The Effect of Dignity Therapy on Terminally-Ill Adult Patients: A Systematic Review and Meta-Analysis
Background: We aimed to evaluate the effect of dignity therapy on the dignity, distress, and quality of life of terminally-ill adult patients.
Methods: All randomized controlled trials published prior to Jan 2021 were searched through database, including PubMed, Medline, OVID, Cochrane Library, CINAHL, Web of Science, Scopus, ProQuest Central, KMBASE, KoreaMed, NDSL, and RISS. The RoB 2 was used to assess risk of bias. Effect sizes, Hedge's g and Higgins I2–statistics were used for meta-analysis.
Results: We finally identified 10 studies for a systematic review, and eight studies out of them were selected for a meta-analysis. Overall, 776 participants were included in the meta-analysis. There were significant differences between with and without dignity therapy groups in dignity and anxiety (SMD = -0.3805, Cl = -0.5606, -0.2004; SMD = -0.1932, Cl = -0.3774, -0.0090, respectively) while there was no significant difference in quality of life and depression (SMD=0.4678, Cl = -0.0989, 1.0345; SMD= -0.0513, Cl= -0.2461, 0.1434, respectively).
Conclusion: Dignity therapy may be effective for terminally ill patients on dignity and anxiety. We suggested further empirical studies with dignity therapy and repetitive meta-analysis in the future due to heterogeneity of the studies.
2. Chochinov HM (2002). Dignity-conserving care--a new model for palliative care: helping the patient feel valued. JAMA, 287 (17): 2253-60.
3. World Health Organization (2020). Palliative Care. Available from: www.who.int/news-room/fact-sheets/detail/palliative-care
4. Borgstrom E (2020). What is a good death? A critical discourse policy analysis. BMJ Support Palliat Care. Published Online First. doi: 10.1136/bmjspcare-2019-002173.
5. Chochinov HM, Hack T, Hassard T, Kris-tjanson LJ, McClement S, Harlos M (2002). Dignity in the terminally ill: a cross-sectional, cohort study. Lancet, 360 (9350): 2026-30.
6. Chochinov HM, Hack T, Hassard T, Kris-tjanson LJ, McClement S, Harlos M (2005). Dignity therapy: a novel psycho-therapeutic intervention for patients near the end of life. J Clin Oncol, 23 (24): 5520-5.
7. Hall S, Goddard C, Opio D, Speck P, Hig-ginson IJ (2012). Feasibility, acceptability and potential effectiveness of Dignity Therapy for older people in care homes: a phase II randomized controlled trial of a brief palliative care psychotherapy. Palli-at Med, 26 (5): 703-12.
8. Grijo L, Tojal C, Rego F (2021). Effects of dignity therapy on palliative patients' family members: A systematic review. Pal-liat Support Care, 19 (5): 1-10.
9. Montross LP, Meier EA, De Cervantes-Monteith K, Vashistha V, Irwin SA (2013). Hospice staff perspectives on Dignity Therapy. J Palliat Med, 16 (9): 1118-20.
10. Aoun SM, Chochinov HM, Kristjanson LJ (2015). Dignity therapy for people with motor neuron disease and their family caregivers: a feasibility study. J Palliat Med, 18 (1): 31-7.
11. Vergo MT, Nimeiri H, Mulcahy M, Benson A, Emmanuel L (2014). A feasibility study of dignity therapy in patients with stage IV colorectal cancer actively receiving second-line chemotherapy. J Community Support Oncol, 12 (12): 446-53.
12. Juliao M, Barbosa A, Oliveira F, Nunes B, Vaz Carneiro A (2013). Efficacy of digni-ty therapy for depression and anxiety in terminally ill patients: early results of a randomized controlled trial. Palliat Support Care, 11 (6): 481-9.
13. Juliao M, Oliveira F, Nunes B, Carneiro AV, Barbosa A (2017). Effect of dignity ther-apy on end-of-life psychological distress in terminally ill Portuguese patients: A randomized controlled trial. Palliat Support Care, 15 (6): 628-37.
14. Juliao M, Oliveira F, Nunes B, Vaz Carneiro A, Barbosa A (2014). Efficacy of dignity therapy on depression and anxiety in Portuguese terminally ill patients: a phase II randomized controlled trial. J Palliat Med, 17 (6): 688-95.
15. Rahimi H, Mehrpooya N, Vagharseyyedin SA (2020). Dignity therapy improves hope and quality of life in cancer patients: A randomized clinical trial. Journal of Ad-vances in Medical and Biomedical Research, 28 (128): 156-62.
16. Chochinov HM, Kristjanson LJ, Breitbart W, et al (2011). Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised con-trolled trial. Lancet Oncol, 12 (8): 753-62.
17. Rudilla D, Galiana L, Oliver A, Barreto P (2016). Comparing counseling and digni-ty therapies in home care patients: A pilot study. Palliat Support Care, 14 (4): 321-9.
18. Oh PJ, Shin SR (2014). Effects of dignity in-terventions on psychosocial and existen-tial distress in terminally ill patients: a me-ta-analysis. J Korean Acad Nurs, 44 (5): 471-83.
19. Xiao J, Chow KM, Liu Y, Chan CWH (2019). Effects of dignity therapy on dig-nity, psychological well-being, and quality of life among palliative care cancer pa-tients: A systematic review and meta-analysis. Psychooncology, 28 (9): 1791-802.
20. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting sys-tematic reviews. BMJ, 372: n71.
21. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med, 6 (7): e1000097.
22. Sterne JAC, Savovic J, Page MJ, et al (2019). RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ, 366: l4898.
23. Tong T (2020). Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range 2020. Available from: www.math.hkbu.edu.hk/~tongt/papers/median2mean.html
24. Luo D, Wan X, Liu J, Tong T (2018). Op-timally estimating the sample mean from the sample size, median, mid-range, and/or mid-quartile range. Stat Methods Med Res, 27 (6): 1785-805.
25. Wan X, Wang W, Liu J, Tong T (2014). Es-timating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol, 14: 135.
26. Brydges CR (2019). Effect Size Guidelines, Sample Size Calculations, and Statistical Power in Gerontology. Innov Aging, 3 (4): 1-8.
27. Higgins JPT, Green S (2008). Cochrane Hand-book for Systematic Reviews of Interventions. Chichester, West Sussex, England, pp. 310-19
28. Hall S, Goddard C, Opio D, Speck PW, Martin P, Higginson IJ (2011). A novel approach to enhancing hope in patients with advanced cancer: a randomised phase II trial of dignity therapy. BMJ Sup-port Palliat Care, 1 (3): 315-21.
29. Iani L, De Vincenzo F, Maruelli A, et al (2020). Dignity Therapy Helps Terminally Ill Patients Maintain a Sense of Peace: Early Results of a Randomized Con-trolled Trial. Front Psychol, 11: 1468.
30. Vuksanovic D, Green HJ, Dyck M, Morris-sey SA (2017). Dignity Therapy and Life Review for Palliative Care Patients: A Randomized Controlled Trial. J Pain Symptom Manage, 53 (2): 162-70.
31. Weru J, Gatehi M, Musibi A (2020). Ran-domized control trial of advanced cancer patients at a private hospital in Kenya and the impact of dignity therapy on quality of life. BMC Palliative Care, 19 (1): 1-12.
32. Chochinov HM, Hack T, McClement S, Kristjanson L, Harlos M (2002). Dignity in the terminally ill: a developing empirical model. Soc Sci Med, 54 (3) :433-43.
33. Houmann LJ, Chochinov HM, Kristjanson LJ, Petersen MA, Groenvold M (2014). A prospective evaluation of Dignity Thera-py in advanced cancer patients admitted to palliative care. Palliat Med, 28 (5): 448-58.
34. Martinez M, Arantzamendi M, Belar A, et al (2017). 'Dignity therapy', a promising in-tervention in palliative care: A compre-hensive systematic literature review. Palliat Med, 31 (6): 492-509.
|Issue||Vol 52 No 1 (2023)|
|Anxiety Depression Dignity Quality of life Terminally ill|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|