title: Care of the human spirit and the role of dignity therapy: a systematic review of dignity therapy research.
abstract: BACKGROUND
  Dignity Therapy (DT), an intervention for people facing serious illness, focuses on dignity conservation tasks such as settling relationships, sharing words of love, and preparing a legacy document for loved ones. Research on DT began more than a decade ago and has been conducted in 7 countries, but a systematic review of DT research has not been published.
  
  
  METHODS
  Using a PubMed search with key terms of 'dignity therapy', 'dignity psychotherapy', 'Chochinov', and 'dignity care', we found 29 articles on DT and retained 25 after full-text review.
  
  
  RESULTS
  Of these, 17 articles representing 12 quantitative studies establish that patients who receive DT report high satisfaction and benefits for themselves and their families, including increased sense of meaning and purpose. The effects of DT on physical or emotional symptoms, however, were inconsistent.
  
  
  CONCLUSIONS
  Conclusions point to three areas for future research on DT, to determine: (1) whether the DT intervention exerts an impact at a spiritual level and/or as a life completion task; (2) how DT should be implemented in real world settings; and (3) if DT has an effect on the illness experience within the context of not only the patient, but also the family and community. Building on this body of DT research, investigators will need to continue to be sensitive as they involve participants in DT studies and innovations to facilitate the generation and delivery of legacy documents to participants near the end of life.
authors.affiliation: Rush University Medical Center, 630 S. Hermitage Ave. Suite 505, Chicago, IL 60612 USA.
authors.forename: George
authors.initials: G
authors.lastname: Fitchett
authors.affiliation: Buehler Center on Health, Aging & Society Northwestern University, 750N Lake Shore Dr. Suite 601, Chicago, IL 60611 USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Emanuel
authors.affiliation: HealthCare Chaplaincy Network, 65 Broadway, 12th Floor, New York, NY 10006 USA.
authors.forename: George
authors.initials: G
authors.lastname: Handzo
authors.affiliation: Buehler Center on Health, Aging & Society Northwestern University, 750N Lake Shore Dr. Suite 601, Chicago, IL 60611 USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Boyken
authors.affiliation: Center of Excellence for End-of-Life Transition Research, University of Illinois at Chicago College of Nursing, 845S. Damen Ave., M/C 802, Chicago, IL 60612 USA.
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Wilkie
keywords: Dignity therapy; End-of-Life care; Literature review; Spiritual care
references.citation: BMJ Support Palliat Care. 2011 Dec;1(3):315-21
references.pmid: 24653477
references.citation: Palliat Med. 2010 Oct;24(7):715-23
references.pmid: 20605851
references.citation: Omega (Westport). 2013;67(1-2):135-45
references.pmid: 23977789
references.citation: Palliat Support Care. 2013 Dec;11(6):481-9
references.pmid: 23506744
references.citation: Palliat Med. 2006 Dec;20(8):745-54
references.pmid: 17148529
references.citation: J Palliat Med. 2005;8 Suppl 1:S103-15
references.pmid: 16499458
references.citation: J Pain Symptom Manage. 2013 Apr;45(4):712-25
references.pmid: 22921176
references.citation: CA Cancer J Clin. 2013 Jul-Aug;63(4):280-9
references.pmid: 23625473
references.citation: JAMA. 2002 May 1;287(17):2253-60
references.pmid: 11980525
references.citation: Lancet Oncol. 2011 Aug;12(8):753-62
references.pmid: 21741309
references.citation: BMC Palliat Care. 2009 May 16;8:5
references.pmid: 19445711
references.citation: J Palliat Med. 2012 May;15(5):509
references.pmid: 22577783
references.citation: BMC Palliat Care. 2012 Sep 20;11:18
references.pmid: 22995100
references.citation: J Palliat Med. 2007 Oct;10(5):1076-82
references.pmid: 17985964
references.citation: J Palliat Med. 2013 Sep;16(9):1118-20
references.pmid: 23937061
references.citation: Am J Psychiatry. 2011 Dec;168(12):1340
references.pmid: 22193678
references.citation: J Palliat Med. 2011 Jun;14(6):729-34
references.pmid: 21548823
references.citation: J Aging Health. 2008 Aug;20(5):545-59
references.pmid: 18443144
references.citation: Psychiatry. 1963 Feb;26:65-76
references.pmid: 14017386
references.citation: J Palliat Care. 2004 Autumn;20(3):134-42
references.pmid: 15511031
references.citation: J Palliat Med. 2009 Oct;12(10):885-904
references.pmid: 19807235
references.citation: Palliat Support Care. 2012 Mar;10(1):3-15
references.pmid: 22329932
references.citation: Palliat Med. 2012 Jul;26(5):703-12
references.pmid: 21859743
references.citation: BMC Palliat Care. 2010 Sep 22;9:21
references.pmid: 20860786
references.citation: J Palliat Med. 2014 Jun;17(6):688-95
references.pmid: 24735024
references.citation: Clin Psychol Rev. 2008 Mar;28(3):472-93
references.pmid: 17804130
references.citation: Palliat Med. 2014 May;28(5):448-58
references.pmid: 24311296
references.citation: Psychooncology. 2013 Aug;22(8):1748-52
references.pmid: 23055454
references.citation: Crit Care Med. 2014 Sep;42(9):1991-2000
references.pmid: 24797373
references.citation: PLoS One. 2014 May 09;9(5):e96888
references.pmid: 24816742
references.citation: Ann Behav Med. 2005 Oct;30(2):174-9
references.pmid: 16173914
references.citation: J Adv Nurs. 2014 Dec;70(12):2920-31
references.pmid: 24866233
references.citation: Age Ageing. 2009 Jul;38(4):411-6
references.pmid: 19460857
references.citation: BMC Palliat Care. 2014 Mar 19;13(1):12
references.pmid: 24646211
references.citation: Palliat Support Care. 2004 Jun;2(2):149-55
references.pmid: 16594244
references.citation: J Clin Oncol. 2005 Aug 20;23(24):5520-5
references.pmid: 16110012
references.citation: J Palliat Med. 2004 Oct;7(5):611-27
references.pmid: 15588352
references.citation: BMJ Support Palliat Care. 2011 Dec;1(3):296-300
references.pmid: 24653473
references.citation: J Am Geriatr Soc. 2005 Apr;53(4):711-9
references.pmid: 15817022
references.citation: Gerontologist. 2002 Oct;42 Spec No 3:24-33
references.pmid: 12415130
references.citation: J Clin Oncol. 2013 Feb 1;31(4):461-7
references.pmid: 23248245
references.citation: BMC Geriatr. 2009 Mar 24;9:9
references.pmid: 19317898
references.citation: J Behav Med. 2010 Feb;33(1):1-14
references.pmid: 19784868
references.citation: Int J Palliat Nurs. 2012 Oct;18(10):483-9
references.pmid: 23123951
references.citation: Palliat Med. 2012 Jul;26(5):768-9
references.pmid: 22733965
references.citation: J Community Support Oncol. 2014 Dec;12(12):446-53
references.pmid: 25866895
references.citation: J R Soc Med. 2001 Sep;94(9):430-2
references.pmid: 11535742
references.citation: BMC Med. 2010 Oct 08;8:57
references.pmid: 20932275
references.citation: Ann Intern Med. 2000 May 16;132(10):825-32
references.pmid: 10819707
references.citation: JAMA. 2009 Mar 18;301(11):1140-7
references.pmid: 19293414
references.citation: Psychooncology. 2012 Apr;21(4):343-50
references.pmid: 21882287
references.citation: Palliat Med. 2013 Apr;27(4):358-66
references.pmid: 22707179
references.citation: PLoS Med. 2009 Jul 21;6(7):e1000097
references.pmid: 19621072