School of Medicine, Dentistry and Nursing, University of Glasgow.
NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK.
Curr Opin Support Palliat Care. 2023 Sep 1;17(3):186-192. doi: 10.1097/SPC.0000000000000664. Epub 2023 Jul 10.
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.
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.
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.
本综述旨在综合系统评价和荟萃分析的证据，评估尊严疗法（DT）在以患者为中心且文化上能胜任的支持性和姑息性护理背景下，对有支持性和姑息性护理需求的患者的心理社会和精神结局的疗效。
共发现 13 篇综述，其中 7 篇由护士撰写。大多数综述质量较高，包括癌症、运动神经元疾病和非恶性疾病等各种研究人群。根据 DT 实施中的文化差异，确定了 6 个心理社会和精神结局：生活质量、焦虑、抑郁、希望、生活意义和目的以及痛苦。
DT 对有姑息性护理需求的患者的焦虑、抑郁、痛苦和生活意义和目的有积极影响，但在文化上有能力的关怀背景下，DT 是否能有效改善希望、生活质量和精神结局的证据有些矛盾。鉴于 DT 在姑息性护理患者护理中的关键作用，由护士主导的 DT 似乎是可取的。应该为具有不同文化背景的人群开展更多的随机对照试验，以提供以患者为中心且文化上能胜任的支持性和姑息性护理。
