An umbrella review of the effectiveness of dignity therapy for patients with advanced illness — ASN Events
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An umbrella review of the effectiveness of dignity therapy for patients with advanced illness (#916)

Pei-Fan Mu 1 2 , Yi-Wei Chen 3 4 , Chih-Yu Huang 5 , Yi-Chen Wu 6
  1. Distinguished Professor, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
  2. Director, Taiwan Evidence Based Practice Center: A Joanna Briggs Center of Excellence, Taipei, Taiwan
  3. Attending Physician, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
  4. Assistant Professor, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
  5. Doctoral student, Department of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
  6. Master’s student, Institute of Clinical Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan

Background

Dignity therapy is an evidence-based and brief psychotherapeutic intervention which is for the purpose of relieving psychological, emotional, and spiritual distress and improving the life meaning and dignity among terminally ill patients. Literature reviews have shown that the duration of dignity therapy, outcome variables, and conclusions of these reviews are mixed.

Aims

The objective of this review was to synthesize systematic reviews of the effectiveness of dignity therapy for patients with advanced illness.

Method

This umbrella review included systematic reviews and meta‐analysis reporting on effectiveness of dignity therapy for patients with advanced illnesses. Six electronic databases included MEDLINE, Cochrane, CINAHL, JBI Evidence Synthesis, Web of Science (WOS) and Airiti-library were systematic searched from inception to August 2022. Quality assessments were used the standard JBI critical appraisal instrument for systematic reviews and research syntheses. All dignity therapy outcomes considered under the primary outcomes of the study.

Results

Five systematic reviews and meta‐analysis were identified. Average quality of the reviews was high. In terms of participant characteristics, four studies focused on patients with advanced or terminal cancer, and one wasn't confined to any diseases. Intervention duration included 7 to 10 days, 1 month, and 2 months. The primary outcome was used Patient Dignity Inventory (PDI) to assess dignity. The secondary outcomes included hope, spiritual well-being, quality of life, anxiety, and depression with different measuring instruments. The findings indicated that the duration of dignity therapy longer than one week or one month could significantly decrease patients’ anxiety scale, and depression score, as well as increase, hope score respectively. 

Conclusion

Dignity therapy is associated with the psychological well-being of patients with advanced illnesses. This study provided evidence for clinical professionals to implement dignity therapy depending on patients' characteristics and the duration of providing dignity therapy. Dignity therapy should be recommended for people with advanced illnesses to improve mental health to improve quality of life.

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