Abstract / Summary
Dignity therapy is a life review intervention that can help reduce existential and spiritual distress in patients with heart failure. However, there is limited evidence comparing the two delivery modes (in-person and virtual) of this intervention. This study aimed to evaluate changes in quality of life, life satisfaction, and anxiety following in-person and virtual dignity therapy and to compare these outcomes with a control group. This study employed a quasi-experimental, three-arm non-randomized controlled trial design in Tehran, Iran, involving 90 patients (30 per group), including two intervention groups and one control group. Eligible patients were consecutively recruited using convenience sampling during each sampling period, with recruitment progressing from the control group to the virtual and then in-person intervention groups. The dignity therapy intervention consisted of structured sessions designed to promote participants’ sense of meaning, personal worth, and dignity through guided therapeutic dialogue. Data were collected at baseline and four weeks after the intervention using the Sociodemographic and clinical characteristics form, the Chronic Heart Failure Health-Related Quality of Life (CHFQOLQ-20), the Satisfaction With Life Scale (SWLS), and the Generalized Anxiety Disorder Scale (GAD-7). Reporting was guided by the TREND statement. A total of 83 patients completed the study and were included in the final analysis (attrition rate: 7.78%). No significant baseline differences were observed among the three groups in quality of life ( p = 0.358), life satisfaction ( p = 0.922), or anxiety ( p = 0.933). At four-week follow-up, between-group analyses revealed significant differences in quality of life ( p < 0.001, η²=0.609), life satisfaction ( p < 0.001, η²=0.593), and anxiety ( p < 0.001, η²=0.417). Both intervention groups showed more favorable outcomes than the control group across all outcomes (all p < 0.001), while the in-person group demonstrated significantly greater improvements in quality of life (95% CI [3.26, 10.75], p < 0.001) and life satisfaction (95% CI [1.54, 4.97], p < 0.001) compared with the virtual group. Within-group analyses showed significant improvements in quality of life and life satisfaction and reductions in anxiety in both intervention groups (all p < 0.001). In this study, improvements in quality of life and life satisfaction and reductions in anxiety were observed following both in-person and virtual dignity therapy compared with the control group. Although both approaches are beneficial, the in-person modality showing more favorable outcomes in quality of life and life satisfaction. These findings suggest that both modalities may serve as complementary approaches within patient-centered care, with modality selection guided by patients’ physical condition, preferences, technological resources, and access to healthcare services. IRCT20250714066482N1 on July 15, 2025.