The Effect of Dignity Therapy on Human Dignity in Patients with Chronic Renal Failure Undergoing Hemodialysis

Document Type : Original Quantitative and Qualitative Research Paper


1 Instructor of nursing, Department of Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

2 MS In Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

3 PhD in Nursing, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

4 Instructor of nursing, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

5 Assistant Professor of Clinical Psychology, Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


Background: Chronic renal failure is a life-threatening condition; patients due to the prolonged stress are very susceptible to mental health problems. Dignity therapy is a novel therapeutic approach to the treatment of psychological problems for patients who suffer from life-threatening illnesses.
Aim: This study examined the impact of dignity therapy on human dignity in patients undergoing hemodialysis.
Methods: This is a two-group experimental research with pre and post tests design, which was conducted on selected hospitals of Mashhad in 139. From 74 patients recruited for the study; 36 patients of even days were assigned in intervention group and 38 patients of the odd days were assigned to be the control group. In the intervention group, during the hemodialysis, dignity therapy has been performed in 3-4 sessions. Human dignity was examined before and one month after the intervention by Patient Dignity Inventory, and collected data were analyzed by using statistical tests.
Results: The mean age of subjects in this study was 49.0±12.8 years (20-70 years) .The most of patient were married (44.6%) and had primary education (81.1%). Results showed the mean scores of Human dignity in intervention group in the pretest (47.2±15.3), and posttest (40.4±18.35), were significantly different (P=0.001), while this change in control group did not reach statistical significance (P=0.572)
Conclusion: By planning and performing such interventions, the dignity level in chronic renal failure patients may be increased.


  1. O'Mathuna DP. The Place of Dignity In Everyday Ethics. J Christ Nurs. 2011;28(1):12-8; quiz 9-20.
  2. Bagheri H, Yaghmaei F, Ashktorab T. Patient Dignity and Related Factors: A Qualitative Meta-Synthesis Study. Knowledge&Health Journal. 2011;1(6):49-56.(Persian)
  3. Berglund B, Anne-Cathrine M, Randers I. Dignity Not Fully Upheld When Seeking Health Care: experiences expressed by individuals suffering from Ehlers-Danlos syndrome. Disabil Rehabil. 2010;32 (1):1-7
  4. Chochinov HM, Hack T, McClement S, Kristjanson L, Harlos M. Dignity In The Terminally Ill: A Developing Empirical Model. Soc Sci Med. 2002;54(3):433-43
  5. Chochinov HM. Dignity therapy:Final Words for Final Days,A Handbook for Clinician. [book online].Oxford University Press: Available at: ?id=3OhqU4o5VTgC&printsec. Accessed:2012/10/16
  6. Thompson GN, Chochinov HM. Dignity-based Approaches In The Care Of Terminally Ill Patients. Current opinion in supportive and palliative care. 2008;2(1):49-53.
  7. ZakeriMoghadam M, AliAsgharpor M. Critical care nursing in  ICU,CCU & dialysis. Tehran: AndisheRafie; 2007.(Persian)
  8. Son YJ, Choi KS, Park YR, Bae JS, Lee JB. Depression, Symptoms And The Quality Of Life In Patients On Hemodialysis For End-Stage Renal Disease. Am J Nephrol. 2009;29(1):36-42
  9. Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M. Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life. J Clin Oncol. 2005;23(24):5520-5.
  10. Chochinov HM, Kristjanson LJ, Breitbart W, McClement S, Hack TF, Hassard T, et al. Effect Of Dignity Therapy On Distress And End-Of-Life Experience In Terminally Ill Patients: A Randomised Controlled Trial. Lancet Oncol. 2011;12(8):753-62
  11. Hall S, Goddard C, Opio D, Speck P, Higginson IJ. Feasibility, Acceptability And Potential Effectiveness Of Dignity Therapy For Older People In Care Homes: A Phase II Randomized Controlled Trial Of A Brief Palliative Care Psychotherapy. Palliat Med. 2012;26(5):703-12.
  12. Hall S, Goddard C, Opio D, Speck PW, Martin P, Higginson IJ. A Novel Approach To Enhancing Hope In Patients With Advanced Cancer: A Randomised Phase II Trial Of Dignity Therapy. BMJ Supportive & Palliative Care. 2011;10(1136).