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Life meaning constructed from dignity therapy in traditional Chinese culture: A qualitative analysis of dignity therapy generativity documents

Published online by Cambridge University Press:  23 December 2022

Junyi Lin
Affiliation:
School of Nursing, Capital Medical University, Beijing, China
Hong Zhang
Affiliation:
Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Day Oncology Unit, Peking University Cancer Hospital & Institute, Beijing, China
Lanxin Xi
Affiliation:
School of Nursing, Capital Medical University, Beijing, China
Fang Liu
Affiliation:
Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Day Oncology Unit, Peking University Cancer Hospital & Institute, Beijing, China
Wei Liu
Affiliation:
Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Day Oncology Unit, Peking University Cancer Hospital & Institute, Beijing, China
Qiaohong Guo*
Affiliation:
School of Nursing, Capital Medical University, Beijing, China
*
Author for correspondence: Qiaohong Guo, School of Nursing, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Fengtai District, Beijing 100069, China. Email: qguo@ccmu.edu.cn

Abstract

Objectives

To examine the thematic features of dignity therapy generativity documents of advanced cancer patients receiving chemotherapy in mainland China from the perspective of meaning-making during dignity therapy.

Methods

This is a qualitative descriptive study. Content analysis was used to analyze 24 dignity therapy generativity documents derived from a quasi-experimental trial of dignity therapy for advanced cancer patients receiving chemotherapy in a daycare center at a cancer hospital in northern China.

Results

Among the 24 advanced cancer patients whose generativity documents were analyzed, 14 were male and ranged in age from 26 to 78 years (average = 50.3). Two dimensions emerged from the data: (1) the sources of meaning in life, which consisted of social relationships, things and circumstances providing meaning in life, and (2) the ultimate meaning in life, referring to finding one’s real self and realizing the purpose in life, including personal life goals, dignity and autonomy, and morality of patients.

Significance of results

The multidimensional constructs of meaning in life with distinctive traditional Chinese cultural characteristics could provide insights into dignity-conserving care for advanced cancer patients with Chinese culture and provide evidence for refining the implementation protocol of DT through intentionally addressing the ultimate meaning of patients in the therapeutic session.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press.

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References

Alavi, M, Latif, AA, Ninggal, MT, et al. (2020) Family functioning and attachment among young adults in western and non-western societies. Journal of Psychology 154(5), 346366. doi:10.1080/00223980.2020.1754153CrossRefGoogle ScholarPubMed
Auhagen, AE and Holub, F (2006) Ultimate, provisional, and personal meaning of life: Differences and common. Psychological Reports 99(1), 131146. doi:10.2466/pr0.99.1.131-146CrossRefGoogle ScholarPubMed
Bedford, O and Yeh, K (2019) The history and the future of the psychology of filial piety: Chinese norms to contextualized personality construct. Frontiers in Psychology 10, . doi:10.3389/fpsyg.2019.00100CrossRefGoogle ScholarPubMed
Bluck, S, Mroz, EL, Wilkie, DJ, et al. (2022) Quality of life for older cancer patients: Relation of psychospiritual distress to meaning-making during dignity therapy. The American Journal of Hospice & Palliative Care 39(1), 5461. doi:10.1177/10499091211011712CrossRefGoogle ScholarPubMed
Buonaccorso, L, Tanzi, S, De Panfilis, L, et al. (2021) Meanings emerging from dignity therapy among cancer patients. Journal of Pain and Symptom Management 62(4), 730737. doi:10.1016/j.jpainsymman.2021.02.028CrossRefGoogle ScholarPubMed
Chen, Z, Guo, Q, Geng, H, et al. (2022) Development and formative evaluation of the family-based dignity therapy protocol for palliative cancer patients and their families: A mixed-methods study. Cancer Nursing. doi:10.1097/NCC.0000000000001174Google 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. The Lancet Oncology 12(8), 753762. doi:10.1016/S1470-2045(11)70153-XCrossRefGoogle ScholarPubMed
Dose, AM and Rhudy, LM (2018) Perspectives of newly diagnosed advanced cancer patients receiving dignity therapy during cancer treatment. Supportive Care in Cancer 26(1), 187195. doi:10.1007/s00520-017-3833-2CrossRefGoogle ScholarPubMed
Elo, S and Kyngäs, H (2008) The qualitative content analysis process. Journal of Advanced Nursing 62(1), 107115. doi:10.1111/j.1365-2648.2007.04569.xCrossRefGoogle ScholarPubMed
Hack, TF, McClement, SE, Chochinov, HM, et al. (2010) Learning from dying patients during their final days: Life reflections gleaned from dignity therapy. Palliative Medicine 24(7), 715723. doi:10.1177/0269216310373164CrossRefGoogle ScholarPubMed
Henry, M, Cohen, SR, Lee, V, et al. (2010) The meaning-making intervention (MMi) appears to increase meaning in life in advanced ovarian cancer: A randomized controlled pilot study. Psycho-Oncology 19(12), 13401347. doi:10.1002/pon.1764CrossRefGoogle ScholarPubMed
Jiang, XH, Chen, XJ, Xie, QQ, et al. (2020) Effects of art therapy in cancer care: A systematic review and meta-analysis. European Journal of Cancer Care 29(5), . doi:10.1111/ecc.13277CrossRefGoogle Scholar
Johnsen, AT, Eskildsen, NB, Thomsen, TG, et al. (2017) Conceptualizing patient empowerment in cancer follow-up by combining theory and qualitative data. Acta Oncologica 56(2), 232238. doi:10.1080/0284186X.2016.1267403CrossRefGoogle ScholarPubMed
Johnston, B, Lawton, S and Pringle, J (2017) “This is my story, how I remember it”: In-depth analysis of dignity therapy documents from a study of dignity therapy for people with early stage dementia. Dementia 16(5), 543555. doi:10.1177/1471301215605629CrossRefGoogle ScholarPubMed
Julião, M, Sobral, MA, Johnston, B, et al. (2022) A Portuguese trial using dignity therapy for adults who have a life-threatening disease: Qualitative analysis of generativity documents. Palliative & Support Care 20(2), 189195. doi:10.1017/S1478951521000754CrossRefGoogle ScholarPubMed
Lee, V, Cohen, SR, Edgar, L, et al. (2004) Clarifying “meaning” in the context of cancer research: A systematic literature review. Palliative & Support Care 2(3), 291303. doi:10.1017/s1478951504040386CrossRefGoogle ScholarPubMed
Li, Y (2022) The Confucian concept of human dignity and its implications for bioethics. Developing World Bioethics 22(1), 2333. doi:10.1111/dewb.12312CrossRefGoogle ScholarPubMed
Liao, J, Wu, B, Mao, J, et al. (2020) Preference for aggressive end-of-life care among advanced cancer patients in Wuhan, China: A cross-sectional study. International Journal of Environmental Research and Public Health 17(18), . doi:10.3390/ijerph17186592CrossRefGoogle ScholarPubMed
Li, Y, Li, X, Hou, L, et al. (2020) Effectiveness of dignity therapy for patients with advanced cancer: A systematic review and meta-analysis of 10 randomized controlled trials. Depression and Anxiety 37(3), 234246. doi:10.1002/da.22980CrossRefGoogle Scholar
Liu, L, Ma, L, Chen, Z, et al. (2021) Dignity at the end of life in traditional Chinese culture: Perspectives of advanced cancer patients and family members. European Journal of Oncology Nursing 54, . doi:10.1016/j.ejon.2021.102017CrossRefGoogle ScholarPubMed
Masel, EK, Trinczek, H, Adamidis, F, et al. (2018) Vitamin “G”arden: A qualitative study exploring perception/s of horticultural therapy on a palliative care ward. Supportive Care in Cancer 26(6), 17991805. doi:10.1007/s00520-017-3978-zCrossRefGoogle Scholar
Montross, L, Winters, KD and Irwin, SA (2011) Dignity therapy implementation in a community-based hospice setting. Journal of Palliative Medicine 14(6), 729734. doi:10.1089/jpm.2010.0449CrossRefGoogle Scholar
Rosa, WE, Chochinov, HM, Coyle, N, et al. (2022) Attending to the existential experience in oncology: Dignity and meaning amid awareness of death. JCO Global Oncology 8, . doi:10.1200/GO.22.00038Google Scholar
Salamanca-Balen, N, Merluzzi, TV and Chen, M (2021) The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis. Palliative Medicine 35(4), 710728. doi:10.1177/0269216321994728CrossRefGoogle ScholarPubMed
Tait, GR, Schryer, C, McDougall, A, et al. (2011) Exploring the therapeutic power of narrative at the end of life: A qualitative analysis of narratives emerging in dignity therapy. BMJ Supportive & Palliative Care 1(3), 296300. doi:10.1136/bmjspcare-2011-000051CrossRefGoogle ScholarPubMed
Tong, A, Sainsbury, P and Craig, J (2007) Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care 19(6), 349357. doi:10.1093/intqhc/mzm042CrossRefGoogle ScholarPubMed
Xiao, J, Chow, KM, Liu, Y, et al. (2019) Effects of dignity therapy on dignity, psychological well‐being, and quality of life among palliative care cancer patients: A systematic review and meta-analysis. Psycho-Oncology 28(9), 17911802. doi:10.1002/pon.5162CrossRefGoogle ScholarPubMed
Zalenski, RJ and Raspa, R (2006) Maslow’s hierarchy of needs: A framework for achieving human potential in hospice. Journal of Palliative Medicine 9(5), 11201127. doi:10.1089/jpm.2006.9.1120CrossRefGoogle Scholar
Zheng, R, Guo, Q, Chen, Z, et al. (2021) An exploration of the challenges for oncology nurses in providing hospice care in mainland China: A qualitative study. Asia-Pacific Journal of Oncology Nursing 8(2), 139146. doi:10.4103/apjon.apjon.6220CrossRefGoogle ScholarPubMed