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Effectiveness of dignity therapy for patients with advanced cancer: A systematic review and meta-analysis of 10 randomized controlled trials.

Authors
  • Li, Yanfei1, 2
  • Li, Xiuxia1, 2
  • Hou, Liangying1, 2
  • Cao, Liujiao1, 2
  • Liu, Guanghua1, 3
  • Yang, Kehu1, 2, 4
  • 1 Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China. , (China)
  • 2 Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China. , (China)
  • 3 Law School of Lanzhou University, Lanzhou, China. , (China)
  • 4 Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China. , (China)
Type
Published Article
Journal
Depression and anxiety
Publication Date
Mar 01, 2020
Volume
37
Issue
3
Pages
234–246
Identifiers
DOI: 10.1002/da.22980
PMID: 31808977
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Dignity is a vitally important aspect of the lives of advanced cancer patients. We conducted a systematic review and meta-analysis of the effectiveness of dignity therapy in this patient population. We searched for randomized controlled trials comparing dignity therapy versus standard care for patients with advanced cancer in five comprehensive databases (March 2019), two clinical trial registries and one gray literature database (August 2019). The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook Version 5.1.0. We used GRADE approach to assess the certainty of evidence. Meta-analysis was performed with RevMan version 5.3. Outcomes of interest included anxiety, depression, dignity-related distress and quality of life (QoL). Ten trials evaluating 904 patients (control, 449; experimental, 455) were identified. Six trials included patients with different types of advanced cancer, and four trials included patients with a single advanced cancer (lung cancer [20%], breast cancer [10%], and hepatocellular carcinoma [10%]). Compared with the standard care, dignity therapy decreased the score of anxiety, depression, and dignity-related distress of the advanced cancer patients (SMD = -1.07, 95% CI: [-1.57, -0.58], p < .05; SMD = -1.31, 95% CI: [-1.92, -0.70], p < .05; MD = -7.30, 95% CI: [- 12.04, - 2.56], p < .05). In addition, no significant differences were found in the patient's QoL (p > .05). Very low certainty evidence demonstrated that dignity therapy might be a promising treatment, especially in reducing anxiety and depression in advanced cancer patients. © 2019 Wiley Periodicals, Inc.

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