The Effect of Dignity Therapy on Terminally-Ill Adult Patients: A Systematic Review and Meta-Analysis

Background: We aimed to evaluate the effect of dignity therapy on the dignity, distress, and quality of life of terminally-ill adult patients. Methods: All randomized controlled trials published prior to Jan 2021 were searched through database, including PubMed, Medline, OVID, Cochrane Library, CINAHL, Web of Science, Scopus, ProQuest Central, KMBASE, KoreaMed, NDSL, and RISS. The RoB 2 was used to assess risk of bias. Effect sizes, Hedge's g and Higgins I2–statistics were used for meta-analysis. Results: We finally identified 10 studies for a systematic review, and eight studies out of them were selected for a meta-analysis. Overall, 776 participants were included in the meta-analysis. There were significant differences between with and without dignity therapy groups in dignity and anxiety (SMD = -0.3805, Cl = -0.5606, -0.2004; SMD = -0.1932, Cl = -0.3774, -0.0090, respectively) while there was no significant difference in quality of life and depression (SMD=0.4678, Cl = -0.0989, 1.0345; SMD= -0.0513, Cl= -0.2461, 0.1434, respectively). Conclusion: Dignity therapy may be effective for terminally ill patients on dignity and anxiety. We suggested further empirical studies with dignity therapy and repetitive meta-analysis in the future due to heterogeneity of the studies.