Fostering hope and enhancing end of life experiences: two Phase II RCTs of dignity therapy
Bibliographic record
Abstract
Abstract Introduction and aims Maintaining dignity and having hope are important at the end of life. The aim of these studies is to assess the acceptability and potential effectiveness of Dignity Therapy to reduce psychological and spiritual distress in people (i) with advanced cancer, and (ii) living in care homes for older people. Methods We randomly allocated 45 cancer patients and 60 care home residents to an intervention (Dignity Therapy) or control group. We collected outcomes in face-to-face interviews at two post intervention follow-ups: 1 and 4 weeks for cancer patients; and 1 and 8 weeks for care home residents (equivalent in the control group). The primary outcome was dignity related distress. Secondary outcomes were: hopefulness; anxiety/depression; quality of life; and acceptability (views on the intervention/taking part in the study). Results Cancer patients in the intervention group were more hopeful at both follow-ups. Effect sizes were large (partial η 2 0.195 and 0.150 respectively). Baseline levels of distress were low in both studies and the two groups did not differ on measures of distress or quality of life. Residents in both groups showed a decrease in dignity-related distress at 8 weeks. Participants in the intervention groups outperformed the control groups on all acceptability items at both follow-ups. Effect sizes (Cohen's d) ranged from 0.25 to 1.09). Conclusion Dignity Therapy increases hopefulness for people with advanced cancer and enhances their end of life experiences and those of residents of care homes. The impact of Dignity Therapy on more distressed patients needs to be determined.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".