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Cited by 16Palliative Care and End-of-Life IssuesPalliative and Oncologic CareComplementary and Alternative Medicine Studies

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Implementation and outcomes of complementary therapies in hospice care: an integrative review

Open access
Dingley, Catherine, Ruckdeschel, Angela, Kotula, Keshia, Lekhak, Nirmala·2021·Palliative Care and Social Practice

Abstract

Complementary therapies are increasingly integrated into hospice care, emphasizing the need to examine the evidence regarding implementation and effects on end-of-life outcomes. This review synthesizes the evidence regarding the implementation of complementary therapies and effects on end-of-life outcomes in hospice care. Whittemore and Knafl’s five-step integrative review process was applied. Using predefined search terms, research-based articles between 2006 and 2020 were reviewed. Twenty-three quantitative/mixed method studies conducted across eight countries met the final review criteria. Most commonly used complementary therapies were music, biofield therapies (reiki, therapeutic touch), and massage therapy. Most studies reported significant findings on physical symptoms (pain, dyspnea, fatigue, gastrointestinal symptoms, agitation) and/or psychosocial/spiritual symptoms (anxiety, depression, spirituality, well-being, quality of life); 40% of studies had both significant and nonsignificant findings. Methodological limitations included study design (few randomized controlled trials), small sample size, high attrition rate, lack of racial/ethnic diversity, unstandardized intervention implementation, and multiple outcome measurement instruments. Complementary therapies are promising components of hospice care; however, rigorous studies are needed to validate the effect on end-of-life outcomes and determine the most efficacious implementation. Complementary therapy studies face challenges consistent with end-of-life research; however, efforts to design rigorous trials and address methodological issues are required to enhance the state of the science.

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Figure 1. PRISMA Flow Diagram of Record Selection. Source: Moher et al. 33
Figure 1. PRISMA Flow Diagram of Record Selection. Source: Moher et al. 33CC BY-NC · PubMed Central

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Metadata

Authors
Dingley, C., Ruckdeschel, A., Kotula, K., & Lekhak, N.
Affiliations
  • University of Nevada, Las Vegas (US)
  • University of Mississippi (US)
Corresponding author
Dingley, Catherine
Venue
Palliative Care and Social Practice
Published
2021-01
Volume
15
Pages
26323524211051753-26323524211051753
ISSN
2632-3524 (ISSN-L)
OpenAlex
W3209995685
Cited by
16
References
1
Citations by year
2026: 5 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 1
FWCI
0.27
Type
journal article
Language
en
Open access
Locations
  • Palliative Care and Social Practice (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Digital Scholarship - UNLV (University of Nevada Reno) (submittedVersion, cc-by-nc)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • 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
  • Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
Keywords
complementary therapy, hospice care, end-of-life care, music therapy, biofield energy healing, Reiki, therapeutic touch, massage, symptom management, pain, dyspnea, fatigue, gastrointestinal symptoms, agitation, anxiety, depression, spirituality, quality of life, implementation

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CoChat. (2026). Citation check: Implementation and outcomes of complementary therapies in hospice care: an integrative review. https://app.cochat.ai/papers/10.1177/26323524211051753
The paper
Dingley, C., Ruckdeschel, A., Kotula, K., & Lekhak, N. (2021). Implementation and outcomes of complementary therapies in hospice care: an integrative review. Palliative Care and Social Practice. https://doi.org/10.1177/26323524211051753

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.