Browse > Article
http://dx.doi.org/10.4040/jkan.2014.44.5.471

Effects of Dignity Interventions on Psychosocial and Existential Distress in Terminally ill Patients: A Meta-analysis  

Oh, Pok Ja (Department of Nursing, Sahmyook University)
Shin, Sung-Rae (Department of Nursing, Sahmyook University)
Publication Information
Journal of Korean Academy of Nursing / v.44, no.5, 2014 , pp. 471-483 More about this Journal
Abstract
Purpose: This study was done to evaluate the effects of dignity interventions on depression, anxiety and meaning of life in terminally ill patients. Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms indicating dignity intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.2.11 program of Cochrane Library. Results: Twelve clinical trials met the inclusion criteria with a total of 878 participants. Dignity intervention was conducted for a mean of 2.2 weeks, 2.8 sessions and an average of 48.7 minutes per session. Effect sizes were heterogeneous and subgroup analysis was done. Dignity interventions had a significant effect on depression (ES= -1.05, p<.001, $I^2$=15%) and anxiety (ES= -1.01, p<.001, $I^2$=0). For meaning of life, dignity interventions were effective (ES= -1.64, p=.005) and effect sizes were still heterogeneous. Conclusion: Results support findings that dignity interventions can assist terminal ill patients in reducing emotional distress and improving meaning of life. Further well-designed dignity studies will lead to better understanding of the effects of treatments on spiritual well-being.
Keywords
Terminally ill; Dignity; Intervention studies; Meta-analysis;
Citations & Related Records
Times Cited By KSCI : 5  (Citation Analysis)
연도 인용수 순위
1 Ahn SH, An YL, Yoo YS, Ando M, Yoon SJ. Effects of a short-term life review on spiritual well-being, depression, and anxiety in terminally ill cancer patients. Journal of Korean Academy of Nursing. 2012;42(1):28-35. http://dx.doi.org/10.4040/jkan.2012.42.1.28   DOI
2 Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M. Dignity therapy: A novel psychotherapeutic intervention for patients near the end of life. Journal of Clinical Oncology. 2005;23(24):5520-5525. http://dx.doi.org/10.1200/jco.2005.08.391   DOI   ScienceOn
3 Field MJ, Cassel CK, editors. Approaching death: Improving care at the end of life. Washington, DC: The National Academies Press; 1997.
4 Breitbart W, Rosenfeld BD, Passik SD. Interest in physician-assisted suicide among ambulatory HIV-infected patients. The American Journal of Psychiatry. 1996;153(2):238-242.   DOI
5 Meier DE, Emmons CA, Wallenstein S, Quill T, Morrison RS, Cassel CK. A national survey of physician-assisted suicide and euthanasia in the United States. The New England Journal of Medicine. 1998;338(17):1193-1201. http://dx.doi.org/10.1056/nejm199804233381706   DOI
6 Kim JN, I R. A review of research on the psychosocial interventions for the cancer patients. The Korean Journal of Health Psychology. 2008;13(2):329-357.   DOI
7 Oh PJ, Lee EA. Cognitive behavioral therapy for psychological distress, self care and quality of life in patients with cancer: A meta-analysis. Korean Journal of Adult Nursing. 2013;25(4):377-388.   DOI
8 Kim HC. The effect of hospice/palliative care on anxiety, depression and pain in some terminal cancer patient [dissertation]. Gwangju: Chosun University; 2008.
9 Juliao M, Barbosa A, Oliveira F, Nunes B, Vaz Carneiro A. Efficacy of dignity therapy for depression and anxiety in terminally ill patients: Early results of a randomized controlled trial. Palliative & Supportive Care. 2013;11(6):481-489. http://dx.doi.org/10.1017/s1478951512000892   DOI
10 Akechi T. Psychotherapy for depression among patients with advanced cancer. Japanese Journal of Clinical Oncology. 2012;42(12):1113-1119. http://dx.doi.org/10.1093/jjco/hys152   DOI
11 Frankl VE. Man's search for meaning: An introduction to logotherapy. 4th ed. Boston, MA: Beacon Press; 1992.
12 Jenko M, Gonzalez L, Alley P. Life review in critical care: Possibilities at the end of life. Critical Care Nurse. 2010;30(1):17-27. http://dx.doi.org/10.4037/ccn2010122   DOI
13 Raingruber B. The effectiveness of psychosocial interventions with cancer patients: An integrative review of the literature (2006-2011). ISRN Nursing. 2011;2011:638218. http://dx.doi.org/10.5402/2011/638218
14 Kim SY, Park JE, Seo HJ, Seo HS, Son HJ, Shin CM, et al. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-based Health Care Collaborating Agency; 2011.
15 Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of intervention version 5.0.0. London, UK: The Cochrane Collaboration; 2008.
16 Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1998.
17 Lee J. Meta-analysis. Journal of Korean Endocrine Society. 2008; 23(6):361-378. http://dx.doi.org/10.3803/jkes.2008.23.6.361   DOI   ScienceOn
18 Oh SS. Meta-analysis: Theory and practice. Seoul: Konkuk University Press; 2002.
19 Goedendorp MM, Gielissen MF, Verhagen CA, Bleijenberg G. Psychosocial interventions for reducing fatigue during cancer treatment in adults. The Cochrane Database of Systematic Reviews. 2009;1:CD006953. http://dx.doi.org/10.1002/14651858.CD006953.pub2
20 Ranchor AV, Fleer J, Sanderman R, Van der Ploeg KM, Coyne JC, Schroevers M. Psychological interventions for cancer survivors and cancer patients in the palliative phase (Protocol). The Cochrane Database of Systematic Reviews. 2012;1:CD009511. http://dx.doi.org/10.1002/14651858.CD009511
21 Haber D. Life review: Implementation, theory, research, and therapy. International Journal of Aging and Human Development. 2006;63(2):153-171.   DOI
22 Hwang SS, Chang VT, Fairclough DL, Cogswell J, Kasimis B. Longitudinal quality of life in advanced cancer patients: Pilot study results from a VA medical cancer center. Journal of Pain and Symptom Management. 2003;25(3):225-235.   DOI
23 Chung C, Lee S, Hwang S, Park E. Systematic review of exercise effects on health outcomes in women with breast cancer. Asian Nursing Research. 2013;7(3):149-159.   DOI   ScienceOn
24 Oh PJ, Jang ES. Effects of psychosocial interventions on cortisol and immune parameters in patients with cancer: A meta-analysis. Journal of Korean Academy of Nursing. 2014;44(4):446-457. http://dx.doi.org/10.4040/jkan.2014.44.4.446   DOI
25 Kang SR. Concept analysis of spiritual care. Journal of Korean Academy of Nursing. 2006;36(5):803-812.   DOI
26 Chochinov HM, Hassard T, McClement S, Hack T, Kristjanson LJ, Harlos M, et al. The patient dignity inventory: A novel way of measuring dignity-related distress in palliative care. Journal of Pain and Symptom Management. 2008;36(6):559-571. http://dx.doi.org/10.1016/j.jpainsymman.2007.12.018   DOI
27 Ando M, Morita T, Okamoto T, Ninosaka Y. One-week short-term life review interview can improve spiritual well-being of terminally ill cancer patients. Psycho-Oncology. 2008;17(9):885-890. http://dx.doi.org/10.1002/pon.1299   DOI
28 Ro YJ, Kim NC, Lee SM. The present status and the proposals of hospice in Korea. Journal of Korean Academy of Adult Nursing. 1996;8(2):338-349.
29 Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and metaanalyses of studies that evaluate health care interventions: Explanation and elaboration. Annals of Internal Medicine. 2009;151(4):W65-W94.
30 Kim BH, Choe SO, Chung BY, Yoo YS, Kim HS, Kang KA, et al. Job analysis for role identification of general hospice palliative nurse. Korean Journal of Hospice and Palliative Care. 2010;13(1):13-23.