Cinema-based interventions for coping with life-threatening illness, dying or loss: A systematic review and realist synthesis.

Cinematherapy is increasingly being used as a complementary therapy and psychosocial approach in clinical settings, including end-of-life contexts. However, more needs to be understood about the mechanisms underpinning its therapeutic potential. The aim of this study was to identify cinema-based interventions that have been used as a resource for helping patients cope with life-threatening illness, dying or loss, focusing on the contexts in which they have been applied, the mechanisms through which they appear to operate, and the outcomes achieved. To this end we conducted a systematic review and realist synthesis of the literature, with reporting guided by the PRISMA statement and RAMESES standards. The review identified 24 interventions implemented with two broad aims (contexts of use): (1) improving the hospital experience, and (2) as a tool in psychotherapy. In terms of the mechanisms underpinning their therapeutic potential, the analysis suggests that this is achieved primarily through psychological processes associated with narrative transportation, which can be facilitated by creating a cinema-like environment and through the targeted selection of content. In terms of outcomes, studies reported a positive impact on a range of variables, including psychological well-being, communication, personal reflection, social connectedness, anxiety, fear, and pain. Further research is required to define the specific esthetic, narrative, and thematic aspects of films that may contribute to their therapeutic potential. There is also a need for in-depth exploration of the perspectives of both patients and professionals so as to develop a more systematic approach to the use of cinematherapy in these clinical contexts.