Dignity therapy improves psychological well-being in cancer patients on palliative care
Dignity therapy results in better psychological wellbeing among cancer patients under palliative care, a new meta-analysis has found.
Accessing 13 electronic databases, researchers identified English and Chinese studies that investigated the effects of dignity therapy or psychotherapy on dignity, psychological wellbeing and quality of life (QoL) outcomes in adults with cancer. Only randomized controlled trials (RCTs) or those quasi-experimental in design were eligible for inclusion.
Ten articles describing eight individual studies were selected for the final analysis. All patients had incurable and advanced cancers of different types, such as respiratory, genitourinary, colorectal, breast and gastrointestinal. Only one study had a sample size ≥100.
Three RCTs reported results from the Patient Dignity Inventory, and significant pooled effects were found for the items of change in appearance (MD, –0.26, 95 percent CI, –0.50 to –0.02; p=0.03) and social support from family and friends (MD, –0.23, –0.39 to –0.07; p=0.004). Surveys also indicated improvement in sense of dignity when dignity therapy was administered after cancer therapy.
Pooled analysis also revealed that dignity therapy had small and nonsignificant beneficial effects on both depression (standardized MD [SMD], –0.24, –0.48 to 0.00; p=0.05) and anxiety (SMD, –0.26, –0.96 to 0.54; p=0.48).
However, in five studies, feedback questionnaires were administered to identify the perceived benefits of dignity therapy on patients. Those who received the intervention were more likely to note that dignity therapy was helpful to them and their families due to improvements in emotional and spiritual wellbeing, as well as sense of purpose and will to live.
Not enough evidence was available for a meta-analysis on the effect of dignity therapy on QoL, though studies included indicated that the impacts were insignificant.