Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-20T03:13:57.180Z Has data issue: false hasContentIssue false

A feasibility study of Dignity Psychotherapy delivered via telemedicine

Published online by Cambridge University Press:  04 April 2005

STEVEN D. PASSIK
Affiliation:
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky
KENNETH L. KIRSH
Affiliation:
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky
SUZANNE LEIBEE
Affiliation:
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky
LISA S. KAPLAN
Affiliation:
Editor, Health and Wellness Magazine, Lifeworks Video, Lexington, Kentucky
CELIA LOVE
Affiliation:
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky
ELLEN NAPIER
Affiliation:
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky
DEBORAH BURTON
Affiliation:
Kentucky Telemedicine, University of Kentucky, Lexington, Kentucky
ROBERT SPRANG
Affiliation:
Kentucky Telemedicine, University of Kentucky, Lexington, Kentucky

Abstract

Objective: Dignity Psychotherapy has shown great promise as a value-affirming intervention for patients with advanced disease. We delivered the Dignity Psychotherapy intervention in a feasibility study of a series of eight cancer patients via videophone technology to deliver the therapy into their homes.

Methods: Once eligible patients were consented on this IRB-approved study, they completed baseline assessments and were scheduled to have the videophone placed in their homes. The Dignity Therapy sessions then encompassed a first session, which was transcribed and edited, followed by a second session to go over the edited transcript and allow the patient to make changes. Patients then filled out follow-up questionnaires and had the telemedicine equipment removed from their homes, and their legacy document delivered.

Results: Participants had a mean age of 56.32 years (range = 41–66, SD = 7.65) and were diagnosed with lung (n = 5, 62.5%), breast (n = 2, 25%), or colon cancer (n = 1, 12.5%). They reported overall benefit from the intervention along with a high level of satisfaction. We were able to deliver the intervention in a timely fashion, with minimal length between sessions and transcript delivery and few technical difficulties.

Significance of results: Telemedicine can greatly extend the benefits of Dignity Psychotherapy by bringing it to patients who are dying at home. Our very preliminary work suggests that delivering the intervention to patients who are too ill to leave their homes or who are in rural locations may be a feasible way to help them.

Type
Research Article
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bindemann, S., Soukop, M., & Kaye, S.B. (1991). Randomised control study of relaxation training. European Journal of Cancer, 27, 170174.Google Scholar
Bruera, E., Brenneis, C., Michaud, M., et al. (1989). Association between asthenia and nutritional status, lean body mass, anemia, psychological status, and tumor mass in patients with advanced breast cancer. Journal of Pain Symptom Management, 4, 5963.Google Scholar
Chochinov, H.M. (2002). Dignity-conserving care—A new model for palliative care: Helping the patient feel valued. JAMA, 287, 22532260.Google Scholar
Chochinov, H.M., Hack, T., Hassard, T., et al. (2002a). Dignity in the terminally ill: A cross-sectional, cohort study. Lancet, 360, 20262030.Google Scholar
Chochinov, H.M., Hack, T., McClement, S., et al. (2002b). Dignity in the terminally ill: A developing empirical model. Social Science and Medicine, 54, 433443.Google Scholar
Cohen, S.R., Mount, B.M., Strobel, M.G., et al. (1995). The McGill Quality of Life Questionnaire: A measure of quality of life appropriate for people with advanced disease. A preliminary study of validity and acceptability. Palliative Medicine, 9, 207219.Google Scholar
Decker, T.W., Cline-Elsen, J., & Gallagher, M. (1992). Relaxation therapy as adjunct in radiation oncology. Journal of Clinical Psychology, 48, 388393.Google Scholar
Devine, E.C. & Westlake, S.K. (1995). The effects of psychoeducational care provided to adults with cancer: Meta-analysis of 116 studies. Oncology Nursing Forum, 22, 13691381.Google Scholar
Glover, J., Dibble, S.L., Dodd, M.J., et al. (1995). Mood states of oncology outpatients: Does pain make a difference? Journal of Pain Symptom Management, 10, 120128.Google Scholar
Gotay, C.C. (1985). Why me? Attributions and adjustments by cancer patients and their mates at two stages in the disease process. Social Science Medicine, 20, 825831.Google Scholar
Gutierrez, G. (2001). Medicare, the Internet, and the future of telemedicine. Critical Care Medicine, 29(Suppl. 8), N144150.Google Scholar
Hopwood, P., Howell, A., & Maguire, P. (1991). Psychiatric morbidity in patients with advanced cancer of the breast: Prevalence measured by two self-rating questionnaires. British Journal of Cancer, 64, 349352.Google Scholar
Mahon, S.M., Cella, D.F., & Donovan, M.I. (1990). Psychosocial adjustment to recurrent cancer. Oncology Nursing Forum, 17(suppl.), 4754.Google Scholar
Northouse, L.L., Laten, D., & Reddy, P. (1995). Adjustment of women and their husbands to recurrent breast cancer. Research Nursing Health, 18, 515524.Google Scholar
Passik, S.D., Inman, A., Kirsh, K.L., et al. (2003). Initial validation of a scale to measure purposelessness, understimulation, and boredom in cancer patients: Toward a redefinition of depression in advanced disease. Palliative and Supportive Care, 1, 4150.Google Scholar
Passik, S.D., Kirsh, K.L., Theobald, D., et al. (2002). Use of a depression screening tool and a fluoxetine-based algorithm to improve the recognition and treatment of depression in cancer patients: A demonstration project. Journal of Pain Symptom Management, 24, 318327.Google Scholar
Pinder, K.L., Ramirez, A.J., Black, M.E., et al. (1993). Psychiatric disorder in patients with advanced breast cancer: Prevalence and associated factors. European Journal of Cancer, 29A, 524527.Google Scholar
Sheard, T. & Maguire, P. (1996). The effects of psychological interventions on anxiety and depression in oncology: Results of two meta-analyses (Abstract). In Proceedings of the Third World Congress of Psycho-Oncology, October 3–6. New York.
Spiegel, D., Bloom, J.R., Kraemer, H.C., et al. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 14, 888891.Google Scholar
Spiegel, D., Bloom, J.R., & Yalom, I. (1981). Group support for patients with metastatic cancer. Archives of General Psychiatry, 38, 527533.Google Scholar
Sumner, C.R. (2001). Telepsychiatry: Challenges in rural aging. Journal of Rural Health, 17, 370373.Google Scholar
Sutherland, H.J., Lockwood, G.A., & Boyd, N.F. (1990). Ratings of quality of life variables: Therapeutic implications for patients with metastatic breast cancer. Journal of Clinical Epidemiology, 43, 661666.Google Scholar
Theobald, D.E., Kirsh, K.L., Holtsclaw, E., et al. (2003). An open label pilot study of citalopram for depression and boredom in ambulatory cancer patients. Palliative and Supportive Care, 1, 7177.Google Scholar
Watson, M., Denton, S., & Baum, M. (1988). Counselling breast cancer patients: A specialist nurse service. Counselling Psychology Quarterly, 1, 2534.Google Scholar
Wilson, K.G., Scott, J.F., Graham, I.D., et al. (2000). Attitudes of terminally ill patients toward euthanasia and physician-assisted suicide. Archives of Internal Medicine, 160, 24542460.Google Scholar
Zabora, J. (1998). Screening procedures for psychosocial distress. In Psycho-oncology, Holland, J. (ed.), pp. 653661. New York: Oxford University Press.
Zung, W. (1967a). Depression in the normal aged. Psychosomatics, 7, 287292.Google Scholar
Zung, W. (1967b). Factors influencing the self-rating depression scale. Archives of General Psychiatry, 16, 543547.Google Scholar