A Narrative Review of Dignity Therapy Research

Abstract

Introduction Dignity therapy is an end‐of‐life psychological intervention that focuses on the creation of a legacy document to alleviate end‐of‐life distress. Dignity therapy is based on an empirical model of dignity at the end of life. Research on dignity therapy has been ongoing for over 12 years in 11 countries, which has created a solid empirical base. Objective This article presents a narrative overview of the literature on dignity therapy to provide a comprehensive narrative review and critical synthesis of published research. Method Electronic databases (PubMed, CINAHL, PsycINFO, and Scopus) were searched using the key terms “dignity therapy,” “dignity psychotherapy,” and “Chochinov” from 2000 to March 2016. Results Thirty‐nine publications were included and findings were grouped into the following areas: Efficacy; Feasibility with different study populations; Web‐assisted delivery; Impact on families; Cultural studies; Case studies; Themes found in documents; Clinical perspectives; and Implementation studies. Conclusions While dignity therapy is well accepted in most cases, it may not always be effective, therapeutically valid, or practical, and may cause family or cultural frictions. It is recommended that clinicians take into consideration each person's unique circumstances in relation to the current literature before undertaking dignity therapy. Future research is indicated to evaluate dignity therapy with different cultural groups, to investigate the views of recipients of dignity therapy documents, to discover the time and resource commitments required to deliver dignity therapy, to identify who should provide dignity therapy, and to examine the experiences of clinicians who deliver dignity therapy. More research is also needed comparing dignity therapy to other end‐of‐life interventions.

Psychosocial Interventions for End‐of‐Life Care: An Invited Commentary

“…Finally, Bentley, O'Connor, Shaw, and Breen (2017) reviewed the efficacy of DT to alleviate end-of-life distress. In this narrative review Bentley et al (2017) confirmed that DT has been embraced throughout the world and across different population groups, including people who are terminally ill, the elderly, those living with dementia, motor neurone disease or mental illness, or those who are undergoing chemotherapy, and across a variety of formats, including web-based and face-to-face.…”

“…Finally, Bentley, O'Connor, Shaw, and Breen (2017) reviewed the efficacy of DT to alleviate end-of-life distress. In this narrative review Bentley et al (2017) confirmed that DT has been embraced throughout the world and across different population groups, including people who are terminally ill, the elderly, those living with dementia, motor neurone disease or mental illness, or those who are undergoing chemotherapy, and across a variety of formats, including web-based and face-to-face. These authors found that while study participants consistently reported high levels of satisfaction and acceptability of DT, the efficacy of DT in alleviating psychological distress at the end-of-life remained unconfirmed (Bentley et al, 2017).…”

Effectiveness of dignity therapy for patients with advanced cancer: A systematic review and meta‐analysis of 10 randomized controlled trials

“…Similarly, Martinez et al (2017) showed that dignity therapy can effectively improve depression and anxiety in patients. However, Bentley, O'Connor, Shaw, and Breen (2017) indicated that although dignity therapy is well accepted in most cases, it may not always be effective, therapeutically valid, or practical, and may cause family or cultural frictions.…”

Psychotherapeutic Interventions Near the End of Life: Theory, Evidence, and Future Directions

“…Dignity Therapy is one of the most extensively studied psychological interventions for patients with advanced and terminal disease. Bentley, O'Connor, Shaw, and Breen (2017) have reported findings from a narrative review and critical synthesis of published research on this intervention, which was developed by Chochinov et al (2005). They defined dignity broadly, including a wide range of psychological issues that may be important near the end of life, and constructed the Patient Dignity Inventory (Chochinov et al, 2008) to assess them.…”