Fostering human dignity during chemotherapy: An explorative study on Dignity Therapy in advanced gastric and pancreatic cancer.

OBJECTIVES: Advanced pancreatic and gastric cancers are associated with high symptom burden and psychological distress, potentially threatening patients' sense of dignity. Although Dignity Therapy (DT) has mainly been used in end-of-life care, its potential role earlier in the disease trajectory is emerging. This exploratory study investigated the feasibility and potential impact of DT during active chemotherapy on emotional distress, dignity-related distress, and quality of life (QoL). METHODS: Thirty patients with advanced pancreatic or gastric cancer undergoing chemotherapy received a 3-session DT intervention over approximately 3 weeks. Emotional distress, dignity-related distress, and QoL were assessed at baseline (T0), post-intervention (T1), and 1-month follow-up (T2) using the Distress Thermometer, Patient Dignity Inventory, and EORTC Quality of Life Questionnaire-Core 30. Exploratory analyses assessed changes over time. RESULTS: Emotional distress decreased significantly from T0 (M = 6.67, SD = 1.47) to T1 (M = 3.13, SD = 1.43; p < .001) and remained lower at T2 (M = 3.50, SD = 1.53; p < .001). Dignity-related distress also decreased from T0 (M = 37.1, SD = 3.03) to T1 (M = 27.9, SD = 1.79; p < .001), with sustained improvement at T2 (M = 25.4, SD = 12.86; p < .01). QoL remained stable. Participants reported high acceptability of the intervention. SIGNIFICANCE OF RESULTS: DT during chemotherapy appears feasible and may improve emotional and dignity-related outcomes. Results should be interpreted cautiously due to the small sample size, attrition, and lack of a control group.