Objective: To determine the feasibility and acceptability of implementing Dignity Therapy (DT) in a neuropalliative clinic, and to determine preliminary efficacy.

Background: Awareness of the importance of spiritual wellbeing for people with movement disorders is growing. However, neurodegenerative conditions offer unique challenges for existing interventions. DT is a life-review intervention facilitating personal reflection and recognition, and the creation of a legacy document to share with loved ones. Although numerous studies have demonstrated the benefit of DT for people with cancer, research on its role in movement disorders is limited.

Method: Patients (≥ 65 years) with advanced Parkinson’s Disease (PD) or related disorders and a family member receiving care at a movement disorders-neuropalliative care clinic were approached for participation. Patients completed pre- and post-intervention self-report measures and family completed a post-intervention survey. A trained chaplain conducted at least three sessions (an initial phone call, protocolized DT interview, and review of the transcribed, edited legacy document). Feasibility and acceptability outcomes: intervention completion, number of sessions, and post-intervention surveys. Efficacy outcomes: PDQ-8, Patient Dignity Inventory (PDI).

Results: We enrolled 17 patients who completed all study components (46% of eligible patients agreed to participate). Patients (mean age 74.9, SD 6.7) were majority white (76%), male (59%), with PD (65%), Lewy Body Dementia (17.5%), or atypical parkinsonism (17.5%). Most patients (65%) completed the interview in one session, 76% agreed or strongly agreed that DT was helpful, and 65% deemed it helpful to their family. Among family members, 78% would recommend DT to other families, and 67% felt it provided their loved one with a heightened sense of purpose. No efficacy outcome changes were significant, although some trends were promising (PDQ-8: mean pre 22.2 vs. post 20.8, p=0.16; PDI: 65.5 vs. 58.4, p=0.095).

Conclusion: DT was deemed helpful and offered a sense of purpose to individuals living with advanced PD and related disorders. Over one-third of participants required additional interview time due to bradykinesia, hypophonia, or other symptoms. Future efficacy testing will require a larger sample size.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/feasibility-and-acceptability-of-implementing-dignity-therapy-as-a-supportive-intervention-for-people-with-movement-disorders/