West China School of Nursing, Sichuan University/ Department of Nursing, West China Hospital, Sichuan University, No 37 Guo-xue-xiang Lane, Wuhou district, Chengdu, Sichuan, PR China.
West China School of Nursing, Sichuan University/ Department of Nursing, West China Hospital, Sichuan University, No 37 Guo-xue-xiang Lane, Wuhou district, Chengdu, Sichuan, PR China.
Int J Nurs Stud. 2022 Aug;132:104273. doi: 10.1016/j.ijnurstu.2022.104273. Epub 2022 Apr 28.
Cancer presents a progressively deteriorating illness that not only causes significant physical, social and economic burdens in patients but also impacts an individual's psychological well-being and quality of life. Dignity therapy is a well-accepted psychosocial intervention but the effectiveness on hope, quality of life, anxiety, and depression in cancer patients remains inconsistent.
The purpose of this meta-analysis was to identify the effectiveness of dignity therapy on hope, quality of life, anxiety, and depression in cancer patients.
A meta-analysis of randomized controlled trials was performed.
Relevant studies published from inception to February 2022 were retrieved from PubMed, Embase (Ovid), the Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO, CINAHL, CBM, CNKI, VIP and Wanfang. The literature search and data extraction processes were conducted by two independent authors. The methodological quality of the included studies was assessed by the Cochrane Risk-of-Bias Assessment Tool, version 2 and the GRADE approach. The data analysis was performed using Review Manager (Version 5.4).
Fourteen randomized controlled trials published between 2011 and 2021 were included. Most of the studies were assessed as having some concerns. The certainty of the evidence in this review varied from low to high across outcomes. The meta-analysis showed statistically significant effects of dignity therapy on hope (mean difference (MD) = 3.41, 95% CI: 2.82 to 4.00, P < 0.001), anxiety (standardized mean difference (SMD) = -0.75, 95% confidence interval (CI): -1.32 to -0.18, P = 0.01), and depression (SMD = -1.01, 95% CI: -1.60 to -0.43, P = 0.0007) at postintervention, and the separate analysis revealed that dignity therapy had a sustainable effect on anxiety (MD = -2.96, 95% CI: -3.85 to -2.07, P < 0.001) and depression (MD = -3.44, 95% CI: -6.20 to -0.68, P = 0.0003) at one month after the intervention. However, no statistically significant effect on quality of life were found in our study.
Dignity therapy may be effective for improving hope, anxiety, and depression among adult cancer patients, but the effect on quality of life is nonsignificant. Culture-tailored dignity therapy should be further focused and explored. More randomized controlled trials with larger sample sizes, multiple follow-up times, and strict study designs should be further conducted to identify the effect of dignity therapy on cancer patients.
CDR42021275142.
癌症是一种不断恶化的疾病，不仅给患者带来了巨大的身体、社会和经济负担，还影响了个体的心理健康和生活质量。尊严疗法是一种被广泛认可的心理社会干预方法，但它对癌症患者希望、生活质量、焦虑和抑郁的影响仍不一致。
本荟萃分析旨在确定尊严疗法对癌症患者希望、生活质量、焦虑和抑郁的影响。
对随机对照试验进行荟萃分析。
从 PubMed、Embase（Ovid）、Cochrane 对照试验中心注册库、Web of Science、PsycINFO、CINAHL、CBM、CNKI、VIP 和万方数据库中检索从成立到 2022 年 2 月发表的相关研究。由两位独立作者进行文献检索和数据提取过程。使用 Cochrane 偏倚风险评估工具（版本 2）和 GRADE 方法评估纳入研究的方法学质量。使用 Review Manager（版本 5.4）进行数据分析。
共纳入 2011 年至 2021 年发表的 14 项随机对照试验。大多数研究被评估为存在一些问题。本综述中各结局的证据确定性从低到高不等。荟萃分析显示，尊严疗法对希望（均数差（MD）=3.41，95%置信区间（CI）：2.82 至 4.00，P<0.001）、焦虑（标准化均数差（SMD）=-0.75，95%CI：-1.32 至 -0.18，P=0.01）和抑郁（SMD=-1.01，95%CI：-1.60 至 -0.43，P=0.0007）的影响具有统计学意义，而单独分析显示尊严疗法对焦虑（MD=-2.96，95%CI：-3.85 至 -2.07，P<0.001）和抑郁（MD=-3.44，95%CI：-6.20 至 -0.68，P=0.0003）在干预后一个月具有持续效果。然而，本研究未发现尊严疗法对生活质量有统计学意义的影响。
尊严疗法可能对改善成年癌症患者的希望、焦虑和抑郁有一定效果，但对生活质量的影响不显著。应进一步关注和探讨文化定制的尊严疗法。应进一步开展更多具有更大样本量、多个随访时间和严格研究设计的随机对照试验，以确定尊严疗法对癌症患者的影响。
CDR42021275142。
