Effects of Dignity Therapy for Palliative Care Patients and Family Caregivers: A Systematic Review.

Dignity Therapy (DT) is a psychosocial intervention aimed at alleviating existential distress, enhancing meaning, and improving the overall well-being of palliative care patients and their family caregivers. While individual studies have demonstrated the benefits of DT, a comprehensive evaluation of its impact on key outcomes such as quality of life (QoL), depression, anxiety, and well-being is needed. This study aimed to systematically review the effects of DT on palliative care patients and their family caregivers, focusing on outcomes related to QoL, psychological distress (depression and anxiety), and overall well-being. A systematic review was conducted by searching multiple databases, including Cochrane Library, PubMed, ScienceDirect, Web of Science, and Scopus, for randomized controlled trials (RCTs) evaluating DT in palliative care. Inclusion criteria were RCTs reporting on QoL, depression, anxiety, well-being, and dignity-related distress. Two reviewers independently screened studies and extracted data. Study quality was assessed using the Cochrane Risk of Bias tool. Eight RCTs met the inclusion criteria. DT demonstrated significant improvements in QoL and well-being among palliative care patients, with reductions in depression and anxiety. Improvements were observed in the physical, psychological, and social domains of QoL. Family caregivers also experienced enhanced spiritual well-being, hope, family cohesion, and adaptability. However, not all outcomes were consistently improved across all studies, indicating variability in DT effectiveness. DT is a promising intervention for enhancing QoL and reducing psychological distress among palliative care patients and their family caregivers. While evidence supports its beneficial impact, further high-quality research is required to confirm these findings and clarify the mechanisms through which DT works. Incorporating DT into palliative care practice is recommended to address the comprehensive needs of patients and their families.