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Hack et al., 2010 [39]
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50 edited DT transcripts (17 Canadian and 33 Australian) from patients with terminal illness in inpatient palliative care programs, sample from Chochinov et al., 2005 [17]
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Content analysis, constant comparative analysis of completed DT legacy document by three investigators
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• Throughout DT interview patients reflect on two to three personally meaningful core values, such as ‘family’, ‘pleasure’, ‘caring’, and ‘sense of accomplishment’.
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• DT is used by patients to confirm personal identity.
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• Investigators suggest more theoretical analysis of “meaning-making” construct in end-of-life care needed.
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Tait et al., 2011 [40]
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12 Canadian patients with terminal illness in inpatient palliative care
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Constant comparative analysis of DT interviews
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• Three main ‘types of interviews’ emerge: ‘Evaluation narratives’, focusing on life prior to illness; ‘transition narratives’, focusing on change in health status and its meaning; ‘legacy narratives’, focusing on future without the patient.
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• Investigators suggest narrative themes share commonality with medical interview and eulogy genres.
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Montross et al., 2011 [41]
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27 US community-based hospice patients
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Coding consensus, co-occurrence, and comparison analysis of DT legacy documents
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• Similar findings to Hack et al., 2010 [39], core values consistently expressed in transcripts.
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• DT is feasible in a community-based setting.
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Hall et al., 2013 [34]
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49 UK pts in older care homes, sample from Hall et al., 2012 [35,36]
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Framework analysis of qualitative interviews conducted at T1 and T2; interviews on resident views of DT and/or being a study participant (control group).
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• Of 9 themes, 3 were unique to intervention group: ‘views of legacy document’; ‘generativity’; and ‘reminiscence’.
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• DT not recommended by investigators, in current form, with participants with cognitive impairment: findings suggest DT document may reflect ‘distorted sense of self’ and prompt distress.
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Hall et al., 2013 [42]
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29 UK pts with advanced cancer, sample from Hall et al., 2011 [32,33]
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Framework analysis of qualitative interviews conducted at T1 and T2; interviews on pt views of DT and/or being a study participant (control group).
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• 5 of 7 themes in Dignity Model theory present in both interviews groups; ‘generativity’ found only in intervention group.
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• No evidence of ‘role preservation’ as described in Dignity Model in this sample.
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• Qualitative interview reporting of higher levels of hopefulness in both groups from participating in study, despite no change in quantitative component of study.
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