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CancerPhase 2DignityDKNCT01507571

Implementation and Evaluation of Dignity Therapy in Denmark

A Phase 2 study testing Dignity Therapy in people with Cancer, run by Bispebjerg Hospital at 2 sites in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the study is to investigate whether Danish patients with incurable cancer have a need of, interest in and benefit from Dignity Therapy. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cancer
What is being tested?
Dignity Therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
2 sitesDenmark
Study dates
Sep 2005to Sep 2007
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • diagnosis of incurable cancer,
  • 18 years or older,
  • informed of diagnosis and the incurable prognosis.

Who cannot join

  • dementia and other cognitive impairment,
  • physical limitations,
  • sufficient to preclude participation.

Trial locations and contacts

2 sites in 1 country.

Denmark2 sites
  • Department of Palliative Medicine

    Copenhagen, 2400

  • Sankt Lukas Hospice

    Hellerup, 2900

Other trials in Denmark

About this study

The purpose of the study is to investigate whether Danish patients with incurable cancer have a need of, interest in and benefit from Dignity Therapy.

Read the detailed description

Research in palliative care has primarily focused on physical and psychological symptoms. Research in other psychosocial and existential problems has been sparse. Loss of dignity as a consequence of serious illness may be an important cause of suffering. The research team of the Canadian psychiatrist and professor, Harvey Chochinov has investigated the concept of dignity and developed the psychosocial intervention 'Dignity Therapy' (DT). The preliminary research results were promising.

Research questions: Do Danish cancer patients have a need of, interest in, and benefit from DT? Methods: DT consists of an interview revolving around the patient's life, values, and accomplishments and is also an opportunity to leave messages and words of hope and compassion for friends and family. The interview is audio taped, transcribed, and edited together with the patient, and made into a tangible document, which the patient can give to his/her relatives. The project consists of three parts: (1) a cross-sectional investigation of the prevalence of loss of dignity and related symptoms/problems among at least 200 incurable cancer patients. (2) A feasibility study, testing the intervention in terms of relevance and the need of any modifications in relation to Danish patients. (3) An evaluation study testing the effect of and satisfaction with DT.

At least 80 patients are planned for the feasibility and evaluation studies. Questionnaires are used for detection of loss of dignity and as measures of effect. These will be administered before the intervention and, along with a semi-structured evaluation questionnaire, right after the intervention, when the document is received and again approximately two weeks later.

The duration of the intervention (DT) varies markedly between patients. In some cases the process (interview, transcription, editing of document, and the final meeting where the document is given back to the patient) is completed urgently in a few days, whereas in other cases, the patient prefers a slower pace, and may want to sub-divide the interview into two or more parts. Also, when presented with the document, some patients want to have something changed or they want add material. This variation is seen as intentional, as it illustrates that the process is tailored to the patient's wishes.

As stated, the effect of the DT intervention is evaluated at completion of the intervention, i.e. when the final document is given back to the patient, and about two weeks later. Due to process described above, the time from the first measurement (before intervention) to the second measurement (which takes places at completion of the intervention) therefore varies considerably (median 36 days after baseline, range 7-121 days).

Perspective: If Danish patients have a need of, an interest in and benefit from DT, it can be offered to Danish patients admitted to palliative care.

Conditions
Cancer
Being tested
Dignity Therapy
Keywords
Incurable cancer, Palliative care, Dignity Therapy, Loss of dignity, Patient Dignity Intventory, Eortc QLQ-C15-PAL, Structured Interview for Symptoms and Concerns, Hospital Anxiety and Depression Scale
Medical subject headings
Neoplasms, Depression

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dignity TherapyOther

    Also called Psychotherapeutic intervention, Psychosocial intervention, End of life care

    Dignity Therapy is a brief psychotherapeutic intervention consisting of:

    1. a tape-recorded session with the patient using the DT question protocol
    2. Transcription of the interview, which is then edited
    3. A session where the edited transcript is returned to the patient who can give it to family members or friends.

    If needed, one or more sessions are added. Dt allows the patient to give voice to the matters of importance concerning himself and his loved ones. Its purpose is to enhance sense of meaning, purpose and worth. It also gives the opportunity to leave something behind to be remembered by.

Study groups in NCT01507571
Study groupRoleWhat they receive
Dignity TherapyExperimentalNot described
Receives: Other: Dignity Therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Sense of dignity

    Measured with the Structured Interview for Symptoms and Concerns (SISC)

    Measured: Pre-post intervention (when the document was recieved by the patient), and again two weeks later.

Secondary outcomes (43)
  1. Hopelessness

    Measured with the Structured Interview for Symptoms and Concerns (SISC)

    Measured: Pre-post intervention (when the document was recieved by the patient), and again two weeks later.

  2. Anxiety

    Measured on the Hospital anxiety and depression scale

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  3. Depression

    Measured on the Hospital Anxiety and Depression scale

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  4. Not able to perform tasks of daily living

    Measured on the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  5. Suffering

    Measured with the Structured Interview for Symptoms and Concerns

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  6. performance status

    Measured on the Palliative Performance Scale v2

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  7. Communication

    Measured on the Structured Interview for Symptoms and Concerns

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  8. Social Contact

    Measured on the Structured Interview for Symptoms and Concerns

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  9. Depression

    Measured with the Structured Interview for Symptoms and Concerns

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  10. Not able to attend to bodily functions

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  11. Physically distressing symptoms

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  12. Feeling how I look has changed

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  13. Feeling depressed

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  14. Feeling anxious

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  15. Feeling uncertain

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  16. Worried about future

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  17. Not able to think clearly

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  18. Not able to continue usual routines

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  19. Feeling no longer who I was

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  20. Not feeling worthwhile or valued

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  21. Not able to carry out important roles

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  22. Feeling life no longer has meaning or purpose

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  23. Feeling of not having made a meaningful contribution

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  24. Feeling of unfinished business

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  25. Concerns regarding spiritual life

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  26. Feeling like a burden to others

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  27. Feeling of not having control

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  28. Feeling of reduced privacy

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  29. Not feeling supported by friends or family

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  30. Not feeling supported by health care providers

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  31. Not feeling able to mentally fight illness

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  32. Not being able to accept things as they are

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  33. Not being treated with respect

    Item from the Patient Dignity Inventory

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  34. Physical function

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  35. Emotional function

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  36. Overall quality of life

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  37. Fatigue

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  38. Nausea / Vomiting

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  39. Pain

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  40. Dyspnoea

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  41. Insomnia

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  42. Appetite loss

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

  43. Constipation

    Measured on the EORTC QLQ-C15-PAL

    Measured: Pre-post intervention (when the document was received by the patient), and again two weeks later.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jan 2012 (estimated)
  2. Study startSep 2005
  3. Primary completionSep 2007
  4. Study completionSep 2007

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Supportive care
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
80 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01507571
Sponsor's protocol ID
DignityTherapyDK 01
Other IDs
PP04011
Acronym
DignityDK
Status last verified
Jan 2012
First submitted
11 Nov 2011
Last updated
11 Jan 2012
Results posted
No
Data monitoring committee
No

Publications

  • Houmann LJ, Rydahl-Hansen S, Chochinov HM, Kristjanson LJ, Groenvold M. Testing the feasibility of the Dignity Therapy interview: adaptation for the Danish culture. BMC Palliat Care. 2010 Sep 22;9:21. doi: 10.1186/1472-684X-9-21.

    PubMed 20860786
  • Houmann LJ, Chochinov HM, Kristjanson LJ, Petersen MA, Groenvold M. A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care. Palliat Med. 2014 May;28(5):448-58. doi: 10.1177/0269216313514883. Epub 2013 Dec 5.

    PubMed 24311296

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Dignity Therapy in people with Cancer, run by Bispebjerg Hospital at 2 sites in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Jan 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Sense of dignity (time frame: Pre-post intervention (when the document was recieved by the patient), and again two weeks later.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01507571, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jan 2012; AzTrials last refreshed its copy on 30 Oct 2026.

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