Assessing the Benefit of Dignity Therapy for Adolescents with Advanced Cancer: A Prospective Explorative Mixed-method Study

Aims: One of the most difficult challenges faced by end-of-life care providers is helping patients achieve or maintain a sense of dignity. Preliminary evaluation studies of Dignity Therapy have been carried out with adult patients with advanced cancer in Canada and Australia and they have produced positive results. However, no studies have yet addressed younger cancer populations or the appropriateness of the technique for use with children. An initial study is therefore proposed, that would aim to evaluate the potential benefit of dignity therapy for adolecents with advanced cancer. Methods: A small scale open-label RCT comprising two groups: (i) Intervention (Dignity Therapy offered in addition to standard care), and (ii) Control group (standard care) is proposed. It is also suggested that qualitative interviews be conducted with participants and family members shortly after intervention. Family members will also be asked to reflect on the benefits of the therapy three months after bereavement. Alongside the main study it is proposed that there will be user group involvement in the design and execution of the research. Results: The findings of my research to date are suggestive that children have similar responses and worries about death and dying to adult populations, but they struggle to decide who to verbalise these worries to. Currently, there is no shared intervention for this purpose with children. Conclusions: As signified by my allied research findings, there is an element of mutual protectiveness and a truth-telling hesitance complicated in the dyadic relationship of parent and child. In this respect, dignity therapy would be a very worthwhile intervention.