Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
School of Nursing, Capital Medical University, Beijing, China
BMJ Support Palliat Care. 2023 Sep;13(3):263-273. doi: 10.1136/bmjspcare-2021-003180. Epub 2021 Aug 5.
Dignity therapy (DT) is a brief, individualised psychotherapy that aims to alleviate psychosocial and spiritual distress in the final stages of life. It is unknown yet whether DT can enhance sense of dignity and improve psychological and spiritual well-being as well as quality of life of terminally ill patients.
We searched PubMed, EMBASE, CINAHL plus, ProQuest Health & Medical Complete, PsycINFO and the Cochrane Library, as well as Chinese databases including Weipu Data, Wanfang Data and China National Knowledge Infrastructure from inception to 30 April 2021, for randomised controlled trials (RCTs) assessing the effects of DT on dignity, psycho-spiritual well-being and quality of life of terminally ill patients receiving palliative care.
We identified 507 unique records, and included 9 RCTs (871 participants). Comparator was standard palliative care. DT did not improve terminally ill patients' sense of dignity (p=0.90), hope (p=0.15), spiritual well-being (p=0.99) and quality of life (p=0.23). However, DT reduced anxiety and depression after intervention (standardised mean difference, SMD=-1.13, 95% CI (-2.21 to -0.04), p=0.04; SMD=-1.22, 95% CI (-2.25 to -0.18), p=0.02, respectively) and at 4 weeks post-intervention (SMD=-0.89, 95% CI (-1.71 to -0.07), p=0.03; SMD=-1.26, 95% CI (-2.38 to -0.14), p=0.03, respectively).
DT can be offered as a psychological intervention for terminally ill patients to reduce their anxiety and depression. More studies are needed to further evaluate the effects of DT on terminally ill patients' dignity, spiritual well-being and quality of life.
尊严疗法（DT）是一种简短的个体化心理治疗方法，旨在缓解生命终末期的社会心理和精神痛苦。目前尚不清楚 DT 是否可以增强终末期患者的尊严感，改善其心理和精神幸福感以及生活质量。
我们检索了 PubMed、EMBASE、CINAHL plus、ProQuest Health & Medical Complete、PsycINFO 和 Cochrane 图书馆，以及中国的维普数据库、万方数据知识服务平台和中国知网，从建库至 2021 年 4 月 30 日，以评估 DT 对接受姑息治疗的终末期患者尊严、心理-精神幸福感和生活质量影响的随机对照试验（RCT）。
我们共确定了 507 份独特的记录，并纳入了 9 项 RCT（871 名参与者）。对照组为标准姑息治疗。DT 并未改善终末期患者的尊严感（p=0.90）、希望感（p=0.15）、精神幸福感（p=0.99）和生活质量（p=0.23）。然而，DT 可降低干预后（标准化均数差，SMD=-1.13，95%CI（-2.21 至 -0.04），p=0.04；SMD=-1.22，95%CI（-2.25 至 -0.18），p=0.02）和干预后 4 周时（SMD=-0.89，95%CI（-1.71 至 -0.07），p=0.03；SMD=-1.26，95%CI（-2.38 至 -0.14），p=0.03）的焦虑和抑郁程度。
DT 可作为一种心理干预措施提供给终末期患者，以减轻其焦虑和抑郁。需要更多的研究来进一步评估 DT 对终末期患者尊严、精神幸福感和生活质量的影响。
