Development of a personalized, modular intervention to promote dignity, meaning and mindfulness in palliative patients in a swiss acute-care hospital.

BACKGROUND: Patients with serious, life-limiting diseases often experience substantial emotional and spiritual distress, death anxiety, depressive symptoms, and loss of dignity. Fostering dignity and meaning and relieving psychological distress have been identified as core objectives of palliative care. To address the individual needs of palliative patients, a personalized, modular intervention approach may be advantageous. AIM: Based on previous work, we aimed to develop a personalized, modular approach to improve dignity, meaning, and mindfulness in palliative care patients. METHODS: An expert panel of international specialists in palliative care, dignity therapy, psychotherapy, clinical psychology, psychiatry, and psychosomatic medicine was convened to develop the proposed modular approach. Intervention development is described following the “Template for Intervention Description and Replication” TIDieR guidance and is based on results from a literature search on previous work on dignity, meaning-centered therapy, and mindfulness-based interventions, as well as on in-depth needs assessments. RESULTS: Based on the expert consensus, a three-modular approach was formulated, with evidence-based modules providing Dignity Therapy, Managing Cancer and Living Meaningfully (CALM) therapy, and mindfulness-based interventions, each addressing complementary aspects. CONCLUSION: A personalized, modular intervention to promote dignity, meaning, and mindfulness in palliative care patients was developed by a panel of international experts using existing dignity-fostering end-of-life interventions. The resulting modular approach was designed with the aim to address patients’ individual needs.