Dignity Therapy as an aid to coping for COPD patients at their end-of-life stage

Adv Respir Med. 2019;87(3):135-145. doi: 10.5603/ARM.a2019.0021. Epub 2019 May 6.

Abstract

Introduction: Observations indicate that struggling with a burden of an incurable disease such as advanced chronic obstructive pulmonary disease (COPD) may result in the weakening of an individual sense of dignity, and be a source of spiritual suffering. Clinicians providing respiratory care to patients should be open to their spiritual needs, in the belief it may improve coping with the end-of-life COPD. The study aimed to assess overall feasibility and potential benefits of Dignity Therapy (DT) in patients with advanced COPD.

Material and methods: Patients with severe COPD, in whom a DT intervention was implemented according to the protocol established by Chochinov et al. were included into the study. An self-designed questionnaire was applied to assess the patients' satisfaction after intervention. Subsequently, the patients' statements were allocated to specific problem categories, corresponding to the spiritual suffering concerns, as structured by Groves and Klauser.

Results: DT was completed in 10 patients, with no unexpected side effects. Satisfaction Questionnaire showed a positive effect of DT on the patient' well-being (3.9 on a 5-point Likert scale). The analyses of the patients' original statements enabled an effective identification of the spiritual suffering and spiritual resources and faced by COPD patients.

Conclusion: DT is an intervention well received by COPD patients, which may help them in recognising and fulfilling their spiritual needs in the last phase of their life. Information acquired on the patients' resources and spiritual challenges may help clinicians improve their care, especially with regard to supporting their patients at the end-of-life stage.

Keywords: COPD; Dignity Therapy; end of life; spiritual suffering.

MeSH terms

  • Adaptation, Psychological
  • Female
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Pulmonary Disease, Chronic Obstructive / psychology*
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Quality of Life / psychology*
  • Terminally Ill / psychology*
  • Treatment Outcome