{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:31:20Z","timestamp":1791491480502,"version":"4.3.4"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"unspecified","delay-in-days":222,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951526103472_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Advanced pancreatic and gastric cancers are associated with high symptom burden and psychological distress, potentially threatening patients\u2019 sense of dignity. Although Dignity Therapy (DT) has mainly been used in end-of-life care, its potential role earlier in the disease trajectory is emerging. This exploratory study investigated the feasibility and potential impact of DT during active chemotherapy on emotional distress, dignity-related distress, and quality of life (QoL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526103472_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty patients with advanced pancreatic or gastric cancer undergoing chemotherapy received a 3-session DT intervention over approximately 3 weeks. Emotional distress, dignity-related distress, and QoL were assessed at baseline (T0), post-intervention (T1), and 1-month follow-up (T2) using the Distress Thermometer, Patient Dignity Inventory, and EORTC Quality of Life Questionnaire-Core 30. Exploratory analyses assessed changes over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526103472_sec3c\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Emotional distress decreased significantly from T0 (M = 6.67, SD = 1.47) to T1 (M = 3.13, SD = 1.43; p &lt; .001) and remained lower at T2 (M = 3.50, SD = 1.53; p &lt; .001). Dignity-related distress also decreased from T0 (M = 37.1, SD = 3.03) to T1 (M = 27.9, SD = 1.79; p &lt; .001), with sustained improvement at T2 (M = 25.4, SD = 12.86; p &lt; .01). QoL remained stable. Participants reported high acceptability of the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526103472_sec4d\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>DT during chemotherapy appears feasible and may improve emotional and dignity-related outcomes. Results should be interpreted cautiously due to the small sample size, attrition, and lack of a control group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951526103472","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T06:05:57Z","timestamp":1786428357000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Fostering human dignity during chemotherapy: An explorative study on Dignity Therapy in advanced gastric and pancreatic cancer"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2111-3728","authenticated-orcid":false,"given":"Federica","family":"Andreis","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03kt3v622","id-type":"ROR","asserted-by":"publisher"}],"name":"Fondazione Poliambulanza Istituto Ospedaliero"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Deori","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03kt3v622","id-type":"ROR","asserted-by":"publisher"}],"name":"Fondazione Poliambulanza Istituto Ospedaliero"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Meriggi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03kt3v622","id-type":"ROR","asserted-by":"publisher"}],"name":"Fondazione Poliambulanza Istituto Ospedaliero"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Zaniboni","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03kt3v622","id-type":"ROR","asserted-by":"publisher"}],"name":"Fondazione Poliambulanza Istituto Ospedaliero"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"S1478951526103472_ref22","doi-asserted-by":"publisher","DOI":"10.12788\/jcso.0096"},{"key":"S1478951526103472_ref11","first-page":"1745","article-title":"Dignity therapy in Mexican lung cancer patients with emotional distress: Impact on psychological symptoms and quality of life","volume":"31","author":"Gonzalez-ling","year":"2022","journal-title":"Psycho-Oncology"},{"key":"S1478951526103472_ref13","first-page":"587","article-title":"Feasibility, acceptability and potential effectiveness of dignity therapy for older people in care homes: A phase II randomized controlled trial","volume":"25","author":"Hall","year":"2011","journal-title":"Palliative Medicine"},{"key":"S1478951526103472_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.08.004"},{"key":"S1478951526103472_ref21","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000463"},{"key":"S1478951526103472_ref9","first-page":"400","article-title":"Outcomes of a dignity therapy\/life plan intervention for patients with advanced cancer undergoing chemotherapy","volume":"21","author":"Dose","year":"2019","journal-title":"Journal of Hospice and Palliative Nursing"},{"key":"S1478951526103472_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70153-X"},{"key":"S1478951526103472_ref3","first-page":"454","article-title":"Meanings emerging from dignity therapy among cancer patients","volume":"19","author":"Buonaccorso","year":"2021","journal-title":"Palliative and Supportive Care"},{"key":"S1478951526103472_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2023.102301"},{"key":"S1478951526103472_ref18","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2007.0002"},{"key":"S1478951526103472_ref6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.08.391"},{"key":"S1478951526103472_ref15","first-page":"615","article-title":"Implementing dignity therapy service into an acute cancer care setting: A feasibility study","volume":"21","author":"Kelly","year":"2023","journal-title":"Palliative and Supportive Care"},{"key":"S1478951526103472_ref19","first-page":"660","article-title":"Assessment of psychological distress in cancer patients: Validity of the Italian version of the Distress Thermometer","volume":"13","author":"Rossi Ferrario","year":"2004","journal-title":"Psycho-Oncology"},{"key":"S1478951526103472_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2934-5"},{"key":"S1478951526103472_ref25","first-page":"102159","article-title":"The effectiveness of dignity therapy on hope, quality of life, anxiety, and depression in cancer patients: A meta-analysis of randomized controlled trials","volume":"59","author":"Zhang","year":"2022","journal-title":"European Journal of Oncology Nursing"},{"key":"S1478951526103472_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(01)00084-3"},{"key":"S1478951526103472_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.09.009"},{"key":"S1478951526103472_ref24","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-025-01812-4"},{"key":"S1478951526103472_ref2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0146184"},{"key":"S1478951526103472_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62416-2"},{"key":"S1478951526103472_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.11.320"},{"key":"S1478951526103472_ref17","doi-asserted-by":"publisher","DOI":"10.1177\/0269216316665562"},{"key":"S1478951526103472_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-017-3833-2"},{"key":"S1478951526103472_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780195176216.001.0001"},{"key":"S1478951526103472_ref23","first-page":"9723","article-title":"Effects of family-oriented dignity therapy on dignity, depression and spiritual well-being of patients with lung cancer undergoing chemotherapy: A randomized controlled trial","volume":"30","author":"Xiao","year":"2022","journal-title":"Supportive Care in Cancer"},{"key":"S1478951526103472_ref14","first-page":"465","article-title":"Efficacy of dignity therapy for depression and anxiety in terminally ill patients: Early results of a randomized controlled trial","volume":"12","author":"Juli\u00e3o","year":"2014","journal-title":"Palliative and Supportive Care"}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1478951526103472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T06:05:59Z","timestamp":1786428359000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1478951526103472\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":26,"alternative-id":["S1478951526103472"],"URL":"https:\/\/doi.org\/10.1017\/s1478951526103472","relation":{},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e211"}}