The effects of confronting one’s own end of life on older individuals and those with a life-threatening disease: A systematic literature review

Abstract

Background: Awareness of the impending end of one’s life can pose profound existential challenges, thereby impairing well-being. Confronting one’s own end of life may be an approach to meet the psychological needs and consequently enhance overall well-being. Different approaches of confrontation have been evaluated positively using measures of psychosocial comfort. To date, there exists no systematic overview on the different ways of confrontation (e.g. psychosocial or individual coping approaches). Aim: To synthesize the existing knowledge on the effects of different approaches of confronting one’s own end of life on older individuals and those with a life-threatening disease. Design: A systematic review of quantitative, qualitative, and mixed-methods full research reports was conducted. The retrieved studies were screened and appraised for methodological quality by two independent reviewers based on MMAT and CASP. The findings were synthesized narratively using the meta-summary technique by Sandelowski and Barroso. Data sources: Medline, PsycINFO, and Web of Science were searched from inception to 12/2020. Results: N = 49 studies reported on different approaches of confronting one’s own end of life, including psychosocial interventions, meaning-enhancing approaches, educational programs, and learning from lived experiences. The results suggest a clear trend toward beneficial effects on psychosocial comfort (e.g. anxiety, sense of meaning, well-being). Conclusion: Low-threshold opportunities of confrontation have the potential to improve well-being and should be emphasized in practical implementation. The results can serve as a comprehensive basis for future research aiming to investigate the determinants of psychosocial comfort for people nearing the end of life.

Spiritual well-being, dignity-related distress and demoralisation at the end of life-effects of dignity therapy: a randomised controlled trial

“…Several studies have examined the effects of dignity therapy in palliative care, showing mixed results 8 9. A recent meta-analysis including randomised controlled trials and quasi-experimental studies showed no significant effects on anxiety and depression but improvement in dignity-related distress, existential distress and social support domains 10.…”

“…A recent meta-analysis including randomised controlled trials and quasi-experimental studies showed no significant effects on anxiety and depression but improvement in dignity-related distress, existential distress and social support domains 10. Moreover, several systematic reviews found mixed results 9 11–13. For example, the largest randomised controlled trial conducted with terminally ill patients found no significant differences between groups on dignity-related distress, psychological distress, spiritual well-being and quality of life at follow-up 14.…”

Nursing Home Resident, Family, and Staff Perspectives on Achieving Comfort at End of Life

“…Staff assumed that their continuous presence was comforting, whereas some of the residents indicated they would not want this at the EOL. Kukla and colleagues 12 suggested from their systematic review of 49 studies on confronting one's own finitude that palliative care practices should also include supportive strategies to meet a person's psychosocial needs to promote psychosocial comfort and the interventions needed for physical comfort.…”