Trial Title:
The Effect of Dignity Therapy Applied to Cancer Patients
NCT ID:
NCT06105359
Condition:
Cancer
Dignity
Conditions: Keywords:
Dignity therapy
cancer patient
depression
Study type:
Interventional
Study phase:
N/A
Overall status:
Not yet recruiting
Study design:
Allocation:
Randomized
Intervention model:
Parallel Assignment
Intervention model description:
Research, experimental control group and pretest-posttest study will be carried out.
Primary purpose:
Supportive Care
Masking:
Double (Participant, Outcomes Assessor)
Masking description:
To control for performance bias, patients will be blinded to the study hypothesis and
will not be informed which group they are in. There will be no blinding for the
researcher. However, blind technique will be used in the research. This blind technique
will be applied by the researcher with the patients blinded until the application begins.
In the research, in order to meet the blind technical conditions, the process steps were
carried out by an independent statistician from the first stage. The sample will be
sorted by a combination order and number. In this way selection bias will be controlled.
The study will also be controlled for attrition bias and Statistics and reporting bias.
Intervention:
Intervention type:
Behavioral
Intervention name:
Dignity therapy
Description:
Dignity therapy will be applied in the interview room that will be requested in the
oncology clinic to protect the confidentiality of information.
The application is planned as five sessions and the sessions will last approximately 40
minutes. Two questions in the dignity therapy protocol will be discussed in each session.
Arm group label:
experimental group
Intervention type:
Other
Intervention name:
standardize care
Description:
Patients in this group will receive standard treatment and care in the clinic. No action
will be taken other than standard care.
Arm group label:
control group
Arm group label:
experimental group
Other name:
Cancer patients will receive routine treatment and care.
Summary:
The aim of this study is to determine the effect of dignity therapy on the quality of
life and depression levels of cancer patients.
Methods: The research was planned as a randomized controlled experimental study.
Type of Research: Research, experimental, control group and pretest-posttest study will
be carried out.
Population of the Study: The population of the study was sent to Meram Medical Faculty
Hospital Oncology Clinic consists of male and female inpatients.
Sample of the Research: Those who agreed to participate in the research and met the
inclusion criteria. Patients who meet will be included in the study. It was 48. It was
planned to be.
Randomization: In this study, parallel group block randomization method was applied to
the intervention and control groups. will be allocated randomly. Block randomization was
used because the sample size was small. Patients will be selected equally using
permutation method, and randomization will be selected using blocking technique. will be
done. During randomization, CONSORT 2017 will be used.
For randomization; To control for performance bias, patients will be blinded to the study
hypothesis and will not be informed which group they are in. There will be no blinding
for the researcher. However, blind technique will be used in the research. This blind
technique will be applied by the researcher with the patients blinded until the
application begins..
Data Collection Techniques and Tools: "Personal Information Form", "Patient Dignity
Inventory" and "Rosenberg Self-Esteem Scale" were used in data collection (RSES)" will be
used.
Detailed description:
Cancer affects both the patient and their relatives physically and psychologically. From
the moment cancer is diagnosed, psychological problems that affect the adaptation
processes of individuals, which can be defined as crises, may arise along with the
physical effects of the disease and the treatment process. It is suggested that the loss
of dignity that develops in terminally ill patients causes the patients to want to die as
soon as possible. It is important that patients receive care in accordance with the
standards and value judgments they are used to, so that their sense of dignity and status
is not affected by health problems. Dignity therapy is a type of short-term therapy
developed to alleviate the distress of terminally ill patients and improve their
end-of-life experiences. Chochinov emphasizes that dignity depends on productivity
experiences, the search for purpose and meaning, defined dignity-protective care for
patients facing a serious illness, and developed a model to be developed, studied and
used by clinicians.
In the literature, it is seen that dignity therapy can be applied by different health
professionals in patient groups with different diagnoses and provides positive
contributions for patients and their relatives. With the increase in palliative care
units in recent years, it has been considered important to apply this type of therapy to
patients. In addition, no studies on dignity therapy have been found in Turkey. The aim
of this study is to determine the effect of dignity therapy on the quality of life and
depression levels of cancer patients.
Methods: The research was planned as a randomized controlled experimental study. Research
Outpatient and inpatient treatment at Necmettin Erbakan University Faculty of Medicine
hospital oncology clinic It will be done with end-stage cancer patients. October
2023-December 2023 with an average of 48 patients It will be carried out between . In
collecting research data, Personal Information Form, Patient The Reputation Inventory and
the Rosenberg Self-Esteem Scale (RSES) will be used.
Type of Research: Research, experimental, control group and pretest-posttest study will
be carried out.
Place and Characteristics of the Research: The research was conducted in Konya province
by Necmettin Erbakan It will be carried out in the Oncology clinic of University Meram
Faculty of Medicine Hospital.Inpatient clinics are located on the 3rd and 4th floors, and
there are 33 beds on each floor. Population of the Study: The population of the study was
sent to Meram Medical Faculty Hospital Oncology Clinic consists of male and female
inpatients.
Sample of the Research: Those who agreed to participate in the research and met the
inclusion criteria. Patients who meet will be included in the study. The sample size in
this study In order to determine the results, a priori power analysis was performed with
the G-Power 3.1 statistical program. In determining the sample size, "The effect of
Chinese culture-adapted dignity therapy on advanced cancer patients receiving
chemotherapy in the Scores obtained from the "day oncology unit: A quasi-experimental
study" study were used. 95% confidence (1-α), 80% test power (1-β), With an effect size
of f = 0.78, the minimum number of samples to be included in the study was determined as
44 in total, 22 in each group. Patients are excluded from the study for many reasons. It
was thought that there might be a loss of approximately 10% due to separation, and the
number of samples was 48. It was planned to be.
Randomization: In this study, parallel group block randomization method was applied to
the intervention and control groups. will be allocated randomly. Block randomization was
used because the sample size was small. Patients will be selected equally using
permutation method, and randomization will be selected using blocking technique. will be
done. During randomization, CONSORT 2017 (Randomized Parallel Group Updated Guidelines
for Reporting Research) will be used.
For randomization; To control for performance bias, patients will be blinded to the study
hypothesis and will not be informed which group they are in. There will be no blinding
for the researcher. However, blind technique will be used in the research. This blind
technique will be applied by the researcher with the patients blinded until the
application begins. In the research, in order to meet the blind technical conditions, the
process steps were carried out by an independent statistician from the first stage. The
sample will be sorted by a combination order and number. In this way selection bias will
be controlled. The study will also be controlled for attrition bias and Statistics and
reporting bias.
Data Collection Techniques and Tools: "Personal Information Form (sociodemographic and
disease characteristics)", "Patient Dignity Inventory" and "Rosenberg Self-Esteem Scale"
were used in data collection (RSES)" will be used.
Data Collection Tools Personal Information Form: The form created by the researcher by
scanning the literature consists of 8 questions (age, gender, marital status, employment
status, monthly income level, education level, cancer type, how long ago it was
diagnosed).
Patient Dignity Inventory: The scale, consisting of a total of 25 items, was developed by
Chochinov et al. (2008) and translated into Turkish by Eskigülek and Kav (2022) adapted.
This five-point Likert type inventory is rated as "1 = no problem, 2 = slight problem, 3
= problem, 4 = big problem, 5 = very much problem." The minimum and maximum total score
of the inventory is 25 and 125 points respectively. There are no reverse scored items in
the inventory. A higher total score means that the individual's perceived reputation is
complex. Items scoring three or more are clinically meaningful. As a result of factor
analysis, a five-factor structure was obtained; The factors are reported as "symptom
distress", "existential distress", "addiction", "peace of mind" and "social support". The
Cronbach alpha value of the scale was reported as 0.94.
Rosenberg Self-Esteem Scale (RSES): The Rosenberg Self-Esteem Scale was developed by
Morris Rosenberg in 1965 to measure the self-esteem of adolescents (Rosenberg, 1965).
Participants score the questions as very true, true, false and very false. This scale,
developed by Rosenberg, consists of a total of 63 items and 12 subtests. Self-Esteem
Scale, one of these 12 subtests, was used in this study. The scale consists of a total of
10 items, 5 negative and 5 positive items. For questions 1, 2, 4, 6 and 7, respectively,
it is very true (4), true (3), wrong (2), very wrong (1). The opposite is true for
articles 3, 5, 8, 9 and 10. A high score on Rosenberg self-esteem means low self-esteem.
A scale adaptation study was conducted by Çuhadaroğlu in 1985. As a result of this study,
the test-retest reliability of the scale was found to be 0.75. The validity coefficient
of the scale was found to be 0.71.
Application Steps: After the patients coming to the oncology clinic as outpatients or
inpatients are evaluated by their physicians, they will be referred to the researcher if
the predicted survival time is less than 6 months. The purpose of the study will be
explained to patients who meet the inclusion criteria, and for those who accept, planning
will be made in a way that will not disrupt the patient's treatment process, and the
steps applied in dignity therapy will be followed. Dignity therapy will be applied in the
interview room that will be requested in the oncology clinic to protect the
confidentiality of information.
The application is planned as five sessions and the sessions will last approximately 40
minutes. Two questions in the dignity therapy protocol will be discussed in each session.
Dignity Therapy Necmettin Erbakan University Faculty of Nursing, Department of Mental
Health and Diseases Nursing. Lecturer It will be carried out by the researcher who serves
as a member. She has worked as a clinical nurse researcher and is an expert in
psychiatric nursing. Before the researcher started to apply this therapy, the 3-day
"Dignity in Care - Online Training 2023"
(https://www.cpd-umanitoba.com/events/dignityin-care-online-training) was held online
between 14-28 September 2023. -2023/) attended the course. The course is hosted by Harvey
Max Chochinov, a Distinguished Professor of Psychiatry at the University of Manitoba and
Senior Scientist at the Cancer Care Manitoba Research Institute.
The therapist will interview each participant individually, it will be conducted in
accordance with the dignity therapy protocol, the interviews will be recorded with a
voice recorder, all recorded conversations will be transcribed and read to the patient
after a preliminary arrangement.
A discussion will be held on the areas that the patient wishes to change in the text, and
as included in the dignity therapy protocol, a session organization process will be
carried out with the participant, especially in the last session, in which the
participant will be provided with a written legacy (certificate of productivity). The
Dignity therapist prepares a document to be transferred to the participants' families,
relatives or friends, with patient approval. It will be made ready to be given after
submission. The Dignity therapist will create a written report at the end of the
interviews to be given to their families and present this report to the patients. The
final version of the report will be given by the patients.
Data Collection: Data will be collected by the researcher through face-to-face interviews
in the oncology clinic at Necmettin Erbakan University Faculty of Medicine Hospital, from
patients who meet the inclusion criteria and agree to participate in the study, without
disrupting the working order of the clinic. Data collection forms will be applied to both
the experimental and control groups as a pretest before dignity therapy begins to be
applied to the participants (in the 1st session) and as a posttest after dignity therapy
is completed (in the last session). Data collection tools will be filled in the patient
room, respecting the patient's privacy.
Research Variables Dependent variables: Patient Dignity Inventory, Rosenberg Self-Esteem
Scale Independent variables: Sociodemographic and disease characteristics, applied
dignity therapy Control variables: Age, gender Ethical Dimension of the Research:
Permission for the research was received from Necmettin Erbakan University Health
Sciences Scientific Research Ethics Committee and the Faculty of Medicine Hospital
Oncology Clinic. Permission will be obtained via e-mail from the authors of the scales to
be used. Participants who will participate in the research will be given verbal
information about the research and Informed Consent Form will be signed.
Participants who do not agree to participate in the research will not be forced to
participate. There is no conflict of interest between the researchers.
Statistical Evaluation of Data: Statistical analysis will be done using SPSS 23.0
(Statistical Package for Social Sciences Version 23.0) program. Cronbach's Alpha analysis
will be used in the internal consistency examination to determine the validity and
reliability of the scale, descriptive statistics will be used to determine the findings
regarding the individual characteristics of the participants, median and minimum/maximum
values for non-normally distributed variables, and mean±standard deviation values for
normally distributed variables. Appropriate statistical analyzes regarding the hypotheses
will be used to compare independent variables. The results obtained will be tested at the
p<0.05 significance level.
Criteria for eligibility:
Criteria:
Inclusion Criteria:
- Inclusion Criteria for Participants in the Study:
- Able to speak and understand Turkish,
- Those over 18 years of age
- No communication barriers
- Cancer diagnosis is in the 4th stage and in the last stage
- Patients with a predicted survival time of less than 6 months (physician
opinion) will be included
Exclusion Criteria:
- Criteria for Exclusion of Participants in the Study:
- Those diagnosed with dementia, delirium or other organic brain disorders;
- Those with impaired consciousness;
- Patients with mental problems that prevent them from receiving esteem therapy
will be excluded
Gender:
All
Minimum age:
18 Years
Maximum age:
65 Years
Healthy volunteers:
No
Start date:
July 12, 2024
Completion date:
December 2024
Lead sponsor:
Agency:
Necmettin Erbakan University
Agency class:
Other
Source:
Necmettin Erbakan University
Record processing date:
ClinicalTrials.gov processed this data on November 12, 2024
Source: ClinicalTrials.gov page:
https://clinicaltrials.gov/ct2/show/NCT06105359
