Claire: My name is Claire Moroney and I am a Nurse Practitioner in Sunnybrook’s Odette
Cancer Centre.
I saw a better way to convey hope and manage distress in patients with primary brain tumours
during the palliative part of their treatment journey through an innovative approach called
Dignity Therapy.
Claire: Some of our patients with primary brain tumours, unfortunately are given a poor
prognosis and have limited treatment options.
We wanted to see if providing Dignity Therapy might help to reduce their level of psychological
distress and improve their quality of life.
Claire: Dignity Therapy is a novel psychotherapeutic intervention for patients near the end of
life that has been studied and proven to work in other settings, particularly palliative
inpatient populations.
Claire: This brief intervention was developed by Dr. Harvey Chochinov, a palliative care
psychiatrist.
His intention was to reduce the psychological and existential distress of terminally ill
patients and their families.
I wanted to see if we could apply this same intervention to patients in the outpatient
setting at the Odette.
Claire: To assess the feasibility and impact of providing Dignity Therapy in an adult ambulatory
oncology care setting, I conducted a practice-based research study.
Claire: Hi Margaret, hi Mario.
You want to come into my office?
Margaret/Mario: Yes..
Margaret: Boys oversees at our house because our mother had a small…I was the small child
Claire: The way it works is patients are asked a series of questions by a trained health
professional aimed at exploring meaning and purpose in their lives.
It allows them to recount special life events and offers them the opportunity to share their
hopes and wishes for their loved ones’ future.
We start out by asking patients to pretend like they are looking at a photo album of
their life and to stop when they get to the page of the album they would like to talk
about.
Claire: This really provides patients a unique opportunity to look back on their lives and
identify important events and accomplishments that shaped who they are and what their values
are.
Claire: The interview is audio recorded, transcribed, and edited to form an easily readable legacy
document.
The legacy document is to be given to the patient and then remains with loved ones and
family members once the patient has passed away as a means of providing comfort as well
as reducing anxiety and distress during such a stressful and difficult time.
Claire: In many instances, the legacy document has been incorporated into wedding ceremonies,
obituaries, and eulogies, allowing family members to remember their loved ones in a
positive and intimate manner.
Claire: The results of our study have been positive so far.
Not only has the intervention allowed patients and families to speak more freely about end
of life issues, but it has also allowed the staff involved in the project to feel more
connected to patients during their journey, and this has provided them with a high level
of satisfaction as clinicians.
Claire: My most memorable moments in incorporating Dignity Therapy into my practice include the
stories of the impact it has had long after a patient has passed away.
The impact of this intervention truly lives on when it matters most.