:Male D008875:Middle Aged D010166:Palliative Care D010865:Pilot Projects D011614:Psychotherapy, Brief D011788:Quality of Life D055500:Resilience, Psychological D013030:Spain D011795:Surveys and Questionnaires D013727:Terminal Care D019452:Terminally Ill
Counseling Dignity therapy Psychosocial intervention Quality of life End-of-life care