Feasibility, acceptability and potential efficacy of the pediatric family-based dignity therapy for children with advanced cancer: A pilot study

Asia Pac J Oncol Nurs. 2025 Sep 25;12:100793. doi: 10.1016/j.apjon.2025.100793. eCollection 2025 Dec.

ABSTRACT

OBJECTIVE: Pediatric family based dignity therapy (P-FBDT) is an individualized psychotherapy in palliative care, with untested feasibility, acceptability, and efficacy. This study aims to assess its feasibility, acceptability, and potential efficacy among children with advanced cancer and their families.

METHODS: This pilot study used a single-group, pre-post design. Children with advanced cancer and their family caregivers were recruited from two hospitals and one pediatric palliative care institution in northern China between July 2023 and January 2025. Feasibility and acceptability were assessed using a 10-point satisfaction survey. Potential efficacy was evaluated using the Pediatric Quality of Life Inventory-Cancer Module-3.0 (PedsQL-Cancer-3.0), the Hospital Anxiety and Depression Scale and other tools before (T0), immediately after (T1) and two weeks after the intervention (T2), complemented by qualitative interviews at T1. Quantitative data were analyzed using paired-samples t-tests or Wilcoxon signed-rank test, and qualitative data using content analysis.

RESULTS: Of the 77 families approached, 27 (35.06%) consented. 26 (96.30%) completed the intervention, demonstrating good feasibility and high satisfaction (9.40 ​± ​0.69). The primary outcomes, including children’s quality of life and family caregivers’ anxiety and depression, showed no statistically significant changes under Bonferroni correction (P ​> ​0.017), but non-significant trends were noted. Children’s treatment anxiety scores increased from 50.00 (50.00) at T0 to 55.43 ​± ​28.38 at T2 (P ​= ​0.569), and family caregivers’care burden scores decreased from 36.04 ​± ​16.16 at T0 to 32.81 ​± ​17.90 at T1 (P ​= ​0.019), indicating a possible reduction. Qualitative findings revealed two themes: (1) Perceived benefits: facilitating emotional expression, enhancing family relationships, promoting spiritual growth of family, and affirming the children’s life value; (2) Participation challenges: Difficulties with deep emotional expression and memory recall, and cultural barriers to parent-child interaction.

CONCLUSIONS: The P-FBDT demonstrated promising feasibility, acceptability, and potential effectiveness. Larger randomized controlled trials are necessary to confirm its efficacy and inform future implementation.

TRIAL REGISTRATION: China Clinical Trial Registry: ChiCTR2300073390.

PMID:41127828 | PMC:PMC12538918 | DOI:10.1016/j.apjon.2025.100793