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Effects of Dignity Therapy on Family Members

A Systematic Review

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

Journal of Hospice & Palliative Nursing: December 2018 - Volume 20 - Issue 6 - p 542–547
doi: 10.1097/NJH.0000000000000469
Feature Articles

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.

Lisa J. Scarton, PhD, RN, is assistant professor, College of Nursing, University of Florida, Gainesville.

Lara Boyken, BA, is research project coordinator, Buehler Center, Northwestern University Feinberg School of Medicine, Chicago, IL.

Robert J. Lucero, PhD, MPH, RN, FAAN, is associate professor of nursing, Graduate Affiliated Faculty, Center for Latin American Studies, College of Nursing, University of Florida, Gainesville.

George Fitchett, DMin, PhD, is professor, Rush University Medical Center, Chicago, IL.

George Handzo, MDiv, is director, Health Services Research & Quality, HealthCare Chaplaincy Network, New York, NY.

Linda Emanuel, MD, PhD, is professor, Buehler Center, Northwestern University Feinberg School of Medicine, Chicago, IL.

Diana J. Wilkie, PhD, RN, FAAN, is Prairieview Trust–Earl and Margo Powers endowed professor, and director, Center for Palliative Care Research & Education, College of Nursing, University of Florida, Gainesville.

Address correspondence to Lisa J. Scarton, PhD, RN, College of Nursing, University of Florida, 1225 Center Dr, PO Box 100197, Gainesville, FL 32610 (

This research was made possible by grant number 5R01CA200867 from the National Institutes of Health (NIH), National Cancer Institute (NCI), and National Institute of Nursing Research (NINR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCI or NINR. The final peer-reviewed article is subject to the NIH Public Access Policy.

The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2018 by The Hospice and Palliative Nurses Association.