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Dignity Therapy Protocol: reaffirming dignity in care contexts

Dignity therapy is a brief and personalised psychotherapy developed for patients with life-threatening or limiting illnesses, with the aim of letting them talk about their most important things and helping strengthen their dignity and face their suffering.

Using the Dignity Therapy Protocol and following the cues of the respondent, a trained therapist facilitates the expression of thoughts, feelings and memories, inserted in a narrative document that the patient can share with a friend or a loved one.

The Canadian project Dignity in Care is based on fifteen years of study by Dr. Harvey Max Chochinov and the Research Unit on Palliative Care in Manitoba, in collaboration with Australian, British and US researchers, from which it emerged that:

  • Health professionals can significantly affect the dignity of their patients.
  • Good communication is an essential element to provide high quality care.
  • A better interaction between clinicians and patients can bring the former to greater job satisfaction and the latter to better outcomes.

Dignity in Care shows the importance of making dignity a conscious goal of healthcare, in particular at the end-of-life.

The following are the questions included in the Dignity Therapy Question Protocol:

Tell me a little about your life history; particularly the parts that you either remember most or think are the most important? When did you feel most alive?

Are there specific things that you would want your family to know about you, and are there particular things you would want them to remember?

What are the most important roles you have played in life (family roles, vocational roles, community-service roles, etc)? Why were they so important to you and what do you think you accomplished in those roles?

What are your most important accomplishments, and what do you feel most proud of?

Are there particular things that you feel still need to be said to your loved ones or things that you would want to take the time to say once again?

What are your hopes and dreams for your loved ones?

What have you learned about life that you would want to pass along to others? What advice or words of guidance would you wish to pass along to your (son, daughter, husband, wife, parents, other[s])?

Are there words or perhaps even instructions that you would like to offer your family to help prepare them for the future?

In creating this permanent record, are there other things that you would like included?

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