Cultural acceptability and potential effectiveness of dignity therapy for patients with terminal cancer in Taiwan

ISRCTN ISRCTN99678415
DOI https://doi.org/10.1186/ISRCTN99678415
ClinicalTrials.gov (NCT) Nil known
Clinical Trials Information System (CTIS) Nil known
Protocol serial number Nil known
Sponsor National Science and Technology Council
Funder National Science and Technology Council
Submission date
05/11/2025
Registration date
11/11/2025
Last edited
11/11/2025
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
This study explores how culturally acceptable and clinically effective dignity therapy (DT) is for people with terminal cancer in Taiwan. Dignity therapy helps patients reflect on their lives and share meaningful memories, which may reduce emotional distress. The research addresses a gap in evidence about how well this therapy works in East Asian settings.

Who can participate?
Participants include adults diagnosed with terminal cancer who are expected to live less than six months. They must be able to communicate clearly, complete questionnaires, and speak either Mandarin Chinese or Taiwanese.

What does the study involve?
Participants are aged 20 or older and choose to take part voluntarily. They take part in dignity therapy sessions and complete questionnaires to help researchers understand how the therapy affects their emotional well-being.

What are the possible benefits and risks of participating?
Researchers expect that patients who receive dignity therapy will experience less distress related to dignity compared to those receiving standard comfort care. They also anticipate that both patients and their families will find the therapy acceptable and helpful. No major risks are reported.

Where is the study run from?
The study takes place in two oncology wards at a large hospital in southern Taiwan.

When is the study starting and how long is it expected to run for?
The study runs from April to June 2022.

Who is funding the study?
The study is funded by Taiwan’s National Science and Technology Council (NSTC).

Who is the main contact?
Wei-Shu Lai, weisue@mail.ncku.edu.tw

Contact information

Mrs Lai Wei-Shu
Public, Principal investigator

No. 138, Shengli Rd., North Dist.
Tainan city
704302
Taiwan

Phone +886-6-2353535 ext.5821
Email weisue@mail.ncku.edu.tw
Miss Tzuyun Chiu
Scientific

No. 138, Shengli Rd., North Dist.
Tainan city
704302
Taiwan

Phone +886-6-2353535 ext.5821
Email olmd0630@gmail.com

Study information

Primary study designInterventional
Study designQuasi-experimental non-randomized controlled design
Secondary study designQuasi-experimental study
Study type Participant information sheet
Scientific titleCultural acceptability and potential effectiveness of dignity therapy (DT) for patients with terminal cancer in Taiwan: a quasi-experimental study
Study acronymDTIT
Study objectives1. Patients receiving DT would report greater reductions in dignity-related distress over time than those receiving comfort care alone
2. DT would be perceived as acceptable and satisfactory by both patients and their family members
Ethics approval(s)

Approved 09/04/2022, Institutional Review Board of National Cheng Kung University (No. 138, Shengli Rd., North District, Tainan City, 704302, Taiwan; +886 2757575; em51020@email.ncku.edu.tw), ref: A-ER-109-193

Health condition(s) or problem(s) studiedCancer dignity-related distress
InterventionParticipants in the intervention group received a standardized 7-day course of dignity therapy in addition to the standard comfort care provided to the control group. Participants in the control group received standard comfort care in accordance with institutional comfort care protocols. Eligible participants were referred by the clinical care team. After providing informed consent, group assignment was initiated. Due to the narrative and emotionally reflective nature of DT, full randomization was not feasible. Participants who expressed a preference for DT were directly assigned to the intervention group, while the remaining eligible participants were randomly allocated to either the intervention or control group using block randomization sequences (e.g., EECC, CCEE). An independent research assistant conducted the randomization, and a senior research coordinator supervised the allocation process to ensure procedural integrity and transparency. Participants who withdrew from the study continued to receive standard care.
Blinding of participants and intervention providers was not possible due to the nature of the intervention. However, to mitigate bias, self-reported questionnaires were used for outcome measurement, and participants were provided adequate time and privacy to complete them. Importantly, research personnel responsible for data collection and analysis were blinded to group allocation to enhance objectivity and minimize response bias.
Intervention typeSupplement
Primary outcome measure(s)

Dignity-related distress was measured using the Patient Dignity Inventory–Mandarin Version (PDI-MV) at baseline, post-intervention, and two-week follow-up

Key secondary outcome measure(s)

Acceptability was assessed using the Dignity Therapy Patient and Family Feedback Questionnaires (DTPFQ/DTFFQ) at post-intervention

Completion date01/06/2022

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit20 Years
Upper age limit80 Years
SexAll
Target sample size at registration63
Total final enrolment24
Key inclusion criteria1. Aged 20 years or older
2. Voluntarily agreed to participate
3. Capable of effective communication and completing self-report questionnaires
4. Fluent in either Mandarin Chinese or Taiwanese
5. Diagnosed with terminal cancer with a medically estimated life expectancy of less than six months
Key exclusion criteria1. Diagnosis of a severe organic brain disorder
2. The presence of a diagnosed mental illness or depression
3. Unconsciousness or cognitive impairment
4. Expected hospital discharge within three days
5. Currently receiving formal palliative care
Date of first enrolment27/04/2022
Date of final enrolment01/06/2022

Locations

Countries of recruitment

  • Taiwan

Study participating centre

Two oncology wards at a tertiary medical center in southern Taiwan.
No. 138, Shengli Rd., North District
Tainan city
704302
Taiwan

Results and Publications

Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
IPD sharing planAfter the intervention of this study, the researcher will assist in completing the editing of the patient’s Life Memory Book and will deliver it to the important person designated by the patient. Based on the principles of confidentiality and privacy, the contents of the patient’s documents and the designated recipient should not be disclosed arbitrarily. The information collected from participants during the research process will be kept confidential. All questionnaires will be administered anonymously. After collection, the data will be coded and entered into a computer for storage. If the findings are published in academic papers or presented publicly in the future, only the overall research results will be reported without including any personal information. All paper questionnaires will be destroyed within three years after the completion and publication of this research. The physical, psychological, and spiritual well-being of the participants will be prioritized, and every effort will be made to prevent them from experiencing any harm.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

11/11/2025: Trial's existence confirmed by Institutional Review Board of National Cheng Kung University.