Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T20:15:06.908Z Has data issue: false hasContentIssue false
  • English
  • Français

Description of a training protocol to improve research reproducibility for dignity therapy: an interview-based intervention

Published online by Cambridge University Press:  26 May 2021

Tasha M. Schoppee Open the ORCID record for Tasha M. Schoppee [Opens in a new window] ,
Lisa Scarton ,
Susan Bluck ,
Yingwei Yao ,
Gail Keenan ,
George Handzo ,
Harvey M. Chochinov ,
George Fitchett ,
Linda L. Emanuel  and
Diana J. Wilkie Open the ORCID record for Diana J. Wilkie [Opens in a new window]
Tasha M. Schoppee*
Affiliation:
University of Florida, Gainesville, FL Community Hospice & Palliative Care, Jacksonville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
Lisa Scarton
Affiliation:
University of Florida, Gainesville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
Susan Bluck
Affiliation:
University of Florida, Gainesville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
Yingwei Yao
Affiliation:
University of Florida, Gainesville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
Gail Keenan
Affiliation:
University of Florida, Gainesville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
George Handzo
Affiliation:
HealthCare Chaplaincy Network, New York, NY
Harvey M. Chochinov
Affiliation:
CancerCare Manitoba, Winnipeg, MB, Canada
George Fitchett
Affiliation:
Rush University Medical Center, Chicago, IL
Linda L. Emanuel
Affiliation:
Northwestern University, Chicago, IL
Diana J. Wilkie
Affiliation:
Center for Palliative Care Research & Education, University of Florida, Gainesville, FL Florida-California Cancer Research Education and Engagement Health Equity Center (CaRE2 Center), University of Florida, Gainesville, FL
*
Author for correspondence: Tasha M. Schoppee, 4266 Sunbeam Rd., Building 100, Jacksonville, FL 32257, USA. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Dignity Therapy (DT) has been implemented over the past 20 years, but a detailed training protocol is not available to facilitate consistency of its implementation. Consistent training positively impacts intervention reproducibility.

Objective

The objective of this article is to describe a detailed method for DT therapist training.

Method

Chochinov's DT training seminars included preparatory reading of the DT textbook, in-person training, and practice interview sessions. Building on this training plan, we added feedback on practice and actual interview sessions, a tracking form to guide the process, a written training manual with an annotated model DT transcript, and quarterly support sessions. Using this training method, 18 DT therapists were trained across 6 sites.

Results

The DT experts’ verbal and written feedback on the practice and actual sessions encouraged the trainees to provide additional attention to eight components: (1) initial framing (i.e., clarifying and organizing of the patient's own goals for creating the legacy document), (2) verifying the patient's understanding of DT, (3) gathering the patient's biographical information, (4) using probing questions, (5) exploring the patient's story thread, (6) refocusing toward the legacy document creation, (7) inviting the patient's expression of meaningful messages, and (8) general DT processes. Evident from the ongoing individual trainee mentoring was achievement and maintenance of adherence to the DT protocol.

Discussion

The DT training protocol is a process to enable consistency in the training process, across waves of trainees, toward the goal of maintaining DT implementation consistency. This training protocol will enable future DT researchers and clinicians to consistently train therapists across various disciplines and locales. Furthermore, we anticipate that this training protocol could be generalizable as a roadmap for implementers of other life review and palliative care interview-based interventions.

Keywords

Cancer careDignity therapyHospiceLife reviewPalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 2 , April 2022 , pp. 178 - 188
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by 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

Allen, JD, Linnan, LA and Emmons, KM (2012) Fidelity and its relationship to implementation effectiveness, adaptation, and dissemination. In Brownson, RC, Colditz, GA & Proctor, EK (eds.), Dissemination and Implementation Research in Health. New York, NY: Oxford University Press, pp. 281–304.Google Scholar
Beidas, RS and Kendall, PC (2010) Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology (New York) 17(1), 1–30. doi:10.1111/j.1468-2850.2009.01187.xGoogle ScholarPubMed
Bellg, AJ, Resnick, B, Minicucci, DS, et al. (2004) Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH behavior change consortium. Health Psychology 23(5), 443–451. doi:10.1037/0278-6133.23.5.443CrossRefGoogle ScholarPubMed
Bentley, B, Aoun, SM, O'Conner, MO, et al. (2012) Is dignity therapy feasible to enhance the end of life experience for people with motor neuron disease and their family carers? BMC Palliative Care 11(18), 1–7.CrossRefGoogle Scholar
Bentley, B, O'Connor, M, Breen, LJ, et al. (2014a) Feasibility, acceptability and potential effectiveness of dignity therapy for family carers of people with motor neurone disease. BMC Palliative Care 13(1), 12. doi:10.1186/1472-684X-13-12CrossRefGoogle ScholarPubMed
Bentley, B, O'Connor, M, Kane, R, et al. (2014b) Feasibility, acceptability, and potential effectiveness of dignity therapy for people with motor neurone disease. PLoS ONE 9(5), e96888. doi:10.1371/journal.pone.0096888CrossRefGoogle ScholarPubMed
Block, L, Brenner, J, Conigliaro, J, et al. (2018) Perceptions of a longitudinal standardized patient experience by standardized patients, medical students, and faculty. Medical Education Online 23. doi:10.1080/10872981.2018.1548244CrossRefGoogle ScholarPubMed
Chochinov, H (2012) Dignity Therapy: Final Words for Final Days. New York, NY: Oxford University Press.CrossRefGoogle Scholar
Chochinov, H, Hack, T, McClement, S, et al. (2002) Dignity in the terminally ill. A developing empirical model. Social Science Medicine 54, 433–443.CrossRefGoogle ScholarPubMed
Chochinov, HM, Hack, T, Hassard, T, et al. (2005) Dignity therapy: A novel psychotherapeutic intervention for patients near the end of life. Journal of Clinical Oncology 23(24), 5520–5525. doi:10.1200/jco.2005.08.391CrossRefGoogle ScholarPubMed
Chochinov, HM, Kristjanson, LJ, Breitbart, W, et al. (2011) Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: A randomised controlled trial. Lancet Oncology 12(8), 753–762. doi:10.1016/s1470-2045(11)70153-xCrossRefGoogle ScholarPubMed
Chochinov, HM, Cann, B, Cullihall, K, et al. (2012) Dignity therapy: A feasibility study of elders in long-term care. Palliative & Supportive Care 10(1), 3–15. doi:10.1017/S1478951511000538CrossRefGoogle ScholarPubMed
Donato, SC, Matuoka, JY, Yamashita, CC, et al. (2016) Effects of dignity therapy on terminally ill patients: A systematic review. Revista da Escola de Enfermagem da USP 50(6), 1014–1024. doi:10.1590/s0080-623420160000700019CrossRefGoogle ScholarPubMed
Erby, LAH, Roter, DL and Biesecker, BB (2011) Examination of standardized patient performance: Accuracy and consistency of six standardized patients over time. Patient Education & Counseling 85(2). doi:10.1016/j.pec.2010.10.005CrossRefGoogle ScholarPubMed
Fitchett, G, Emanuel, L, Handzo, G, et al. (2015) Care of the human spirit and the role of dignity therapy: A systematic review of dignity therapy research. BMC Palliative Care 14, 8. doi:10.1186/s12904-015-0007-1CrossRefGoogle ScholarPubMed
Haber, D (2006) Life review: Implementation, theory, research, and therapy. International Journal of Aging & Human Development 63(2), 153–171.CrossRefGoogle ScholarPubMed
Hall, S and Chochinov, H (2009) Assessing the feasibility, acceptability study protocol. BMC Palliative Care 8(5), 1–8. doi:10.1186/1472-684X-8-5Google ScholarPubMed
Hall, S, Chochinov, H, Harding, R, et al. (2009) A phase II randomised controlled trial assessing the feasibility, acceptability and potential effectiveness of dignity therapy for older people in care homes: Study protocol. BMC Geriatrics 9, 9. doi:10.1186/1471-2318-9-9CrossRefGoogle ScholarPubMed
Hall, S, Goddard, C, Opio, D, et al. (2011) A novel approach to enhancing hope in patients with advanced cancer: A randomised phase II trial of dignity therapy. BMJ Supportive & Palliative Care 1(3), 315–321. doi:10.1136/bmjspcare-2011-000054CrossRefGoogle Scholar
Hall, S, Goddard, C, Opio, D, et al. (2012) Feasibility, acceptability and potential effectiveness of dignity therapy for older people in care homes: A phase II randomized controlled trial of a brief palliative care psychotherapy. Palliative Medicine 26(5), 703–712. doi:10.1177/0269216311418145CrossRefGoogle Scholar
Hall, S, Goddard, C, Speck, P, et al. (2013) ‘It makes me feel that I'm still relevant': A qualitative study of the views of nursing home residents on dignity therapy and taking part in a phase II randomised controlled trial of a palliative care psychotherapy. Palliative Medicine 27(4), 358–366. doi:10.1177/0269216312449272CrossRefGoogle Scholar
Hasson, H (2010) Systematic evaluation of implementation fidelity of complex interventions in health and social care. Implementation Science 5(67), 1–9.CrossRefGoogle ScholarPubMed
Juliao, M, Oliveira, F, Nunes, B, et al. (2014) Efficacy of dignity therapy on depression and anxiety in Portuguese terminally ill patients: A phase II randomized controlled trial. Journal of Palliative Medicine 17(6), 688–695. doi:10.1089/jpm.2013.0567CrossRefGoogle ScholarPubMed
Kittelson, S, Scarton, L, Barker, P, et al. (2019) Dignity therapy led by nurses or chaplains for elderly cancer palliative care outpatients: Protocol for a randomized controlled trial. Journal of Medical Internet Research 8(4). doi:10.2196/12213Google ScholarPubMed
Kruzinga, R, Helmich, E, Schildermann, JBAM, et al. (2016) Professional identity at stake: A phenomenological analysis of spiritual counselors’ experiences working with a structured model to provide care to palliative care patients. Supportive Care in Cancer 24, 3111–3118.Google Scholar
Lewis, KL, Bohnert, CA, Gammon, WL, et al. (2017) The association of standardized patient educators (ASPE) standards of best practice (SOBP). Advances in Simulation 2(10), 1–8. doi:10.1186/s41077-017-0043-4CrossRefGoogle ScholarPubMed
Lindqvist, O, Threlkeld, G, Street, AF, et al. (2015) Reflections on using biographical approaches in end-of-life care: Dignity therapy as example. Qualitative Health Research 25(1), 40–50. doi:10.1177/1049732314549476CrossRefGoogle ScholarPubMed
Martinez, M, Arantzamendi, M, Belar, A, et al. (2017) ‘Dignity therapy’, a promising intervention in palliative care: A comprehensive systematic literature review. Palliative Medicine 31(6), 492–509. doi:10.1177/0269216316665562CrossRefGoogle ScholarPubMed
McGee, D, Lorencatto, F, Matvienko-Sikar, K, et al. (2018) Surveying knowledge, practice and attitudes towards intervention fidelity within trials of complex healthcare interventions. BMC, 1–14. doi:10.1186/s13063-018-2838-6Google ScholarPubMed
Santacroce, SJ, Macarelli, LM and Grey, M (2004) Intervention fidelity. Nursing Research 53(1), 63–66.CrossRefGoogle ScholarPubMed
Schryer, C, McDougall, A, Tait, GR, et al. (2012) Creating discursive order at the end of life: The role of genres in palliative care settings. Written Communication 29(2), 111–141. doi:10.1177/0741088312439877CrossRefGoogle Scholar
Taylor, KL, Weston, M and Batterham, AM (2015) Evaluating intervention fidelity: An example from a high-intensity interval training study. PLoS ONE, 1–8. doi:10.1371/journal.pone.0125166Google ScholarPubMed
Vuksanovic, D, Green, H, Morrissey, S, et al. (2017) Dignity therapy and life review for palliative care patients: A qualitative study. Journal of Pain & Symptom Management 54(4), 530–537.e531. doi:10.1016/j.jpainsymman.2017.07.016CrossRefGoogle ScholarPubMed