A Qualitative Study of Family Centrality in Modified Dignity Therapy Experiences Among Korean Patients With Advanced Cancer: KCSG-PC22-10

BACKGROUND: Patients with advanced cancer experience significant existential distress, necessitating culturally sensitive interventions to enhance psychological well-being. This study explored a modified form of dignity therapy (mDT) that incorporates a photo-collage intervention to address these needs considering the Korean cultural context, where family relationships fundamentally shape individual identity and coping processes. METHODS: Thirteen Korean patients with advanced cancer participated in this qualitative study, which involved integrated reflexive thematic analysis of interview transcripts and participant-generated photo-collages. The intervention combined semi-structured interviews based on mDT protocols with autobiographical image collections reflecting meaningful life experiences. Data were analyzed using an integrated approach, systematically cross-referencing verbal narratives with visual expressions. RESULTS: The analysis revealed that family serves as the central organizing principle through which Korean patients interpret illness experiences. Family provided the foundation of meaning and identity, with life values gained through familial roles and sacrifices, prominently represented in images of family members. Participants emphasized reluctance to burden loved ones, and treatment decisions were filtered by family considerations. CONCLUSION: Psychosocial interventions for Korean patients with advanced cancer benefit from addressing family dynamics as a core therapeutic component. Integrated analysis of textual and visual data revealed cultural themes not fully captured through interviews alone, supporting the development of family-centered therapeutic models tailored to Korean cultural values and collective identity structures. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0009394.