Skip Navigation
Skip to contents

J Korean Acad Nurs : Journal of Korean Academy of Nursing

OPEN ACCESS

Articles

Page Path
HOME > J Korean Acad Nurs > Volume 44(5); 2014 > Article
Review Article
Effects of Dignity Interventions on Psychosocial and Existential Distress in Terminally ill Patients: A Meta-analysis
Pok Ja Oh, Sung-Rae Shin
Journal of Korean Academy of Nursing 2014;44(5):471-483.
DOI: https://doi.org/10.4040/jkan.2014.44.5.471
Published online: October 31, 2014

Department of Nursing, Sahmyook University, Seoul, Korea.

Address reprint requests to: Shin, Sung-Rae. Department of Nursing, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul 139-742, Korea. Tel: +82-2-3399-1588, Fax: +82-2-3399-1594, shinsr@syu.ac.kr
• Received: June 3, 2014   • Revised: June 18, 2014   • Accepted: July 25, 2014

© 2014 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

  • 26 Views
  • 0 Download
  • 4 Scopus
prev next
  • 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.
  • 1. Ando M, Morita T, Okamoto T, Ninosaka Y. One-week short-term life review interview can improve spiritual well-being of terminally ill cancer patients. Psychooncology. 2008;17(9):885–890. http://dx.doi.org/10.1002/pon.1299ArticlePubMed
  • 2. Ahn SH, An YL, Yoo YS, Ando M, Yoon SJ. Effects of a short-term life review on spiritual well-being, depression, and anxiety in terminally ill cancer patients. J Korean Acad Nurs. 2012;42(1):28–35. http://dx.doi.org/10.4040/jkan.2012.42.1.28ArticlePubMed
  • 3. Ro YJ, Kim NC, Lee SM. The present status and the proposals of hospice in Korea. J Korean Acad Adult Nurs. 1996;8(2):338–349.
  • 4. Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M. Dignity therapy: A novel psychotherapeutic intervention for patients near the end of life. J Clin Oncol. 2005;23(24):5520–5525. http://dx.doi.org/10.1200/jco.2005.08.391ArticlePubMed
  • 5. In: Field MJ, Cassel CK. editors. Approaching death: Improving care at the end of life. Washington, DC: The National Academies Press; 1997.
  • 6. Breitbart W, Rosenfeld BD, Passik SD. Interest in physician-assisted suicide among ambulatory HIV-infected patients. Am J Psychiatry. 1996;153(2):238–242.ArticlePubMed
  • 7. Meier DE, Emmons CA, Wallenstein S, Quill T, Morrison RS, Cassel CK. A national survey of physician-assisted suicide and euthanasia in the United States. N Engl J Med. 1998;338(17):1193–1201. http://dx.doi.org/10.1056/nejm199804233381706ArticlePubMed
  • 8. Kim JN, I R. A review of research on the psychosocial interventions for the cancer patients. Korean J Health Psychol. 2008;13(2):329–357.Article
  • 9. Oh PJ, Lee EA. Cognitive behavioral therapy for psychological distress, self care and quality of life in patients with cancer: A meta-analysis. Korean J Adult Nurs. 2013;25(4):377–388.ArticlePDF
  • 10. Kim HC. The effect of hospice/palliative care on anxiety, depression and pain in some terminal cancer patient [dissertation]. Gwangju, Chosun University. 2008.
  • 11. Julião M, Barbosa A, Oliveira F, Nunes B, Vaz Carneiro A. Efficacy of dignity therapy for depression and anxiety in terminally ill patients: Early results of a randomized controlled trial. Palliat Support Care. 2013;11(6):481–489. http://dx.doi.org/10.1017/s1478951512000892ArticlePubMed
  • 12. Akechi T. Psychotherapy for depression among patients with advanced cancer. Jpn J Clin Oncol. 2012;42(12):1113–1119. http://dx.doi.org/10.1093/jjco/hys152ArticlePubMed
  • 13. Frankl VE. Man's search for meaning: An introduction to logotherapy. 4th ed. Boston, MA: Beacon Press; 1992.
  • 14. Jenko M, Gonzalez L, Alley P. Life review in critical care: Possibilities at the end of life. Crit Care Nurse. 2010;30(1):17–27. http://dx.doi.org/10.4037/ccn2010122ArticlePubMedPDF
  • 15. Raingruber B. The effectiveness of psychosocial interventions with cancer patients: An integrative review of the literature (2006-2011). ISRN Nurs. 2011;2011:638218. http://dx.doi.org/10.5402/2011/638218ArticlePubMedPMCPDF
  • 16. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Ann Intern Med. 2009;151(4):W65–W94.ArticlePubMed
  • 17. Kim SY, Park JE, Seo HJ, Seo HS, Son HJ, Shin CM, et al. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-based Health Care Collaborating Agency; 2011.
  • 18. In: Higgins JPT, Green S. editors. Cochrane handbook for systematic reviews of intervention version 5.0.0. London, UK: The Cochrane Collaboration; 2008.
  • 19. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1998.
  • 20. Lee J. Meta-analysis. J Korean Endocr Soc. 2008;23(6):361–378. http://dx.doi.org/10.3803/jkes.2008.23.6.361Article
  • 21. Oh SS. Meta-analysis: Theory and practice. Seoul: Konkuk University Press; 2002.
  • 22. Goedendorp MM, Gielissen MF, Verhagen CA, Bleijenberg G. Psychosocial interventions for reducing fatigue during cancer treatment in adults. Cochrane Database Syst Rev. 2009;1:CD006953. http://dx.doi.org/10.1002/14651858.CD006953.pub2Article
  • 23. Ranchor AV, Fleer J, Sanderman R, Van der Ploeg KM, Coyne JC, Schroevers M. Psychological interventions for cancer survivors and cancer patients in the palliative phase (Protocol). Cochrane Database Syst Rev. 2012;1:CD009511. http://dx.doi.org/10.1002/14651858.CD009511
  • 24. Haber D. Life review: Implementation, theory, research, and therapy. Int J Aging Hum Dev. 2006;63(2):153–171.ArticlePubMedPDF
  • 25. Hwang SS, Chang VT, Fairclough DL, Cogswell J, Kasimis B. Longitudinal quality of life in advanced cancer patients: Pilot study results from a VA medical cancer center. J Pain Symptom Manage. 2003;25(3):225–235.PubMed
  • 26. Chung C, Lee S, Hwang S, Park E. Systematic review of exercise effects on health outcomes in women with breast cancer. Asian Nurs Res. 2013;7(3):149–159.Article
  • 27. Oh PJ, Jang ES. Effects of psychosocial interventions on cortisol and immune parameters in patients with cancer: A meta-analysis. J Korean Acad Nurs. 2014;44(4):446–457. http://dx.doi.org/10.4040/jkan.2014.44.4.446ArticlePubMed
  • 28. Kang SR. Concept analysis of spiritual care. J Korean Acad Nurs. 2006;36(5):803–812.ArticlePDF
  • 29. Chochinov HM, Hassard T, McClement S, Hack T, Kristjanson LJ, Harlos M, et al. The patient dignity inventory: A novel way of measuring dignity-related distress in palliative care. J Pain Symptom Manage. 2008;36(6):559–571. http://dx.doi.org/10.1016/j.jpainsymman.2007.12.018ArticlePubMed
  • 30. Kim BH, Choe SO, Chung BY, Yoo YS, Kim HS, Kang KA, et al. Job analysis for role identification of general hospice palliative nurse. Korean J Hosp Palliat Care. 2010;13(1):13–23.Article
Appendix

Reviewed Paper List

jkan-44-471-a001.jpg
Figure 1
Flow of studies included from database search.
jkan-44-471-g001.jpg
Figure 2
Forest plot of effect size and 95% CI by dignity intervention on depression and funnel plot of effectsizes by standard error.
jkan-44-471-g002.jpg
Figure 3
Forest plot of effect size and 95% CI by dignity intervention on anxiety.
jkan-44-471-g003.jpg
Table 1
Descriptive Summary of Included Studies (N=12)
jkan-44-471-i001.jpg

Exp.=Experimental group; Cont.=Control group; RCT=Randomized controlled trials; Non-RCT=Non-randomized controlled trial; FACIT-Sp=Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale; HADS=Hospital Anxiety and Depression Scale; SELT-M=Skalen zur Erfassung von Lebens qualitat bei Tumorkranken-modified version; NRS=Numeric Rating Scale; PDI=Patient dignity inventory; (+)=Statistically significant difference between two groups; No diff=No significant difference between two groups.

Figure & Data

REFERENCES

    Citations

    Citations to this article as recorded by  

      • Cite
        CITE
        export Copy Download
        Close
        Download Citation
        Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

        Format:
        • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
        • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
        Include:
        • Citation for the content below
        Effects of Dignity Interventions on Psychosocial and Existential Distress in Terminally ill Patients: A Meta-analysis
        J Korean Acad Nurs. 2014;44(5):471-483.   Published online October 31, 2014
        Close
      • XML DownloadXML Download
      Figure
      • 0
      • 1
      • 2
      We recommend
      Related articles
      Effects of Dignity Interventions on Psychosocial and Existential Distress in Terminally ill Patients: A Meta-analysis
      Image Image Image
      Figure 1 Flow of studies included from database search.
      Figure 2 Forest plot of effect size and 95% CI by dignity intervention on depression and funnel plot of effectsizes by standard error.
      Figure 3 Forest plot of effect size and 95% CI by dignity intervention on anxiety.
      Effects of Dignity Interventions on Psychosocial and Existential Distress in Terminally ill Patients: A Meta-analysis

      Descriptive Summary of Included Studies (N=12)

      Exp.=Experimental group; Cont.=Control group; RCT=Randomized controlled trials; Non-RCT=Non-randomized controlled trial; FACIT-Sp=Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale; HADS=Hospital Anxiety and Depression Scale; SELT-M=Skalen zur Erfassung von Lebens qualitat bei Tumorkranken-modified version; NRS=Numeric Rating Scale; PDI=Patient dignity inventory; (+)=Statistically significant difference between two groups; No diff=No significant difference between two groups.

      Table 1 Descriptive Summary of Included Studies (N=12)

      Exp.=Experimental group; Cont.=Control group; RCT=Randomized controlled trials; Non-RCT=Non-randomized controlled trial; FACIT-Sp=Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale; HADS=Hospital Anxiety and Depression Scale; SELT-M=Skalen zur Erfassung von Lebens qualitat bei Tumorkranken-modified version; NRS=Numeric Rating Scale; PDI=Patient dignity inventory; (+)=Statistically significant difference between two groups; No diff=No significant difference between two groups.


      J Korean Acad Nurs : Journal of Korean Academy of Nursing
      Close layer
      TOP