Evidence map›Paper›PMID 39911002›Full record

ArticlePalliative & supportive care2025

Sharing "off-script": A qualitative analysis of providers' empathic self-disclosures during dignity therapy.

Emily L Mroz, Tithi Amin, Sheri Kittelson, Mary Kate Koch, Alyssa Crowe, Susan Bluck, Joshua Hauser, George F Handzo, Diana J Wilkie, Carma L Bylund

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Palliative & supportive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Emily L MrozSection of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.ORCID https://orcid.org/0000-0003-4539-0252
Tithi AminDepartment of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA.
Sheri KittelsonDivision of Palliative Care, Department of Medicine, University of Florida, Atlant, FL, USA.
Mary Kate KochDepartment of Psychology, University of Florida, Gainesville, FL, USA.ORCID https://orcid.org/0000-0003-3003-8715
Alyssa CroweDepartment of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA.
Susan BluckDepartment of Psychology, University of Florida, Gainesville, FL, USA.
Joshua HauserFeinberg School of Medicine, Northwestern University, Evanston, IL, USA.
George F HandzoHealth Care Chaplaincy Network, NY, USA.
Diana J WilkieDepartment of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA.ORCID https://orcid.org/0000-0002-3954-8933
Carma L BylundDepartment of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA.ORCID https://orcid.org/0000-0002-9335-1496

Funding

Yale Training Program in Geriatric Clinical Epidemiology and Aging-Related ResearchT32AG019134 · NIA · YALE UNIVERSITY · PI Terri R. Fried · 2001 to 2026
$7.5M
Dignity Therapy RCT led by Nurses or Chaplains for Elderly Cancer OutpatientsR01CA200867 · NCI · UNIVERSITY OF FLORIDA · PI EMANUEL, LINDA LEAH, FITCHETT, GEORGE · 2016 to 2020
$3.2M
Dignity Therapy for Older Cancer Patients: Identifying Mechanisms and ModeratorsR01CA253330 · NCI · UNIVERSITY OF FLORIDA · PI BLUCK, SUSAN, BYLUND, CARMA L. · 2021 to 2023
$1.0M
NCI NIH HHS R01 CA200867NCI NIH HHS R01 CA253330NIA NIH HHS T32 AG019134
6 · The paper itself

Abstract

objectivesHealthcare provider self-disclosures are common although sometimes controversial. Providers have unique opportunities to self-disclose for the purpose of conveying empathic concern during Dignity Therapy sessions. We examine the topics of empathic self-disclosures (ESDs) during Dignity Therapy sessions.

methodsWe analyzed 203 audio-recorded, transcribed Dignity Therapy sessions from a stepped-wedge, randomized trial of Dignity Therapy led by 14 nurses and chaplains in outpatient palliative care. We extracted 117 ESDs across sessions and applied thematic analysis guided by the constant comparative method to generate ESD topic themes and properties.

resultsProviders disclosed ESDs referring to topics of SIGNIFICANCE OF

resultsProviders engage in ESD across a range of personal topics in a Dignity Therapy context. Some ESD topics overlapped with those considered appropriate in existing health communication literature. Other topics involved complex or underexamined types of disclosures. While self-disclosures appear to be made with empathic intent, providers undermined the impact of some ESDs by portraying them as unprescribed components of the conversation. More research is needed to assess the positive and negative impacts of ESDs during Dignity Therapy and to support augmentation of Dignity Therapy training protocols to account for providers' ESDs.

Indexed as

EmpathyHealth PersonnelRespectSelf DisclosureAdultDignity TherapyFemaleHumansMaleMiddle AgedPalliative CareQualitative Researchchaplain-led interventionEmpathic communicationlife reviewnurse-led interventionpatient–provider communicationpsycho-oncology

Identifiers

PMID39911002
PMCPMC11931517

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.