Exploring difficulties, dropout causes, and professional involvement in applying dignity therapy for palliative care patients: a scoping review.

PURPOSE: To explore and summarize the published literature on the most common causes of dropout and the challenges in implementing Dignity Therapy (DT) in terminally ill patients, as well as the training of the professionals involved.

METHODS

A systematic scoping review was conducted following the methodology of the Joanna Briggs Institute (JBI) for scoping reviews, using the PAGER framework. The databases consulted included PUBMED, CINAHL, PsycINFO, and SCOPUS. Two independent reviewers applied the established criteria. The PRISMA-ScR guidelines were followed for reporting.

RESULTS

The review identified twenty-seven published articles, highlighting three key themes: reasons for dropout and/or recruitment issues, challenges and limitations in studies on Dignity Therapy, and the professionals who implement it, along with their training. These themes prompted reflection on the pre-methodological preparation for patient and family recruitment, as well as therapy continuity. While Dignity Therapy is beneficial, it presents challenges in terms of follow-up and efficacy.

CONCLUSIONS

Refusal or dropout from Dignity Therapy in palliative care is associated with emotional, cultural, physical, and contextual factors. Understanding these factors is crucial to improving communication and adapting the therapy, thereby promoting its acceptance. Dignity Therapy faces challenges related to patient health, costs, cultural diversity, and staff training. The shortage of trained professionals and the lack of detailed information on therapist training are key limitations that must be addressed for effective implementation.