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Chapman K, Dixon A, Kendall E, Clanchy K. Defining dignity at the intersection of disability: a scoping review. Disabil Rehabil 2024:1-11. [PMID: 38265032 DOI: 10.1080/09638288.2024.2302582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024]
Abstract
PURPOSE This scoping literature review aimed to determine the definition of dignity in relation to disability. It also examined the extent to which inclusive research methods have been used to develop working definitions. MATERIALS AND METHODS A comprehensive search was conducted in five electronic databases, using a modified framework by Arksey and O'Malley. Narrative synthesis and qualitative content analysis were employed to examine definitions of dignity and the use of inclusive research methods. RESULTS 22 peer-reviewed studies were included. The majority of the studies were qualitative (72.72%) and examined various disability populations in diverse settings. Although 19 studies offered a definition of dignity, there was no clear consensus. Dignity was frequently defined from a utilitarian perspective, emphasising affordances and barriers. However, engagement with theoretical constructs was superficial and limited. Further, no studies mentioned the use of inclusive research methods. CONCLUSIONS The absence of inclusive research methods hinders the development of a comprehensive definition of dignity that is accepted by and relevant to people with disability. Engaging with both theoretical and empirical perspectives of dignity is crucial to develop a meaningful and inclusive definition, which can inform interventions and policies that enhance dignity for people with disability across diverse settings and contexts.
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Affiliation(s)
- Kelsey Chapman
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
| | - Angel Dixon
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
| | - Elizabeth Kendall
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
| | - Kelly Clanchy
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
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Fuseini AG, Rawson H, Redley B, Ley L, Mohebbi M, Kerr D. Self-reported dignity and factors that influence dignity in hospitalised older adults: A cross-sectional survey. J Clin Nurs 2023; 32:7791-7801. [PMID: 37604797 DOI: 10.1111/jocn.16850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/09/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE This study examined levels of self-reported dignity and explored factors expected to influence dignity experienced by older adults during acute hospitalisation in Ghana. BACKGROUND Dignified care has been recognised as inseparable from quality nursing care and maintaining patients' dignity has been highlighted in professional codes of conduct for nurses. However, there is a lack of research on self-reported dignity and the factors that influence the dignity of older adults during acute hospitalisation in Africa. SETTING A large teaching hospital in the northern region of Ghana. PARTICIPANTS Hospitalised older adults. METHODS A cross-sectional survey was used to gather data from a convenience sample of 270 older inpatients, using the Hospitalized Older Adults' Dignity Scale. Data were analysed using descriptive statistics and stepwise ordinal logistic regression to investigate stratified dignity outcomes. The study was reported following the STROBE checklist. RESULTS More than half of the older adults surveyed reported low to moderate levels of dignity. Demographic characteristics such as age, marital status, religious status, occupation, level of education and type of hospital ward did not show any significant associations with dignity levels. However, there was a significant association found between dignity levels and sex and the number of hospitalisations. CONCLUSION Most older adults in a Ghanian hospital experienced loss of dignity during their acute hospitalisation. Male older adults reported higher dignity levels during acute hospitalisation than their female counterparts. Further, older adults who were admitted to hospital for the second time reported less dignity compared to those admitted three or more times. RELEVANCE TO CLINICAL PRACTICE The results emphasise the importance of healthcare professionals having the necessary knowledge and skills to provide gender-sensitive care, which ultimately promotes the dignity of all patients. Additionally, the results underscore the urgency of implementing measures that guarantee patients' dignity during all hospital admissions. PATIENT OR PUBLIC CONTRIBUTION Survey questionnaires were completed by hospitalised older adults at the study setting.
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Affiliation(s)
- Abdul-Ganiyu Fuseini
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Helen Rawson
- Monash Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Bernice Redley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Lenore Ley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Mohammadreza Mohebbi
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
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Laranjeira C. Dignity promotion in people with advanced chronic diseases: contributions for a value-based healthcare practice. Front Public Health 2023; 11:1156830. [PMID: 37575126 PMCID: PMC10415073 DOI: 10.3389/fpubh.2023.1156830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Affiliation(s)
- Carlos Laranjeira
- Department of Nursing Science, School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
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Fuseini AG, Redley B, Rawson H, Ley L, Kerr D. Methodological quality of dignity-related patient reported outcome measures used in acute hospital settings: A systematic review using the COSMIN methodology. J Clin Nurs 2023. [PMID: 36604845 DOI: 10.1111/jocn.16598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/26/2022] [Accepted: 11/23/2022] [Indexed: 01/07/2023]
Abstract
AIMS AND OBJECTIVE The aim of this systematic review was to examine the methodological quality of dignity-related patient reported outcome measures (PROMs) used to measure patients' dignity during acute hospitalisation using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology for systematic review of PROMs. BACKGROUND Previous scoping review studies on the methodological quality of dignity-related PROMs lack specificity for dignity during acute hospital admission. They included PROMs that were developed to measure constructs of care other than patient dignity or designed to measure dignity in contexts outside of the acute hospital setting. STUDY DESIGN A systematic review based on COSMIN methodology. METHODS A systematic search was undertaken using five databases (CINAHL Complete, Medline Complete, EMBASE, PsycINFo and AgeLine) for articles published between 2000 and 2022. Relevant papers were identified using strict adherence to eligibility criteria, and studies that included development of dignity-related PROMs for use in acute hospital settings were selected. Two reviewers independently screened the identified papers, extracted data and examined the quality of studies. RESULTS Six papers met the inclusion criteria. Two PROMs, the 25-item Patient Dignity Inventory and the 34-item Inpatient Dignity Scale, met the COSMIN quality criteria because of their sufficient quality of evidence for content validity and reliable internal consistency. None of the PROMs met the quality criteria for assessment of measurement error, criterion validity, cross-cultural validity and responsiveness. CONCLUSION We recommend the Patient Dignity Inventory and the Inpatient Dignity Scale as the PROMs of choice for evaluating patients' dignity and/or dignified care during acute hospital admissions. These PROMs were developed using robust procedures with sufficient overall quality for content validity, internal consistency reliability and other measurement properties, and with moderate to high quality of evidence for these measurement properties. Researchers and clinicians who wish to use other dignity-related PROMs identified in this review should consider the methodological limitations of these PROMs, as highlighted in the present systematic review. RELEVANCE TO CLINICAL PRACTICE The review findings will guide healthcare professionals about their choice of patient reported outcome measures for evaluating patients' dignity or dignified care during acute hospitalisation.
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Affiliation(s)
- Abdul-Ganiyu Fuseini
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Bernice Redley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Helen Rawson
- Monash Nursing and Midwifery, Monash University, Victoria, Melbourne, Australia
| | - Lenore Ley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
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Fuseini A, Ley L, Rawson H, Redley B, Kerr D. A systematic review of patient-reported dignity and dignified care during acute hospital admission. J Adv Nurs 2022; 78:3540-3558. [PMID: 35841334 PMCID: PMC9795980 DOI: 10.1111/jan.15370] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/13/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
AIMS To synthesize quantitative evidence on levels of dignity during acute hospital admission and identify barriers and facilitators to patients' dignity or dignified care from the perspective of hospitalized patients. The secondary aim was to examine the relationship between dignity and demographic, clinical and psychological characteristics of patients. DESIGN A systematic review based on the protocol of the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline for reporting systematic reviews. DATA SOURCES Five electronic databases (PubMed, CINAHL, Embase, PsycINFO, AgeLine) were searched in February 2021, followed by backward-forward searching using Web of Science and Scopus databases. REVIEW METHODS Potentially eligible articles were scrutinized by two reviewers. Articles that met the eligibility criteria were appraised for quality using the Critical Appraisal Tool for Cross-Sectional Studies. Two reviewers extracted data for the review and resolved differences by consensus. RESULTS Out of 3052 potentially eligible studies, 25 met the inclusion criteria. Levels of dignity for hospitalized patients vary widely across geographic locations. Patients' dignity is upheld when healthcare professionals communicate effectively, maintain their privacy, and provide dignity therapy. Patients' perceptions of dignity were, in some studies, reported to be associated with demographic (e.g. age, marital status, gender, employment, educational status), clinical (e.g. hospitalization, functional impairment, physical symptoms) and psychological (e.g. depression, anxiety, demoralization, coping mechanisms) variables whilst other studies did not observe such associations. CONCLUSION Patients in acute care settings experience mild to a severe loss of dignity across different geographic locations. Patients' dignity is influenced by several demographic, clinical and psychological characteristics of patients. IMPACT The findings of the review support impetus for improvement in dignified care for hospitalized patients, addressing factors that facilitate or impede patients' dignity. Measures aimed at alleviating suffering, fostering functional independence and addressing patients' psychosocial needs can be used to promote dignity.
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Affiliation(s)
- Abdul‐Ganiyu Fuseini
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and MidwiferyDeakin University, Geelong Waterfront CampusGeelongVictoriaAustralia
| | - Lenore Ley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and MidwiferyDeakin University, Geelong Waterfront CampusGeelongVictoriaAustralia
| | - Helen Rawson
- Nursing and Midwifery, Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneVictoriaAustralia
| | - Bernice Redley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and MidwiferyDeakin University, Geelong Waterfront CampusGeelongVictoriaAustralia
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and MidwiferyDeakin University, Geelong Waterfront CampusGeelongVictoriaAustralia
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Tehranineshat B, Rakhshan M, Torabizadeh C, Fararouei M, Gillespie M. The dignity of burn patients: a qualitative descriptive study of nurses, family caregivers, and patients. BMC Nurs 2021; 20:205. [PMID: 34686167 PMCID: PMC8539828 DOI: 10.1186/s12912-021-00725-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/04/2021] [Indexed: 11/10/2022] Open
Abstract
Background As an ethical principle, showing respect for human dignity is a professional duty of all nurses. The aggressive nature of severe burn injuries makes it hard to respect the existential values and dignity of burn patients. However, only a few studies have been conducted on the preservation of the dignity of burn patients. The purpose of this study is to identify and describe burn patients’ dignity as perceived by nurses, family caregivers, and burn patients. Methods The present study has a descriptive, qualitative research design. Nurses, family caregivers and patients in the biggest burns hospital in the south of Iran were selected via purposeful sampling from October 2017 to August 2018 (n = 25). Data were collected using semi-structured, in-depth, individual interviews. Thereafter, data analysis was performed through conventional content analysis. Results Three main themes were extracted from the information obtained in the interviews: empathic communication, showing respect, and providing comprehensive support. Conclusion The care provided to burn patients should be combined with effective communication, spending time with them, and attending to their repetitive requests, so that they can freely express their feelings and concerns. In addition, the patients’ human values and beliefs should be respected and all aspects of their existence should be taken into account to preserve their dignity. Workshops designed based on the findings of the present study can help with improving the quality of burn nursing care. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00725-w.
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Affiliation(s)
- Banafsheh Tehranineshat
- Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Camellia Torabizadeh
- Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mark Gillespie
- School of Health Nursing and Midwifery, University of the West of Scotland, Paisley, Scotland, UK
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Dakessian Sailian S, Salifu Y, Saad R, Preston N. Dignity of patients with palliative needs in the Middle East: an integrative review. BMC Palliat Care 2021; 20:112. [PMID: 34271909 PMCID: PMC8285813 DOI: 10.1186/s12904-021-00791-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/03/2021] [Indexed: 12/31/2022] Open
Abstract
Background Patients with palliative needs experience high psychological and symptom distress that may lead to hopelessness and impaired sense of dignity. Maintaining patient dignity or the quality of being valued is a core aim in palliative care. The notion of dignity is often explained by functionality, symptom relief and autonomy in decision making. However, this understanding and its implications in Middle Eastern countries is not clear. The aim of this review is to 1) explore the understanding of dignity and how dignity is preserved in adult patients with palliative care needs in the Middle East 2) critically assess the findings against the Dignity Model dominant in western literature. Method Using an integrative review we searched four databases EMBASE, Psych-Info, CINAHL, and PubMed. These databases retrieve a broad literature on palliative care and are often chosen in other palliative care reviews. To enhance the search strategy, three online journals were hand searched, reference lists of review papers scanned, and forward citations sought. No time limits were applied. The retrieved papers were assessed independently by two authors including quality assessment using the Hawker’s appraisal tool. Results Out of the 5113 studies retrieved, 294 full texts were assessed. Sixteen studies were included for synthesis of which fourteen were published in Iran. Seven themes were developed after data analysis: Maintaining Privacy and Secrecy; Gentle communication with a dialogue that preserves hope instead of blunt truth-telling; Abundance characterised by accessibility to medical supplies and financial stability; Family Support where relatives deliver major assistance in care; Physical Fitness; Reliable health care, and Social justice that endorses equal care to all. Conclusion The results are compatible with the existing evidence from the Dignity Model ascertaining that dignity is socially mediated and influenced by interactions and physical fitness. Nevertheless, the findings highlight that patient dignity is also shaped by the socio-political, cultural, and economic conditions of the country, where family support, gentle communication and accessible health care are essential elements.
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Affiliation(s)
- Silva Dakessian Sailian
- American University of Beirut, Hariri School of Nursing, Riad El Solh, PO Box: 11 0236, Beirut, 1107 2020, Lebanon.
| | - Yakubu Salifu
- International Observatory on End of Life Care, Division of Health Research, Faculty of Health and Medicine, Sir John Fisher Drive, Lancaster University, Lancaster, LA1 4YW, UK
| | - Rima Saad
- American University of Beirut, Hariri School of Nursing, Riad El Solh, PO Box: 11 0236, Beirut, 1107 2020, Lebanon
| | - Nancy Preston
- International Observatory on End of Life Care, Division of Health Research, Faculty of Health and Medicine, Sir John Fisher Drive, Lancaster University, Lancaster, LA1 4YW, UK
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Bagnasco A, Zanini M, Dasso N, Rossi S, Timmins F, Galanti MC, Aleo G, Catania G, Sasso L. Dignity, privacy, respect and choice-A scoping review of measurement of these concepts within acute healthcare practice. J Clin Nurs 2020; 29:1832-1857. [PMID: 32220088 DOI: 10.1111/jocn.15245] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/23/2020] [Accepted: 03/12/2020] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES To synthesise and review literature related to instruments that measure psychosocial aspects of fundamental care in acute hospital care settings. BACKGROUND Psychosocial aspects of care often receive less priority in terms of care provision in acute care environments. At the same time, if these elements are overlooked, there may be consequences. Despite the availability of many instruments designed to measure specific aspects of care, these concepts are often not studied within the broader context of fundamentals of care, but rather coexist as isolated explorations of specific subelements. DESIGN A scoping review was conducted, based on Arksey & O'Malley's (2005) methodological framework and following the PRISMA checklist. METHODS Using the five recommended steps-identifying the research question; identifying relevant studies; study selection; charting the data; and summarising and reporting the results-three databases were searched: MEDLINE/PubMed, CINAHL and EMBASE, in February 2019. RESULTS Following independent screening by two of the authors, 48 papers were included. From these 48 papers, 33 instruments were identified. Only five of these tools thoroughly assessed psychosocial aspects elements of care (dignity, respect, privacy and patients' choice) through dedicated items. CONCLUSIONS This review provides nurses with a synthesis of 33 instruments that assess the psychosocial aspects of care. This provides an important resource to guide measurement of dignity, respect, privacy and patients' choice. The findings also provide guidance to future research in this field. RELEVANCE TO CLINICAL PRACTICE This paper reviews and synthesises these instruments to provide a resource to nurses to inform their decisions and practice around measurement and evaluation of these key aspects of care. This provides a useful guide to measure and monitor the improvement of fundamental care delivery in practice and points to strengths and weaknesses of the instruments concerned.
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Affiliation(s)
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Nicoletta Dasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Rossi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | | | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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“A montanha-russa da insuficiência cardíaca”: a percepção de dignidade pelas equipes de enfermagem. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ao0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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