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Cited by 215Patient Dignity and PrivacyPalliative Care and End-of-Life IssuesPalliative and Oncologic Care

‘Dignity therapy’, a promising intervention in palliative care: A comprehensive systematic literature review

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Martínez, Marina, Arantzamendi, María, Belar, Alazne, Carrasco, José Miguel, Carvajal, Ana, Rullán, María, Centeno, Carlos·2017·Palliative Medicine
DOI 10.1177/0269216316665562PMC PMC5405836
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Abstract

Background: Dignity therapy is psychotherapy to relieve psychological and existential distress in patients at the end of life. Little is known about its effect. Aim: To analyse the outcomes of dignity therapy in patients with advanced life-threatening diseases. Design: Systematic review was conducted. Three authors extracted data of the articles and evaluated quality using Critical Appraisal Skills Programme. Data were synthesized, considering study objectives. Data sources: PubMed, CINAHL, Cochrane Library and PsycINFO. The years searched were 2002 (year of dignity therapy development) to January 2016. ‘Dignity therapy’ was used as search term. Studies with patients with advanced life-threatening diseases were included. Results: Of 121 studies, 28 were included. Quality of studies is high. Results were grouped into effectiveness, satisfaction, suitability and feasibility, and adaptability to different diseases and cultures. Two of five randomized control trials applied dignity therapy to patients with high levels of baseline psychological distress. One showed statistically significant decrease on patients’ anxiety and depression scores over time. The other showed statistical decrease on anxiety scores pre–post dignity therapy, not on depression. Nonrandomized studies suggested statistically significant improvements in existential and psychosocial measurements. Patients, relatives and professionals perceived it improved end-of-life experience. Conclusion: Evidence suggests that dignity therapy is beneficial. One randomized controlled trial with patients with high levels of psychological distress shows DT efficacy in anxiety and depression scores. Other design studies report beneficial outcomes in terms of end-of-life experience. Further research should understand how dignity therapy functions to establish a means for measuring its impact and assessing whether high level of distress patients can benefit most from this therapy.

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  • RCTs of dignity therapy showed statistically significant decreases in anxiety and depression.

    “RCTs showed statistically significant decreases in anxiety and depression”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Martínez et al. 2017

    The Discussion reports that one RCT found statistically significant decreases in both anxiety and depression, while another found a decrease in anxiety but not depression. It says the five RCTs were inconclusive overall, so the unqualified plural claim overstates their findings. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Nonrandomized studies suggested improvements in existential and psychosocial measurements with dignity therapy.

    “nonrandomized studies suggested improvements in existential and psychosocial measurements”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Martínez et al. 2017

  • A 2017 review of dignity therapy included 28 studies, 5 of which were RCTs, of generally high methodological quality.

    “This review included 28 studies, 5 of which were RCTs, of generally high methodological quality.”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Martínez et al. 2017

  • Patients, relatives, and professionals perceived dignity therapy as improving the end-of-life experience.

    “Patients, relatives, and professionals perceived dignity therapy as improving the end-of-life experience.”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Martínez et al. 2017

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Research works printed but not linked: 30

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  2. [3]Chochinov HM Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care. BMJ 2007; 335: 184– 187. 17656543 PMC1934489
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  6. [8]Akechi T Akazawa T Komori Y Dignity therapy: preliminary cross-cultural findings regarding implementation among Japanese advanced cancer patients. Palliat Med 2012; 26: 768– 769. 22733965
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  16. [20]Goddard C Speck P Martin P Dignity therapy for older people in care homes: a qualitative study of the views of residents and recipients of ‘generativity’ documents. J Adv Nurs 2013; 69: 122– 132. 22489609
  17. [21]Hall S Goddard C Martin P Exploring the impact of dignity therapy on distressed patients with advanced cancer: three case studies. Psychooncology 2013; 22: 1748– 1752. 23055454
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Authors
Martínez, M., Arantzamendi, M., Belar, A., Carrasco, J. M., Carvajal, A., Rullán, M., & Centeno, C.
Affiliations
  • Navarre Institute of Health Research (ES)
  • Universidad de Navarra (ES)
  • Complejo Hospitalario de Navarra (ES)
Corresponding author
Arantzamendi, María
ORCID
Venue
Palliative Medicine
Publisher
SAGE Publications
Published
2016-08-26
Volume
31
Issue
6
Pages
492-509
ISSN
  • 0269-2163 (ISSN-L)
  • 1477-030X
DOI
10.1177/0269216316665562
PMC
PMC5405836
OpenAlex
W2508646516
Cited by
215
References
7
Citations by year
2026: 19 · 2025: 23 · 2024: 23 · 2023: 27 · 2022: 31 · 2021: 30 · 2020: 21 · 2019: 17 · 2018: 14 · 2017: 9 · 2016: 1
FWCI
2.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Palliative Medicine (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Deposito Adademico Digital Universidad De Navarra (University of Navarra) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Dignity and Privacy
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
dignity therapy, palliative care, end-of-life care, psychological distress, existential suffering, anxiety, depression, psychotherapy, end-of-life experiences, patient satisfaction, feasibility
MeSH terms
Counseling, Humans, Palliative Care, Psychotherapy, Brief, Quality of Life, Stress, Psychological, Terminal Care, Terminally Ill

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