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尊严疗法在姑息治疗中的应用:一项全面的范围综述。

Use of dignity therapy in palliative care: a comprehensive scoping review.

作者信息

Yanez Romel Jonathan Velasco, de Freitas Corpes Erilaine, Sixsmith Judith, Fernandes Ana Fátima Carvalho, de Souza Aquino Priscila, Castro Régia Christina Moura Barbosa, Jorge Herla Maria Furtardo

机构信息

Department of Nursing, Federal University of Ceará, Fortaleza, Brazil.

School of Health Sciences, University of Dundee, 11 Airlie Pl, Dundee DD1 4HJ, Dundeee, Scotland, UK.

出版信息

BMC Palliat Care. 2025 Jul 1;24(1):177. doi: 10.1186/s12904-025-01812-4.

Abstract

INTRODUCTION

Dignity Therapy is an innovative intervention designed to alleviate emotional suffering and address the distress associated with loss of dignity in individuals with advanced illness or at the end of life. Its use has steadily increased, and previous systematic reviews have synthesized evidence on its effectiveness in palliative care. However, there is no comprehensive synthesis that explores aspects of this intervention beyond commonly reported clinical outcomes. The aim of this review was to identify and synthesize the available evidence on the use of Dignity Therapy in palliative care.

METHODS

This comprehensive scoping review followed the Joanna Briggs Institute methodology, and the final report was prepared in accordance with the PRISMA-ScR checklist. The protocol was registered on the Open Science Framework (DOI: 10.17605/OSF.IO/MNWUJ). From 2016 onward, systematic searches were conducted in 11 databases, including gray literature. Study selection was performed using RAYYAN software, and qualitative content analysis was used for data analysis.

RESULTS

Of the 815 records identified, 82 articles with 11 Gy literature documents included. Most studies were published in 2023 (19.5%), originated from the United States (23.1%), used an experimental design (29.2%), and focused on oncology (58.5%). Nine key categories emerged from the analysis: feasibility, acceptability, satisfaction, and effectiveness; perceived health benefits; impact on family; adaptation to diverse contexts; use of technology; economic feasibility; professional profiles; and implementation in underrepresented populations.

CONCLUSIONS

The evidence suggests benefits across various dimensions of health, including among family members, pediatric and adolescent populations, and traditionally underrepresented groups, as well as its implementation in early stages of illness and posthumous delivery. The expansion of Dignity Therapy has also driven cultural and linguistic adaptations, the development of derivative tools, and its application in a range of clinical contexts, along with the involvement of a broader spectrum of professionals. This review provides a comprehensive synthesis to guide healthcare professionals on the current state of knowledge, while identifying key research gaps and new insights to inform future studies.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12904-025-01812-4.

摘要

引言

尊严疗法是一种创新干预措施,旨在减轻晚期疾病患者或临终患者的情感痛苦,并解决与尊严丧失相关的困扰。其应用稳步增加,先前的系统评价已综合了其在姑息治疗中有效性的证据。然而,尚无全面的综合研究探讨该干预措施除常见临床结果之外的其他方面。本综述的目的是识别并综合关于尊严疗法在姑息治疗中应用的现有证据。

方法

本全面的范围综述遵循乔安娜·布里格斯研究所的方法,最终报告根据PRISMA-ScR清单编写。该方案已在开放科学框架(DOI:10.17605/OSF.IO/MNWUJ)上注册。从2016年起,在11个数据库(包括灰色文献)中进行了系统检索。使用RAYYAN软件进行研究筛选,并采用定性内容分析法进行数据分析。

结果

在确定的815条记录中,纳入了82篇文章及11篇灰色文献。大多数研究发表于2023年(19.5%),源自美国(23.1%),采用实验设计(29.2%),并聚焦于肿瘤学(58.5%)。分析得出九个关键类别:可行性、可接受性、满意度和有效性;感知到的健康益处;对家庭的影响;适应不同环境;技术应用;经济可行性;专业概况;以及在代表性不足人群中的实施情况。

结论

证据表明,尊严疗法在健康的各个维度均有益处,包括在家庭成员、儿童和青少年人群以及传统上代表性不足的群体中,以及在疾病早期和死后实施方面。尊严疗法的扩展还推动了文化和语言适应性调整、衍生工具的开发及其在一系列临床环境中的应用,以及更广泛专业人员的参与。本综述提供了全面的综合内容,以指导医疗保健专业人员了解当前的知识状态,同时确定关键研究差距和新见解,为未来研究提供参考。

补充信息

在线版本包含可在10.1186/s12904-025-01812-4获取的补充材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fd/12210638/62bbfbe9e048/12904_2025_1812_Fig1_HTML.jpg

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