J Korean Acad Nurs.  2014 Oct;44(5):471-483. 10.4040/jkan.2014.44.5.471.

Effects of Dignity Interventions on Psychosocial and Existential Distress in Terminally ill Patients: A Meta-analysis

• Oh PJ
• Shin SR

• KMID: 2129537
• DOI: http://doi.org/10.4040/jkan.2014.44.5.471

Abstract

PURPOSE
This study was done to evaluate the effects of dignity interventions on depression, anxiety and meaning of life in terminally ill patients.
METHODS
PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms indicating dignity intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.2.11 program of Cochrane Library.
RESULTS
Twelve clinical trials met the inclusion criteria with a total of 878 participants. Dignity intervention was conducted for a mean of 2.2 weeks, 2.8 sessions and an average of 48.7 minutes per session. Effect sizes were heterogeneous and subgroup analysis was done. Dignity interventions had a significant effect on depression (ES= -1.05, p<.001, I2=15%) and anxiety (ES= -1.01, p<.001, I2=0). For meaning of life, dignity interventions were effective (ES= -1.64, p=.005) and effect sizes were still heterogeneous.
CONCLUSION
Results support findings that dignity interventions can assist terminal ill patients in reducing emotional distress and improving meaning of life. Further well-designed dignity studies will lead to better understanding of the effects of treatments on spiritual well-being.

Keyword

Terminally ill; Dignity; Intervention studies; Meta-analysis

MeSH Terms

Clinical Trials as Topic
Databases, Factual
Depression/*therapy
Humans
Psychotherapy
Quality of Life
*Self Concept
Terminally Ill/*psychology

Figure

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  Figure 1 Flow of studies included from database search.

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  Figure 2 Forest plot of effect size and 95% CI by dignity intervention on depression and funnel plot of effectsizes by standard error.

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  Figure 3 Forest plot of effect size and 95% CI by dignity intervention on anxiety.

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