# Dignity Therapy for Older Cancer Patients: Identifying Mechanisms and Moderators

> **NIH NIH R01** · UNIVERSITY OF FLORIDA · 2023 · $341,867

## Abstract

PROJECT SUMMARY
Nearly 600,000 older Americans die a cancer-related death each year. Maintaining human dignity is central to
quality of life for patients with serious illness. Our long-term goal is to foster optimal humanistic modes of
patient-centered clinical communication. We focus in the proposed study on Dignity Therapy (DT) which was
designed to preserve cancer patients’ dignity despite declines in their health. Theoretically grounded in
gerontological life review research, DT involves a therapist guiding a patient to generate their own unique,
structured life narrative. Patients report benefits of DT but to date the mechanisms of DT have not been
empirically investigated. As the use of this therapy spreads internationally, there is thus a pressing need to
delineate precise mechanisms. The proposed study is the first to reliably analyze the content of older cancer
patients’ interactions with the therapist in DT sessions (N=280 older adults who received DT). Our design
allows for investigation of two mechanisms theoretically central to improving patient dignity through DT. These
proposed mechanisms, empathic provider-patient communication during DT and richness of the patient’s life
narrative produced during DT, will be used analytically as predictors of pre-to-post-therapy change in dignity
impact. Our proposed study uses innovative methodological tools: it will employ both interactional and narrative
analysis, grounded in the patient’s own experience, to establish mechanisms through which the therapy affects
patient dignity. Past research has suffered due to assessment of conceptually distal outcomes of receiving DT.
In response, the proposed outcomes have been chosen as proximal constructs closely guided by DT’s
conceptual underpinnings. Our primary outcome of interest is the extent to which the patients sense of dignity
increases from pre-to-posttest (i.e., Dignity Impact). Another aspect of the proposed study is to investigate
when patients are most able to engage in DT. This will be accomplished through assessing whether extent of
dignity impact after DT is moderated by patients’ symptom severity. Together, delineating mechanisms and
identifying best timing for patient engagement in DT will provide substantial progress in implementing DT as a
form of psychosocial care for older cancer patients. Our interdisciplinary team ensures that study findings will
be implemented to improve DT training and delivery. This includes our innovative dissemination plan of hosting
a Science of Care Summit with national opinion leaders. Our specific aims are as follows: SA1: Delineate the
relation between empathic communication and higher patient dignity impact (primary outcome) pre-to-post-
therapy. SA2: Investigate the relation between richness of the life narrative the patient is guided to produce
during DT, and dignity impact (primary outcome) pre-to-post therapy.SA3: Identify the best-fitting model of
relation of patient-provider empathic communicati...

## Key facts

- **NIH application ID:** 10692706
- **Project number:** 5R01CA253330-03
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** SUSAN BLUCK
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $341,867
- **Award type:** 5
- **Project period:** 2021-09-10 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10692706

## Citation

> US National Institutes of Health, RePORTER application 10692706, Dignity Therapy for Older Cancer Patients: Identifying Mechanisms and Moderators (5R01CA253330-03). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10692706. Licensed CC0.

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