Intervenções promotoras da dignidade da pessoa no fim de vida e suas pessoas significativas

: uma revisão scoping

Abstract

Introduction: Changes in disease patterns raised questions about dignity at the end oflife. However, it is a broad concept that needs to be conceptualized. In the context ofhealth it is a multidimensional and dynamic concept. Professional support seems to beessential in dignity maintenance but still constitutes a challenge for health careprofessionals.Methods: Scoping review guided by Joanna Briggs Institute. The objective is to map theevidence about interventions that promote dignity at the end-of-life. The databasessearch was carried out on February 14th 2020. The selection of the studies counted withtwo independent reviewers. The results were analysed and synthesized for each reviewquestion in the light of the “Dignity-Conserving Model of Care” by Chochinov.Results: 47 studies were included in the review. The results confirm the applicability ofthe empirical model and other subcategories emerged: “Advanced care planning”“Environment conditions”, “Therapeutic relationship” and “Family support”. Theinterventions identified can be distinguished into diagnostic or therapeutic and specificor generalist. Those who implement specific interventions need great communicationand relational skills. Each member of the care team may implement generalistinterventions, including the person at end of life and family. It was possible to identifysimple and complex interventions. The application of dignity interventions wasconditioned by characteristics of the person, the professional and the system. In general,dignity interventions’ application does not require many resources but psychotherapeutic interventions require specialized training. Applicability and efficacy studies are scarce, especially for generalist interventions. However, Dignity therapy (DT),Patient dignity inventory (PDI) and Patient dignity question (PDQ) have been shown tobe effective in promoting dignity at the end of life. Conclusions: Mapping these interventions brought knowledge that can be useful for developing effectiveness studies and for the training and care management fields. We hope this may contribute to improve the care delivered.

Date of Award	15 Jun 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Ana Querido (Supervisor)