Effects of Dignity Therapy on Family Members

A Systematic Review

Lisa J. Scarton, PhD, RN; Lara Boyken, BA; Robert J. Lucero, PhD, MPH, RN, FAAN; George Fitchett, DMin, PhD; George Handzo, MDiv; Linda Emanuel, MD, PhD; Diana J. Wilkie, PhD, RN, FAAN

Disclosures

Journal of Hospice and Palliative Nursing. 2018;20(6):542-547. 

In This Article

Abstract and Introduction

Abstract

Dignity therapy (DT) provides, for patients with a serious illness, a guided sharable life review through a protocolized interview and the creation of a legacy document. Evidence is mounting in support of the use of DT for patients with a serious illness; however, it is unclear whether DT has effects on family members. The purpose of this article was to provide a systematic literature review of the effects DT has on family members of patients who receive DT. Using a PubMed search with key terms of "Chochinov," "family," and "dignity care," a total of 18 articles published between January 2000 and July 2016 were identified and included in this review. This systematic review was helpful in identifying the strength of the evidence and gaps in the literature focused on DT and expected or actual effects on the DT recipient or family members. Findings identify the need to conduct further research related to the feasibility, acceptability, and effects of DT for family members. Future research should focus on understanding whether and how family members may benefit from receiving the legacy document and whether the timing of family member involvement plays a role in the outcomes of DT.

Introduction

Dignity therapy (DT) provides, for patients with a serious illness, a guided sharable life review through a protocolized interview and the creation of a legacy document.[1] During DT, patients have the opportunity to record their life story and values in a document that reviews memories and offers statements and personal messages that are important to them. Once the legacy document has been edited to the patient's satisfaction, he/she can share it with family and friends. Evidence is mounting in support of the use of DT for patients with a serious illness;[2] however, it is unclear whether DT has effects on family members.

Patients diagnosed with a serious illness often have family members or friends accompany them through the entire trajectory of the serious illness. One of the main goals of palliative care is to improve the quality of life of not only the patient but also the family members. Providing care to a loved one can take a toll both mentally and physically on the family member. Some patient services now offer supportive services to family members as part of comprehensive care. Dignity therapy has the potential to benefit families as well as the patient. Currently, there is a small body of literature that examines the effects of DT on families but no systematic literature review. The purpose of this article was to provide a systematic literature review of any of the effects of DT on family members of patients who receive DT from both the patient and family perspectives.

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