Dignity therapy, psycho-spiritual well-being and quality of life in the terminally ill: systematic review and meta-analysis

2021 ◽  
pp. bmjspcare-2021-003180
Author(s):  
Ruishuang Zheng ◽  
Qiaohong Guo ◽  
Zhiqian Chen ◽  
Yingchun Zeng
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Terminally Ill ◽  
Well Being ◽  
Cochrane Library ◽  
Anxiety And Depression ◽  
Terminally Ill Patients ◽  
Dignity Therapy ◽  
Spiritual Well Being

ObjectivesDignity therapy (DT) is a brief, individualised psychotherapy that aims to alleviate psychosocial and spiritual distress in the final stages of life. It is unknown yet whether DT can enhance sense of dignity and improve psychological and spiritual well-being as well as quality of life of terminally ill patients.MethodsWe searched PubMed, EMBASE, CINAHL plus, ProQuest Health & Medical Complete, PsycINFO and the Cochrane Library, as well as Chinese databases including Weipu Data, Wanfang Data and China National Knowledge Infrastructure from inception to 30 April 2021, for randomised controlled trials (RCTs) assessing the effects of DT on dignity, psycho-spiritual well-being and quality of life of terminally ill patients receiving palliative care.ResultsWe identified 507 unique records, and included 9 RCTs (871 participants). Comparator was standard palliative care. DT did not improve terminally ill patients’ sense of dignity (p=0.90), hope (p=0.15), spiritual well-being (p=0.99) and quality of life (p=0.23). However, DT reduced anxiety and depression after intervention (standardised mean difference, SMD=−1.13, 95% CI (−2.21 to –0.04), p=0.04; SMD=−1.22, 95% CI (−2.25 to –0.18), p=0.02, respectively) and at 4 weeks post-intervention (SMD=−0.89, 95% CI (−1.71 to –0.07), p=0.03; SMD=−1.26, 95% CI (−2.38 to –0.14), p=0.03, respectively).ConclusionDT can be offered as a psychological intervention for terminally ill patients to reduce their anxiety and depression. More studies are needed to further evaluate the effects of DT on terminally ill patients’ dignity, spiritual well-being and quality of life.

The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Well Being ◽  
Medium Effect ◽  
Spiritual Well Being ◽  
Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

scholarly journals A mixed-methods pilot study of ‘LIFEView’ audiovisual technology: Virtual travel to support well-being and quality of life in palliative and end-of-life care patients

2020 ◽  
Vol 34 (7) ◽  
pp. 954-965
Author(s):  
Monisha Kabir ◽  
Jill L Rice ◽  
Shirley H Bush ◽  
Peter G Lawlor ◽  
Colleen Webber ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Mixed Methods ◽  
Pilot Study ◽  
Preliminary Data ◽  
Psychological Symptoms ◽  
Well Being ◽  
Assessment System ◽  
Spiritual Well Being

Background: There is evidence that psychosocial and spiritual interventions of short duration, such as reminiscence therapy, provide positive impacts on quality of life and emotional and existential well-being in adults receiving palliative care. Aim: To determine (1) the feasibility of integrating ‘LIFEView’, a video-based software with >1600 videos of world destinations, in palliative care settings, and (2) positive, neutral or harmful effects of using ‘LIFEView’ videos. Design: A mixed-methods pre–post intervention pilot study was conducted to collect feasibility and preliminary data on physical and psychological symptoms, physiological indicators, spiritual well-being and aspects of quality of life. Setting/participants: Adult patients on an inpatient palliative care unit or receiving care from a community palliative care consultation team who were capable of providing consent and completing the outcome measures were eligible participants. Results: Overall, 27/41 (66%) participants took part in the study. Feasibility criteria, including participant acceptability, low participant burden, tool completion rate and retention rate, were fulfilled, though challenges were experienced with recruitment. Modest improvements, though non-significant, were shown on preliminary data collected on physical and psychological symptoms using the Edmonton Symptom Assessment System–revised, spiritual well-being assessed by the 12-item Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being scale and physiological measurements. Qualitative analysis revealed five themes: motivations for using ‘LIFEView’, perceptions of the technology, reminiscence, ‘LIFEView’ as an adaptable technology and ongoing or future use. Conclusion: A future adequately powered study to investigate the impacts of ‘LIFEView’ on patient well-being and quality of life appears to be feasible.

The relation between the experience of time and psychological distress in patients with hematological malignancies

2006 ◽  
Vol 4 (4) ◽  
pp. 357-363 ◽  
Author(s):  
MARC WITTMANN ◽  
TANJA VOLLMER ◽  
CLAUDIA SCHWEIGER ◽  
WOLFGANG HIDDEMANN
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Hematological Malignancies ◽  
Well Being ◽  
Anxiety And Depression ◽  
Life Threatening Illness ◽  
Experience Of Time ◽  
Spiritual Well Being ◽  
Life Threatening

Objective: The experience of time is strongly related to our momentary mood states. Patients with a life-threatening illness experience an extreme change in mood and suffer from psychological distress that can develop into clinically relevant psychiatric disorders, like anxiety and depression. The aim of this study was to investigate the associations among the subjective perception of time, psychological distress, and quality of life in patients with hematological malignancies.Methods: Eighty-eight inpatients with hematological malignancies rated how fast time passes subjectively on a visual analog scale and prospectively estimated a time span of 13 min. The Hospital Anxiety and Depression Scale (HADS) self-report measures of health-related quality of life (FACT-G) and spiritual well-being (FACIT-Sp) were employed to assess psychological distress and quality of life.Results: Those patients who reported a lower quality of life, less spiritual well-being, and more anxiety experienced a slower passage of subjective time and overestimated the 13-min time interval.Significance of results: Our interpretation of the results is that patients with a life-threatening illness who show symptoms of psychological distress draw attention away from meaningful thoughts and actions and, thus, experience time as passing more slowly. An altered sense of time can be a sign of mental suffering, which should be addressed within psycho-oncological interventions. As this is the first study to demonstrate this relation in cancer patients, further research is needed to investigate the experience of time and its relation to meaning as an issue in clinical diagnostics.

Effect of a spiritual care training program on patient quality of life and spiritual well-being.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 235-235
Author(s):  
Grace Meijuan Yang ◽  
Yung Ying Tan ◽  
Yin Bun Cheung ◽  
Dennis Dignadice ◽  
Amy Lim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Training Program ◽  
Spiritual Care ◽  
Training Session ◽  
Palliative Care Service ◽  
Well Being ◽  
Spiritual Assessment ◽  
Spiritual Well Being

235 Background: Spiritual care (SC) is a vital part of palliative care (PC) but its provision is still not routine. We studied the effect of a SC training program for staff on patient quality of life (QOL) and spiritual wellbeing (SPS), as measured by the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being (FACIT-Sp). Methods: This study was conducted at two sites: a PC consultative service in an acute hospital and a home PC service. The program comprised a 30 min training session for nurses and doctors on using the FICA tool for spiritual assessment and subsequent referral to a medical social worker (MSW) if needed, and a 60min training session with the MSWs on how to manage spiritual problems. A prospective cluster-controlled trial was done across 7 clusters. FACIT-Sp comprises 27 items for QOL (FACT-G) in the 4 domains and 12 items for SPS. This was administered at T1: upon referral to the palliative care service and T2: after 3 clinical visits by the PC team (doctor, nurse or MSW visits). Results: QOL data from 142 participants (69 intervention and 73 control) were analyzed. There appeared to be some benefit of the program on all domains of QOL as well as SPS, although only the FACT-G score achieved statistical significance. After further statistical adjustment for scores at T1 (to account for any regression to the mean), FACT-G score remained practically significant (p value 0.076). Conclusions: A brief SC training program for staff (30 min for nurses and doctors, 60 min for MSWs) appeared to result in some improved QOL and SPS for patients. However, a larger sample size will be needed to estimate the degree of benefit more accurately. [Table: see text]

Psychometric testing of the Spiritual Well-Being Scale–Mandarin version in Taiwanese cancer patients

2016 ◽  
Vol 15 (3) ◽  
pp. 336-347 ◽  
Author(s):  
Woung-Ru Tang ◽  
Chen-Yi Kao
Keyword(s):  
Quality Of Life ◽  
Factor Analysis ◽  
Psychometric Properties ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Well Being ◽  
Life Questionnaire ◽  
Terminally Ill Cancer Patients ◽  
Spiritual Well Being

AbstractObjective:The spiritual well-being of terminally ill cancer patients is an important indicator of the quality of their lives and of the quality of hospice care, but no validated tools are available for assessing this indicator in Taiwan.Method:The present cross-sectional study validated the Spiritual Well-Being Scale–Mandarin version (SWBS–M) by testing its psychometric properties in 243 cancer patients from five teaching hospitals throughout Taiwan. Construct validity was tested by factor analysis and hypothesis testing. Patients' spiritual well-being and quality of life were assessed using the SWBS–M and the McGill Quality of Life Questionnaire (MQoL), respectively.Results:Overall, the SWBS–M had an internal consistency/reliability of 0.89. Exploratory factor analysis showed that the SWBS–M had an underlying two-factor structure, explaining 46.94% of the variance. SWBS–M scores correlated moderately with MQoL scores (r = 0.48, p < 0.01). Terminally ill cancer patients' spiritual well-being was inversely related to their average pain level during the previous 24 hours (r = –0.183, p = 0.006). Cancer patients' spiritual well-being also differed significantly with their experience of pain (t = –3.67, p < 0.001); terminally ill cancer patients with pain during the previous 24 hours had a lower sense of spiritual well-being than those without pain.Significance of results:Our findings support a two-factor model for the SWBS–M in terminally ill Taiwanese cancer patients. We recommend testing the psychometric properties of the SWBS–M in different patient populations to verify its factorial structure in other Asian countries.

scholarly journals Association between spiritual well-being, quality of life, anxiety and depression in patients with gynaecological cancer in China

Medicine ◽  
2021 ◽  
Vol 100 (1) ◽  
pp. e24264
Author(s):  
Jing Chen ◽  
Huaxuan You ◽  
Yan Liu ◽  
Qian Kong ◽  
Anjiang Lei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Gynaecological Cancer ◽  
Anxiety And Depression ◽  
Spiritual Well Being

scholarly journals Associations Between The Spiritual Well-Being (EORTC QLQ-SWB32) and Quality of Life (EORTC QLQ-C30) of Patients Receiving Palliative Care for Cancer in Cyprus

2021 ◽  
Author(s):  
Maria Kyranou ◽  
Marianna Nicolaou
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Well Being ◽  
Cancer Data ◽  
Patients With Cancer ◽  
Spiritual Well Being ◽  
Eortc Qlq C30 ◽  
The Mean ◽  
Eortc Qlq

Abstract Background: Spiritual well-being is increasingly investigated in relation to patients’ perceived quality of life and is generally thought as having the potential to support patients with cancer who receive palliative care. Until recently, questionnaires used to assess spiritual well-being were developed mainly in the US. The purpose of this study was to translate and use the EORTC- SWB32, a newly developed tool, validated recently in 4 continents, 14 countries, and in 10 languages, to explore relationships of spiritual well-being with quality of life in patients with cancer.Methods: One hundred four patients participated in this study with an average age of 59 years. Of those, 79% were dealing with metastatic cancer. Data collection took place in three oncology centers from two large cities in Cyprus. The acceptability of the translated items was tested. Two questionnaires were employed for the assessment of quality of life and spiritual well-being, developed by the same organization: the EORTC QLQ-C30 and the EORTC QLQ-SWB32. The scores for each tool were analyzed separately and correlations between the two measures were explored. Results: Patients found the items of the SWB32 tool easy to understand and answer. They attested that filling the questionnaire prompted thoughts about their own spirituality. The mean score for Global Spiritual Well-Being was 60.4 (SD=23.7) and it was associated with the mean scores in the scales “Emotional functioning” and “Cognitive functioning” of the EORTC-QOL-C30 (0.42 and 0.40 respectively, p<0.01). The mean score for the “Relationship with God” scale (74.9, SD=29.7) reported by the Cypriot patients is high and compatible with the homogenous spiritual orientation of the island’s population.Conclusions: All subscales of the SWB32 tool demonstrated good internal consistency in this study. Significant associations were observed between dimensions of quality of life and spiritual well-being. Additionally, the participants found the items easy to answer consistent with the tool’s suggested clinical utility which lays the ground for the application of targeted interventions to enhance spiritual well-being.

scholarly journals Associations between the spiritual well-being (EORTC QLQ-SWB32) and quality of life (EORTC QLQ-C30) of patients receiving palliative care for cancer in Cyprus

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Maria Kyranou ◽  
Marianna Nicolaou
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Well Being ◽  
Cancer Data ◽  
Patients With Cancer ◽  
Spiritual Well Being ◽  
Eortc Qlq C30 ◽  
The Mean ◽  
Eortc Qlq

Abstract Background Spiritual well-being is increasingly investigated in relation to patients’ perceived quality of life and is generally thought as having the potential to support patients with cancer who receive palliative care. Until recently, questionnaires used to assess spiritual well-being were developed mainly in the US. The purpose of this study was to translate and use the EORTC- SWB32, a newly developed tool, validated recently in 4 continents, 14 countries, and in 10 languages, to explore relationships of spiritual well-being with quality of life in patients with cancer. Methods One hundred four patients participated in this study with an average age of 59 years. Of those, 79% were dealing with metastatic cancer. Data collection took place in three oncology centers from two large cities in Cyprus. The acceptability of the translated items was tested. Two questionnaires were employed for the assessment of quality of life and spiritual well-being, developed by the same organization: the EORTC QLQ-C30 and the EORTC QLQ-SWB32. The scores for each tool were analyzed separately and correlations between the two measures were explored. Results Patients found the items of the SWB32 tool easy to understand and answer. They attested that filling the questionnaire prompted thoughts about their own spirituality. The mean score for Global Spiritual Well-Being was 60.4 (SD = 23.7) and it was associated with the mean scores in the scales “Emotional functioning” and “Cognitive functioning” of the EORTC-QOL-C30 (0.42 and 0.40 respectively, p < 0.01). The mean score for the “Relationship with God” scale (74.9, SD = 29.7) reported by the Cypriot patients is high and compatible with the homogenous spiritual orientation of the island’s population. Conclusions All subscales of the SWB32 tool demonstrated good internal consistency in this study. Significant associations were observed between dimensions of quality of life and spiritual well-being. Additionally, the participants found the items easy to answer consistent with the tool’s suggested clinical utility which lays the ground for the application of targeted interventions to enhance spiritual well-being.

Comparison of Patient Self-Reported Quality of Life and Health Care Professional-Assessed Symptoms in Terminally ill Patients With Cancer

2020 ◽  
pp. 104990912094415
Author(s):  
Chikako Matsumura ◽  
Nanako Koyama ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
Takehisa Nomura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Terminally Ill ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Patient Reported ◽  
Exact Agreement

Background: Few studies evaluated whether health care professionals accurately assess several symptoms for patients with cancer in palliative care units. We determined the agreement level for several symptoms related to quality of life (QOL) between patient-reported QOL assessment and health care professional-assessed symptoms based on the Support Team Assessment Schedule (STAS). Method: An observational study was performed with terminally ill patients with cancer hospitalized in the palliative care unit between June 2018 and December 2019. Patients and health care professionals independently assessed 7 symptoms at the time of hospitalization and after 1 week. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL). In examining the proportions of exact agreement, “exact agreement” referred to the pairs of the scores (QLQ-C15-PAL vs STAS) being (1 vs 0), (2 vs 1), (3 vs 2 or 3), or (4 vs 4). The relationships of physical functioning between QLQ-C15-PAL and Palliative Performance Scale (PPS) were examined. Results: Of 130 patients, approximately 60% had PPS scores from 40 to 60. The highest mean score on QLQ-C15-PAL was for fatigue (63.8). The exact agreement on symptoms between patients and health care professionals ranged from 15.4% (fatigue) to 57.7% (nausea and vomiting). The mean of the transformed QLQ-C15-PAL and proportions of exact agreement were negatively correlated ( R 2 = 0.949, P < .05). The physical function scores in QLQ-C15-PAL for each PPS group showed no differences. Conclusion: We expect patient-reported outcomes including QLQ-C15-PAL to be added to health care professionals’ assessment of serious symptoms such as fatigue in terminally ill patients with cancer.

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