Learning to promote patient dignity: an inter-professional approach

Explaining the process of learning about dignity by undergraduate nursing students: A grounded theory study

BACKGROUND

The learning process about dignity and how undergraduate nursing students experience and use this ethical knowledge is an under-represented field in nursing research. To overcome the lack of conceptual clarity, it is important to understand what processes and dimensions students develop to support this learning outcome.

OBJECTIVE

This study aimed to explain the process of learning about dignity by undergraduate nursing students.

RESEARCH DESIGN AND METHODS

A qualitative study was conducted using the grounded theory method.

PARTICIPANTS AND RESEARCH CONTEXT

Data was collected through free reports and in-depth semi-structured interviews with 20 participants. A focus group was held for the selective coding. Sampling began purposefully and evolved into theoretical. Reflective and theoretical memos were generated from the data collection and constant comparison. Data analysis was performed using qualitative data analysis software using Corbin and Strauss' method.

ETHICAL CONSIDERATIONS

The research was approved by a specialized research ethics committee from a Health School.

FINDINGS

The process of learning about dignity by undergraduate nursing students revealed 'recognition of dignity' as the core category, supported by five main categories: 'proto-conscience of dignity', 'pathway to nursing', 'consciousness of dignity', 'ways of learning', and 'becoming capable'. These categories illustrate the processes and dimensions involved in nursing students' concept translation of dignity learning, allowing a theory to emerge.

CONCLUSIONS

The 'Recognition of Dignity' theory aims to contribute to developing educational, training, and supervision processes for nursing programs. It seeks to enhance the ethical and moral development of undergraduate nursing students by helping them understand the concept of dignity and its fundamental importance in nursing.

The Turkish version of the students' perceptions of respectful maternity care scale: An assessment of psychometric properties

AIM

The aim of the research was to evaluate the psychometric properties of the Turkish validity and reliability of the Students' Perceptions of Respectful Maternity Care (SP-RMC) scale.

BACKGROUND

Respectful maternity care is an important contributor to intrapartum care quality and maternal birth satisfaction. Determining students' perceptions of respectful maternity care can identify knowledge gaps and inform their future practice.

DESIGN

A descriptive, methodological and cross-sectional design was used.

METHODS

This study was conducted with 226 undergraduate nursing and midwifery students in the western region of Turkey. Data were collected between May and December 2022 from students who completed their birth courses (theory and clinical practicum). Data included sociodemographic details and the Students' Perceptions of Respectful Maternity Care scale (Turkish version). Factor analysis, Cronbach's alpha and item-total score analyses were conducted.

RESULTS

The mean age of the students was 21.88 (SD 1.39). The average number of births observed was 2.57 (SD 3.16). The scale comprised 18 items including three subdimensions. In both exploratory and confirmatory factor tests, the overall factor loading was greater than 0.30, and the total explained variance was 64.89%. The Cronbach's alpha coefficient of the scale was 0.91, with Cronbach's alpha values ranging between 0.80 and 0.91 for the subscales. Pearson correlation coefficients of all the items ranged between 0.42 and 0.78.

CONCLUSIONS

The SP-RMC (Turkish version) is a valid and reliable measure, with 18 items and three dimensions. In this regard, measuring and reporting respectful maternity care perceptions and intrapartum care experiences of students, who are future members of the profession, could contribute to the improvement of the quality of care and the development of educational interventions for behavioral changes.

Dressings and dignity in community nursing

Although dignity has been widely explored in the context of healthcare, it has rarely been the subject of empirical exploration when care is delivered by community district nursing teams. This paper demonstrates how a commonplace community nursing task (changing dressings) can constitute a clinical lens through which to explore the ways in which community nurses can influence patients' dignity. This ethnographic study involved two research methods: interviews with patients and nurses (n=22) and observations of clinical interactions (n=62). Dignity can manifest during routine interactions between community nurses and patients. Patient-participants identified malodour from their ill-bodies as a particular threat to dignity. Nurses can reinforce the dignity of their patients through relational aspects of care and the successful concealment of 'leaky' bodies.

Discovering dignity through experience: How nursing students discover the expression of dignity

Introduction:

Dignity is a core value in nursing. Nursing education shall prepare students for ethical professional practice and facilitate insight into the phenomenon of dignity and its significance. There is limited knowledge about how nursing students discover dignity in their education.

Research aim:

The aim of the study is to develop an understanding of how nursing students discover and acquire dignity.

Research design:

The study has a hermeneutic approach where qualitative interviews of nursing students were employed. The process of interpretation was inspired by text of Fleming, Gaidys and Robbs.

Participants and research context:

Nineteen nursing students agreed to be included in the study, representing six different campuses at three different educational institutions. All were in the final year of their study. The interviews took place at the educational institutions.

Ethical considerations:

The educational institutions facilitated recruitment of the students who signed voluntarily for participation and continuous informed consent. The study was approved by The Norwegian Center of Reporting Data (NSD). The research recommendations of the Declaration of Helsinki were followed.

Findings:

The nursing students discovered the expression and significance of dignity through experiences, gained through introspection and in interaction with others during the education.

Discussion:

The findings are discussed using Gadamer’s concept of experience and how experiences can create new insight. In particular, the students’ experiences with the inner ethical and external aesthetic dimension of dignity are discussed.

Conclusion:

The study shows that students discovered the inner ethical dignity through experiencing vulnerability, pride and shame. They discovered the external aesthetic dignity through incidents, where they experienced both to be confirmed and not to be confirmed, and through observation of good or bad role models. Crucial negative and positive experiences are important for discovering the expression and significance of dignity.

Pre-operative physiotherapy following unilateral ankle fractures at a tertiary hospital in South Africa: Perceptions of patients and nurses

BACKGROUND

Ankle fractures are a common injury because of an increase in levels of physical activity, as well as senescence worldwide. Ankle fractures often require surgical management for optimal stabilisation. Pre-operative physiotherapy is necessary to prepare patients for early mobilisation and home discharge. There is a lack of information on the influence of pre-operative physiotherapy on post-operative rehabilitation success, as well as timeous discharge, in patients with ankle fractures.

OBJECTIVES

To explore the perceptions of patients receiving pre-operative physiotherapy care following a unilateral ankle fracture and the perceptions of nursing staff managing these patients at a tertiary hospital in South Africa.

METHOD

A descriptive qualitative design, using semi-structured interviews, including both patients with unilateral ankle fractures and nurses caring for these patients, was adopted. Interviews were recorded and verbatim transcriptions were analysed utilising thematic analysis.

RESULTS

Four overarching themes emerged: the perceived benefits of pre-operative physiotherapy; inhibitors to physiotherapy rehabilitation; hidden enablers to pre-operative physiotherapy and future initiatives for rehabilitation.

CONCLUSION

The perceived benefits included improved functional independence and safety of patients, as well as reduced burden of care for nurses. Patients also believed that pain and fear were two inhibitors to physiotherapy. Furthermore, nurses identified that organisational limitations, such as short-staffing and inadequately trained staff, inhibited pre-operative physiotherapy and continuity of care. Early post-operative discharge was a crucial hidden enabler to the pre-operative physiotherapy protocol. Recommendations included improved health education; the potential role of nursing staff as facilitators in pre-operative rehabilitation and regular, pre-operative in-patient monitoring of physiotherapy intervention.

CLINICAL IMPLICATIONS

Health education was perceived to have improved patient safety and compliance which subsequently reduced patient safety incidences as well as served as a risk mitigation measure. Furthermore, gait training and muscle strengthening exercises was perceived to have resulted in safe, independent mobility to ensure prompt discharge home. Consequently, a reduced post-operative length of in hospital stay results in major cost savings per patient as well as improved access and bed availability. Future studies may need to explore the effects of pre-operative physiotherapy on post-operative success and return to pre-injury activity.

Respectful care of human dignity: how is it perceived by patients and nurses?

OBJECTIVE

Dignified care protects the patient's rights and provides appropriate ethical care while improving the quality of nursing care. In this context, the opinions of nurses and patients who receive nursing care about dignified care are important. The aim of this study was to explore the opinions and experiences of Turkish patients and nurses about respectful care of human dignity.

METHODS

This descriptive cross-sectional study was conducted in Turkey. Participants were inpatients at cardiology, neurology and neurosurgery clinics and nurses working in these clinics. The data for the study were collected from face-to-face interviews using questionnaires. The percentages of characteristics and preferences of the participants were calculated, and the results were analysed using statistical tests.

RESULTS

A total of 150 patients and 78 nurses participated in the study. The patients stated that the protection of their rights was the most important factor for dignified nursing care. The nurses stated that being careful to not expose the patients' body and being respectful of the patients' privacy were important in dignified nursing care. The age of the patient, duration of the disease, number of hospitalisations and length of time the nurses had been working at the clinic caused significant changes in the factors considered important in dignified care.

CONCLUSIONS

Our findings provide a perspective on dignified care in the Turkish healthcare setting. There were some differences between patients and nurses in the factors considered important for dignified care. The discussion with patients and nurses related to care and practices that protect or detract from human dignity can provide insights to ethics.

Dignity in nursing care: What does it mean to nursing students?

BACKGROUND:

Despite growing interest in the potential of nursing education to enhance dignity in nursing care, relatively little is known about what dignity means to nursing students.

RESEARCH QUESTION:

What meaning does dignity in nursing care have for nursing students?

RESEARCH DESIGN:

Photo-elicitation was embedded within a Nominal Group Technique and responses were analysed by qualitative and quantitative content analysis.

PARTICIPANTS AND RESEARCH CONTEXT:

Participants were recruited from each year of a 3-year undergraduate preregistration adult nursing programme in Scotland. In total, 31 nursing students participated in the study.

ETHICAL CONSIDERATIONS:

The study was approved by the Ethics Committee of the School of Health, Nursing and Midwifery, University of the West of Scotland.

FINDINGS:

Participants articulated the meaning of dignity in nursing care in terms of the relationships and feelings involved. A total of 10 categories of meaning were identified.

DISCUSSION:

The significance of the nature of the nurse-patient interaction to preserving dignity in nursing care is highlighted.

CONCLUSION:

Understanding the meaning of dignity for nursing students may help prepare future nurses more able to preserve dignity in nursing care.

Patients' Dignity and Its Relationship with Contextual Variables: A Cross-Sectional Study

Introduction: Dignity is considered as fundamental human needs and recognized as one of the central concepts in nursing science. The aim of this study was to assess the extent to which patients’ dignity is respected and to evalutae its relationship with contextual variables.

Methods: This cross-sectional study was conducted on 256 hospitalized patients in the two teaching hospitals affiliated to Zanjan University of medical sciences, Iran. Data were collected by a questionnaire consist of two sections: (a) demographic characteristics, and (b) patient dignity including 32 questions. Data were analyzed by SPSS (ver.13) software using independent t-test, ANOVA and Pearson correlation.

Results: The result showed that the mean (standard deviation) of total score of patient’s dignity was 108.17 (25.28). According to the result, the majority of the respondents (76.2%) were not aware of patient’s rights. There was a significant difference in mean scores of total dignity between single and married persons, living in city or village, and hospitalization in Moosavi and Valiasr hospital.

Conclusion: Health care systems should take the provision of the patients' dignity into account through using a comprehensive educational program for informing of patient, family members, and health professionals about patients’ dignity.

How do they feel? Patients' perspectives on draping and dignity in a physiotherapy outpatient setting: A pilot study

BACKGROUND

Research to date has focused on dignity within the hospital rather than outpatient settings which is likely to raise different issues from the patients' perspective.

PURPOSE

To investigate patients' views relating to draping and dignity and their choice of dressing options in the physiotherapy outpatient setting.

METHOD

A custom-designed questionnaire was developed including feedback from a focus group of 10 individuals attending a physiotherapy outpatient clinic. The final version of the questionnaire comprised 14 items covering issues regarding privacy, draping, respect and communication. Patients attending outpatient physiotherapy for musculoskeletal treatment were invited to complete the questionnaire which was administered over a period of seven weeks.

RESULTS

Of the 31 respondents completing the questionnaire (n = 23 females, n = 8 males), the majority of males (87.5% n = 7) felt very confident removing their clothing whereas 26.1% of females (n = 6) reported feeling confident when asked to remove their clothing. Female respondents also considered the gender of their physiotherapist (87% n = 21) as well as physical privacy (73.9% n = 17) to be important factors related to patient dignity. All male respondents (100%) expressed a preference for exposing the bare back whereas the females expressed mixed dressing preferences. The preferred dressing option for the lower body for both males and female respondent was sport shorts (87.5% n = 7; 81.8% n = 18 respectively).

CONCLUSION

The patients' perspective of dignity and draping in a physiotherapy musculoskeletal settings is seen in terms of physical space, the provision of a range of draping options in conjunction with clear communication by their physiotherapist.