Effectiveness of dignity therapy in the context of culturally competent care in people with palliative care needs: a systematic review of systematic reviews

Abstract

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.

Attitudes, expectations, and lived experiences of cancer patients receiving dendritic cell vaccine therapy in Japan

“… 64 Recent studies have demonstrated that interventions using dignity therapy, which attempts to reduce distress and promote dignity and hope in terminally ill patients, can improve negative experiences such as anxiety and depression, although findings regarding the effect of dignity therapy on quality of life are conflicting. 65 , 66 Outstanding nursing practice skills are required to effectively manage patients’ experiences of grief. Nurses must be able to coordinate relationships, even for patients who receive alternative treatments to the standard of care at different medical institutions.…”

Dentistry and palliative care: a concise systematic review

“…If acute infection or dental pain is not treated, it can result in delirium and disruptive behaviors, in addition to altering the homeostatic balance and increasing the risk of cardiovascular complications. Another very common problem in patients at the end of life is poorly adapted prostheses, whose quality of life can be impaired [4,5].…”

“…One of the main functions of the oral health team is to care for patients with a tracheostomy or tracheal intubation. The dental intervention group should improve the care of the mouth of patients with or without mechanical ventilation, brushing the teeth and tongue, in addition to applying 0.12% chlorhexidine gluconate to the mucosa, teeth, gums, and palate and humidification of the lips and oral cavity [5,12].…”

“…Therefore, when performed properly, oral care greatly reduces the occurrence of pneumonia associated with the use of artificial ventilation in ICU patients, due to the dental and nursing teams working on oral care and primary foci of infection [5].…”

“…It is necessary to integrate psychological and spiritual aspects in patient care and offer a support system that allows the patient to live as actively as possible, in addition to helping family members during the patient's illness and providing support in coping with grief. Therefore, the team must start this care protocol as early as possible, to provide a better quality of life and positively influence the course of the disease [4,5].…”