Effects of Dignity Therapy on Family Members: A Systematic Review.
Lisa J Scarton, Lara Boyken, Robert J Lucero and 4 others
PMID 30379798WHAT IT FOUND
Family members often found dignity therapy acceptable and the legacy document comforting, but studies were small and direct family outcomes were mixed.
Do not assume it reliably improves anxiety, depression, burden or hope.
Key findings
01In quantitative studies, family members' burden, anxiety, depression and hope did not show consistent significant pre-post improvement, and samples were too small to detect small effects.
02Family members often viewed the legacy document as a source of comfort and recommended dignity therapy; in one study, 28% of 18 family members thought it reduced stress or prepared them for end of life, and 33% felt it increased hopefulness.
03Some family members reported negative experiences: in a study of nine UK family members, five felt the document was incomplete and six felt the patient experienced emotional stress.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review searched only PubMed, so relevant studies may have been missed. Many included articles did not directly measure effects on family members; some relied on patients' expectations or hospice workers' views. The included studies were small and used different designs, outcome measures and follow-up times, making results hard to combine. There were no adequately powered studies showing whether dignity therapy changes family outcomes.
The easy way to misread this
Do not conclude that dignity therapy reliably improves family mental health. The direct family outcome evidence was mixed and came from small studies without adequate power.