No abstract

Objectives Dignity therapy (DT) is a brief, individualized intervention, which provides terminally ill patients with an opportunity to convey memories, essential disclosures, and prepare a final generativity document. DT addresses psychosocial and existential issues, enhancing a sense of meaning and purpose. Several studies have considered the legacy topics most frequently discussed by patients near the end of life. To date, no Portuguese study has done that analysis. Method We conducted a qualitative analysis of 17 generativity documents derived from a randomized controlled trial (RCT). Inductive content analysis was used to identify emerging themes. Results From the 39 RCT participants receiving DT, 17 gave consent for their generativity document to undergo qualitative analysis. Nine patients were female; mean age of 65 years, with a range from 46 to 79 years. Seven themes emerged: “Significant people and things”; “Remarkable moments”; “Acknowledgments”; “Reflection on the course of life”; “Personal values”; “Messages left to others”; and “Requests and last wishes”. Significance of results Generativity document analysis provides useful information for patients nearing death, including their remarkable life moments and memories, core values, concerns, and wishes for their loved ones. Being conscious of these dominant themes may allow health providers to support humanized and personalized care to vulnerable patients and their families, enhancing how professionals perceive and respond to personhood within the clinical setting.

ÖZETÖlüm, konuşulması zor ve ertelenen bir kavramdır. Nefroloji hemşire-lerinin ölüm kavramını konuşabilmeleri, duygu ve düşüncelerini ifade edebilmeleri hem nefroloji hemşirelerinin kendi gelişimine katkı sağ-layacak hem de hastaya verdiği sağlık bakımının kalitesini artıracaktır. Ayrıca nefroloji hemşirelerinin ölümcül hasta ve ailelerine bütüncül bakım verme sorumluluğunu yerine getirebilmeleri için konsültasyon liyezon psikiyatri hemşireleri ile işbirliği içinde çalışmaları gerekmektedir. Bu derlemede, nefroloji hemşireleri ve diyaliz hastalarının ölüm kavramının anlamına ilişkin literatür gözden geçirilmekte ve konuyla ilgili güncel bilgiler sunulmaktadır.Anahtar sözcükler: Diyaliz hastaları; nefroloji hemşireleri; ölüm. SUMMARY Death is a difficult-to-discuss topic that is largely avoided. Developing the ability of nephrology nurses to discuss the concept of death and express their thoughts and feelings about it will contribute to their own develop

Purpose of review This review aims to synthesise the evidence from systematic reviews and meta-analyses on the efficacy of dignity therapy (DT) in relation to psychosocial and spiritual outcomes in the context of person-centred and culturally competent care for people with supportive and palliative care needs. Recent findings Thirteen reviews were found, including seven conducted by nurses. Most reviews were of high quality, including various study populations such as cancer, motor neurone disease and non-malignant conditions. Six psychosocial and spiritual outcomes were identified: quality of life, anxiety, depression, hopefulness, meaning and purpose in life, and suffering based on the cultural variations in the implementation of DT. Summary DT has a positive impact on anxiety, depression, suffering, and meaning and purpose in life for people with palliative care needs, but the evidence is somewhat conflicted as to whether DT is effective in improving hope, quality of life and spiritual outcomes in the context of culturally competent care. Nurse-led DT seems desirable given its pivotal role when caring for people with palliative care needs. More randomised controlled trials should be conducted for people with different cultural backgrounds to provide person-centred, culturally competent supportive and palliative care.