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

Journal of Korean Academy of Nursing 2014; 44(5): 471-483.

Published online: 31 October 2014

DOI: https://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

Pok Ja Oh, Sung-Rae Shin

Department of Nursing, Sahmyook University, Seoul, Korea.

Address reprint requests to: Shin, Sung-Rae. Department of Nursing, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul 139-742, Korea. Tel: +82-2-3399-1588, Fax: +82-2-3399-1594, shinsr@syu.ac.kr

Received 3 June 2014       Revised 18 June 2014       Accepted 25 July 2014

© 2014 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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, I2=15%) and anxiety (ES=-1.01, p<.001, I2=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

Figures and Tables

Figure 1
Flow of studies included from database search.
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Figure 2
Forest plot of effect size and 95% CI by dignity intervention on depression and funnel plot of effectsizes by standard error.
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Figure 3
Forest plot of effect size and 95% CI by dignity intervention on anxiety.
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Table 1
Descriptive Summary of Included Studies (N=12)
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Exp.=Experimental group; Cont.=Control group; RCT=Randomized controlled trials; Non-RCT=Non-randomized controlled trial; FACIT-Sp=Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale; HADS=Hospital Anxiety and Depression Scale; SELT-M=Skalen zur Erfassung von Lebens qualitat bei Tumorkranken-modified version; NRS=Numeric Rating Scale; PDI=Patient dignity inventory; (+)=Statistically significant difference between two groups; No diff=No significant difference between two groups.

Notes

This paper was supported by the Sahmyook University Research Fund in 2014.

Appendix

Appendix

Reviewed Paper List

jkan-44-471-a001

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