DIGNITY INTERVENTION FOR END-OF-LIFE CARE PATIENTS AND THEIR FAMILIES IN PALLIATIVE CARE: An integrative review

Abstract

Patients approaching the end of their lives are increasingly likely to face physical deterioration, depressive symptoms, and psychological conditions that can potentially compromise their dignity. Perceived loss of dignity and depressive symptoms are important risk factors that affect the quality of health given to end-of-life patients. Therefore, the objective of this thesis was to conduct an integrative review of published studies to provide information on the dignity intervention that can be given to palliative and end-of-life care patients and their relatives. Comprehensive electronic databases (PubMed, ScienceDirect, Emerald Premier, CINHAL, and Web of Science) were searched following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The quality of included studies and their risk of biases were evaluated using the Critical Appraisal Checklist from the Joanna Briggs Institute. Out of the 4612 search hits retrieved, 17 fulfilled the inclusion criteria.

The dignity intervention approaches found in this integrative review was grouped into four categories. These are family dignity intervention, dignity therapy, religious, spiritual, and physical fitness activities, and compassionate healthcare. This integrative review showed that patients who underwent any of the dignity intervention strategies showed improved quality of life and increased sense of dignity. Additionally, these interventions offered the patients the opportunity to highlight their meaningful moments in life and discuss with their family members. Most importantly, the dignity intervention strategies allowed the patients to feel a sense of worth or respect. Considering the significance of dignity enhancement interventions, nurses and policymakers in end-of-life care have a role to play in ensuring the dignity of patients is enhanced since these patients usually have less control over their life at this stage due to several reasons such as old age, illnesses, terminal diseases, and frailty.