Impact of narrative nursing-based life review nursing on dignity and depression in elderly Alzheimer’s disease patients

Abstract

BACKGROUND

Alzheimer’s disease (AD) commonly leads to depression and a profound loss of dignity due to progressive cognitive decline, functional dependence, and social marginalization. While life review nursing can alleviate emotional distress by revisiting past experiences, its effects are often limited by its focus on factual recall rather than meaning-making. Narrative nursing, which emphasizes listening to and co-constructing patients’ illness stories, offers a promising approach to restore identity and self-worth. We hypothesized that integrating narrative nursing into life review would significantly enhance dignity and reduce depressive symptoms in elderly AD patients compared to life review alone.

AIM

To explore narrative life review’s impact on dignity and depression in elderly AD patients.

METHODS

A retrospective study was conducted on 120 elderly AD patients from the Department of Geriatrics (January 2023 to December 2024). Patients were divided into control (n = 60) and combined (n = 60) groups. Both groups received 12-week life review nursing; the combined group additionally received narrative nursing. Dignity was assessed using Patient Dignity Inventory (PDI), and depressive mood using Cornell Scale for Depression in Dementia (CSDD). Changes in scores were compared between groups using t-tests and χ² tests.

RESULTS

There were no statistically significant differences in the scores between the two groups of patients before treatment (P > 0.05). After treatment, the above indicators in both groups were significantly improved compared with those before treatment (P < 0.05). The combined group showed better improvement: The total PDI score in the combined group decreased to 45.85 ± 4.43 points, and the CSDD score decreased to 5.42 ± 0.94 points, both significantly lower than the control group’s 54.94 ± 3.39 points and 6.72 ± 0.83 points (P < 0.001). Among them, the combined group showed the largest decrease in the PDI “mental state” dimension and the CSDD score dropped to the non-depressive standard, with advantages over the control group.

CONCLUSION

Narrative nursing combined with life review significantly enhances dignity and reduces depressive symptoms in elderly AD patients, offering an effective humanistic psychological intervention for clinical practice.

Keywords: Alzheimer’s disease; Narrative nursing; Life review nursing; Sense of dignity; Depression

Core Tip: This study evaluated a comprehensive intervention combining narrative nursing with life review nursing, aiming to enhance dignity and alleviate depressive symptoms in elderly patients with Alzheimer’s disease. By guiding patients to recall life experiences and reconstruct positive life narratives, this approach showed significantly greater efficacy than standalone life review nursing. Results confirmed improved dignity and reduced depression, proving it a safe, feasible, patient-centered non-pharmacological method for clinical and community care.