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Publication
Effects of dignity therapy on dignity and spiritual well-being in people with advanced cancer: study protocol for a randomized controlled trial
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Advisor(s)
Abstract(s)
Background
Dignity Therapy is a person-centered psychotherapeutic intervention designed for people approaching the end of life, fostering reflection on meaningful aspects of life and creating a testimonial legacy. Since 2011, randomized trials have demonstrated its value in addressing psychospiritual needs and preserving dignity in palliative care. However, no controlled studies have been conducted in Latin America to assess its effectiveness within local cultural contexts.
Methods
This is a protocol for an exploratory, randomized, parallel-group clinical trial (1:1 allocation) with an open-label design. A total of 96 hospitalized individuals with advanced cancer will participate, all receiving care from the Palliative Care Service of a university hospital in Fortaleza, Brazil. The control group will receive usual palliative care, while the intervention group will receive the same care along with Dignity Therapy, delivered in three structured sessions. Assessments will be conducted at baseline (T1), at the end of the intervention (T2), and short-term follow-up (T3). The primary outcome will be the perceived dignity impact of the intervention, measured by the Dignity Impact Scale. Secondary outcomes will include spiritual well-being, hope, anxiety, depression, and distress. Perceptions of the intervention experience will also be collected from individuals in the intervention group. The primary analysis will be performed using linear mixed models.
Discussion
This trial will provide evidence on the feasibility and potential benefits of Dignity Therapy in supporting dignity and spiritual well-being among individuals with advanced cancer, while also examining how the intervention performs within distinct cultural contexts that may shape perceptions of dignity and end-of-life care.
Trial registration
Registro Brasileiro de Ensaios Clínicos (ReBEC), RBR-8r3vzw5. Registered on 13 October 2025.
Description
Article number 1403
The authors are grateful to Professor Harvey Max Chochinov for his valuable insights and contributions that strengthened key aspects of this protocol. We also acknowledge the support of the Walter Cantídio University Hospital, whose collaboration has been essential to the development of this study. Additionally, we thank the Coordination for the Improvement of Higher Education Personnel (CAPES – Brazil) for providing scholarship support to the first author.
Contributions The study concept and design were developed by RJVY, JS, BSRP, BJ, and CL. Statistical planning and analysis were carried out by DT. AFCF, MVTBS, RCA, CFSNA, MEBG, LLFM, MTC, ACFB, RCMBC, MBNG, and NCAM contributed to discussions regarding the logistical aspects of implementation within the Palliative Care Service. The first draft of the manuscript was written by RJVY, and all authors contributed to revisions and approved the final version of the protocol for submission.
The authors are grateful to Professor Harvey Max Chochinov for his valuable insights and contributions that strengthened key aspects of this protocol. We also acknowledge the support of the Walter Cantídio University Hospital, whose collaboration has been essential to the development of this study. Additionally, we thank the Coordination for the Improvement of Higher Education Personnel (CAPES – Brazil) for providing scholarship support to the first author.
Contributions The study concept and design were developed by RJVY, JS, BSRP, BJ, and CL. Statistical planning and analysis were carried out by DT. AFCF, MVTBS, RCA, CFSNA, MEBG, LLFM, MTC, ACFB, RCMBC, MBNG, and NCAM contributed to discussions regarding the logistical aspects of implementation within the Palliative Care Service. The first draft of the manuscript was written by RJVY, and all authors contributed to revisions and approved the final version of the protocol for submission.
Keywords
Cancer Dignity Palliative care Person-Centered approach Psychotherapy
Pedagogical Context
Citation
Velasco Yanez, R.J., Carvalho Fernandes, A., Tomé Bandeira de Sousa, M.V. et al. Effects of dignity therapy on dignity and spiritual well-being in people with advanced cancer: study protocol for a randomized controlled trial. BMC Psychol 13, 1403 (2025). https://doi.org/10.1186/s40359-025-03838-y
Publisher
Springer Nature