Article Text

Download PDFPDF
Dignity therapy, psycho-spiritual well-being and quality of life in the terminally ill: systematic review and meta-analysis
  1. Ruishuang Zheng1,
  2. Qiaohong Guo2,
  3. Zhiqian Chen2 and
  4. Yingchun Zeng3
  1. 1Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
  2. 2School of Nursing, Capital Medical University, Beijing, China
  3. 3Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
  1. Correspondence to Dr Qiaohong Guo, School of Nursing, Capital Medical University, Beijing 100069, China; qguo{at}ccmu.edu.cn

Abstract

Objectives Dignity therapy (DT) is a brief, individualised psychotherapy that aims to alleviate psychosocial and spiritual distress in the final stages of life. It is unknown yet whether DT can enhance sense of dignity and improve psychological and spiritual well-being as well as quality of life of terminally ill patients.

Methods We searched PubMed, EMBASE, CINAHL plus, ProQuest Health & Medical Complete, PsycINFO and the Cochrane Library, as well as Chinese databases including Weipu Data, Wanfang Data and China National Knowledge Infrastructure from inception to 30 April 2021, for randomised controlled trials (RCTs) assessing the effects of DT on dignity, psycho-spiritual well-being and quality of life of terminally ill patients receiving palliative care.

Results We identified 507 unique records, and included 9 RCTs (871 participants). Comparator was standard palliative care. DT did not improve terminally ill patients’ sense of dignity (p=0.90), hope (p=0.15), spiritual well-being (p=0.99) and quality of life (p=0.23). However, DT reduced anxiety and depression after intervention (standardised mean difference, SMD=−1.13, 95% CI (−2.21 to –0.04), p=0.04; SMD=−1.22, 95% CI (−2.25 to –0.18), p=0.02, respectively) and at 4 weeks post-intervention (SMD=−0.89, 95% CI (−1.71 to –0.07), p=0.03; SMD=−1.26, 95% CI (−2.38 to –0.14), p=0.03, respectively).

Conclusion DT can be offered as a psychological intervention for terminally ill patients to reduce their anxiety and depression. More studies are needed to further evaluate the effects of DT on terminally ill patients’ dignity, spiritual well-being and quality of life.

  • hospice care
  • psychological care

Data availability statement

Data used in this systematic review and meta-analysis are from previously published studies, which have been cited. The processed data are available from the corresponding author upon request.

Statistics from Altmetric.com

Data availability statement

Data used in this systematic review and meta-analysis are from previously published studies, which have been cited. The processed data are available from the corresponding author upon request.

View Full Text

Footnotes

  • Contributors All authors included in the paper fulfil the criteria for authorship. QG designed the study and acquired funding. RZ and QG did the literature search and interpreted data. RZ, YZ and QG analysed data, with major contributions from RZ. QG, RZ, ZC and YZ drafted and revised the manuscript, with major contributions from QG and RZ.

  • Funding This submission was supported by the National Natural Science Foundation of China (NSFC) (grant no. 81803102).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.