Dignity Therapy for Older Adults in Long-term Care Institutions

NCT07824401 | Recruiting DMC

• 1 other identifier: KMUHIRB-F(I)-20250130
• Study Type: interventional
• Target: 240
• Locations: 1 country
• Sites: 1

Brief Summary

Due to the aging global population, an increasing number of elderly people are spending their remaining years in long-term care facilities. Common physical and psychological challenges in older adults increase with aging, significantly increasing their vulnerability and dependency and diminishing their sense of self and dignity. Loss of dignity is one of the most common challenges faced by older adults and can lead to various psychological issues, such as shame, depression, increased physical and mental stress, and even suicidal thoughts and behaviors. Therefore, care services for the elderly should strive to maintain and enhance their dignity and mitigate the negative impacts of this loss of dignity. Dignity therapy can help elderly people understand themselves by clarifying the value and meaning of life, fostering a sense of dignity and meaning. By creating a permanent, written record of their thoughts and words, which can be shared with important family members and friends, it can improve communication and interaction with family and friends, enhance their sense of dignity, and foster a sense of being functional, contributing, and valuable. The overall purpose of this three-year study was to investigate the effectiveness, applicability, and feasibility of dignity therapy for elderly people in long-term care facilities. The effectiveness of dignity therapy was assessed using indicators related to dignity and depression. Regarding the applicability and feasibility of dignity therapy, the perspectives of residents in long-term care facilities (experimental group), family members who received written documentation, and healthcare professionals were surveyed. The costs associated with the dignity therapy process, including labor, time, and financial costs, were assessed. This study employed a randomized controlled experimental design and recruited residents aged 65 and older from long-term care facilities in southern Taiwan. The experimental group received dignity therapy, while the control group received institutional care. The effective sample size was calculated to be 54 participants, with a minimum of 27 participants in each group. The Patient Dignity Inventory (Mandarin Version, PDI-MV) and the Patient Health Questionnaire-9 (PHQ-9) were used to assess the effectiveness of dignity therapy in residents of long-term care facilities before intervention (T0), immediately after intervention (T1), at one month (T2), two months (T3), three months (T4), and six months (T5). An 18-item semi-structured interview questionnaire was used to survey residents of long-term care facilities (experimental group), 100 family members who received written documentation, and 50 healthcare professionals regarding their opinions on the applicability and feasibility of dignity therapy. The study also calculated the associated human, time, and financial costs. This study anticipates that dignity therapy can enhance the dignity of residents in long-term care facilities and is applicable and feasible for these individuals. The study aims to provide academic and practical communities with a better understanding of the psychological, social, and spiritual needs of residents in long-term care facilities, as well as a reference for developing evidence-based care policies related to dignity therapy.

Conditions

Dignity; Elderly (People Aged 65 or More)

Outcome Measures

Primary Outcomes (2)

• Patient Dignity Inventory Mandarin Version (PDI-MV)

  The Patient Dignity Inventory Mandarin Version (PDI-MV) consists of 25 items with a total score ranging from 25 to 125, where higher scores indicate lower levels of dignity.

  Baseline (T0), Day 7 (T1), 1-month (T2), 2-month (T3), 3-month (T4), and 6-month (T5)

• Patient Health Questionnaire-9 (PHQ-9)

  The Patient Health Questionnaire-9 (PHQ-9) consists of 9 items with a total score ranging from 0 to 27, where higher scores indicate greater severity of depression.

  Baseline (T0), Day 7 (T1), 1-month (T2), 2-month (T3), 3-month (T4), and 6-month (T5)

Study Arms (2)

dignity therapy

EXPERIMENTAL

Dignity therapists use the "Dignity Psychotherapy Question Protocol" to guide patients through life's most important issues, providing them with the opportunity to participate in and discuss the things they would like their families to remember them for. During the process, dignity therapists use audio recording to fully record, transcribe, and edit the interview material, creating a valuable record that the patient wishes to preserve. The edited document is then returned to the patient, who then gives it to their family members.

Behavioral: dignity therapy; Behavioral: long term care

Long-term care

PLACEBO COMPARATOR

Participants receive care in a long-term care facility. Long-term care refers to physical and daily care provided by caregivers and medical professionals through home services, day care centers, residential care centers, and family-based care. Care includes nursing care, assistance with toileting, bathing, dressing, oral hygiene, feeding, medication administration, turning over, back massage, simple passive limb range of motion, getting in and out of bed, exercise assistance, assistance with the use of assistive devices, activity planning, and related services.

Behavioral: dignity therapy; Behavioral: long term care

Interventions

dignity therapy BEHAVIORAL

Dignity therapists use the "Dignity Psychotherapy Question Protocol" to guide patients through life's most important issues, providing them with the opportunity to participate in and discuss the things they would like their families to remember them for. During the process, dignity therapists use audio recording to fully record, transcribe, and edit the interview material, creating a valuable record that the patient wishes to preserve. The edited document is then returned to the patient, who then gives it to their family members.

Long-term care; dignity therapy

long term care BEHAVIORAL

Participants receive care in a long-term care facility. Long-term care refers to physical and daily care provided by caregivers and medical professionals through home services, day care centers, residential care centers, and family-based care. Care includes nursing care, assistance with toileting, bathing, dressing, oral hygiene, feeding, medication administration, turning over, back massage, simple passive limb range of motion, getting in and out of bed, exercise assistance, assistance with the use of assistive devices, activity planning, and related services.

Long-term care; dignity therapy

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• Those who receive long-term care services in a long-term care institution;
• Those aged 65 or above;
• Those who can communicate in Mandarin or Taiwanese;
• Those who are willing to participate in this research project and fill out the consent form after the purpose and process of the research are explained.

You may not qualify if:

• Those diagnosed with dementia, delirium, disability, mental disorder, or other organic brain disease;
• Those who are unconscious and incapable of acting.

Sponsors & Collaborators

• Kaohsiung Medical University Chung-Ho Memorial Hospital: lead
• Kaohsiung Medical University Chung-Ho Memorial Hospital (KMUH), Taiwan: collaborator

Study Sites (1)

Tatung Jianguo Community Day Care Center

Kaohsiung City, 801001, Taiwan

RECRUITING

MeSH Terms

Interventions

Dignity Therapy; Long-Term Care

Intervention Hierarchy (Ancestors)

Psychotherapy; Behavioral Disciplines and Activities; Patient Care; Therapeutics; Health Services; Health Care Facilities Workforce and Services

Central Study Contacts

Yu Chi Li

CONTACT

+886-915363328; yuchi@kmu.edu.tw

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: SUPPORTIVE CARE
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 25, 2025
• First Posted: September 17, 2026
• Study Start: December 12, 2025
• Primary Completion (Estimated): July 31, 2028
• Study Completion (Estimated): July 31, 2028
• Last Updated: September 17, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)