Maintaining dignity for residents of care homes: A qualitative study of the views of care home staff,community nurses,residents and their families

This study uses the Framework approach to qualitative analysis to explore and compare the views of residents in care homes for older people, their families and care providers on maintaining dignity. We interviewed 33 care home managers, 29 care assistants, 18 care home nurses, 10 community nurses, 16 residents and 15 members of residents' families. The most prevalent themes were: “independence,” and “privacy”; followed by “comfort and care,” “individuality,” “respect,” “communication,” “physical appearance” and “being seen as human.” Residents and their families sometimes described incidents where a resident's dignity had been compromised. How to help residents maintain dignity and focusing on fostering dignity, can be a starting point for improving the quality of care and quality of life of residents. It is, however, important to remove the gap between the rhetoric of dignity conserving care and the reality experienced by residents in these and other care settings.     

Dignity: A unifying concept for Palliative Care and human rights

Abstract

The concept of human dignity is complex. Its meaning and emphasis have shifted over time. It is a concept that occupies a central place in two disciplines – palliative care and human rights law. This article examines the evolution of the meaning of dignity, the nature of intrinsic and extrinsic dignity and its place in palliative care and human rights law (especially as it pertains to the international right to health care). The thesis of this article is that the recognition of and response to the inherent dignity of the human person is a unifying concept for the two disciplines and forms part of the theoretical foundation of the assertion that palliative care is a fundamental human right.     

Le don de produits du corps humain : aspects philosophiques et éthiques

In continental Europe, there is a very strong moral condemnation against putting parts or products of the human body on sale–and, consequently, against putting sperms and oocytes on sale. Only a gift is morally permissible. The situation is different in Anglo-Saxon countries. Who is right? Above all, it must be noticed that two views of the human body are facing each other here: for the first, the human body is a part of the person (so, it partakes of the person's dignity), whereas for the second, the human body is a possession of the person (the person is the owner of his/her body). In my opinion, the argument of dignity comes up against serious objections, and the property argument is more consistent. However, it does not follow that it would be judicious to put parts and products of the human body for sale on a market.     

从临终关怀的角度看预先指示

预先指示是指有决定能力的患者对自身将来丧失表意能力时接受何种医疗照护而事先做出的一种安排和指示。预先指示在国外随着临终关怀的发展而出现，在当前中国的文化背景下，其应用和发展也更具有现实意义。     

The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care

Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and spiritual distress are often overlooked. The aim of this study was to test a novel psychometric—the Patient Dignity Inventory (PDI)—designed to measure various sources of dignity-related distress among patients nearing the end of life. Using standard instrument development techniques, this study examined the face validity, internal consistency, test–retest reliability, factor structure and concurrent validity of the PDI. The 25-items of the PDI derive from a model of dignity in the terminally ill. To establish its basic psychometric properties, the PDI was administered to 253 patients receiving palliative care, along with other measures addressing issues identified within the Dignity Model in the Terminally Ill. Cronbach's coefficient alpha for the PDI was 0.93; the test–retest reliability was r = 0.85. Factor analysis resulted in a five-factor solution; factor labels include Symptom Distress, Existential Distress, Dependency, Peace of Mind, and Social Support, accounting for 58% of the overall variance. Evidence for concurrent validity was reported by way of significant associations between PDI factors and concurrent measures of distress. The PDI is a valid and reliable new instrument, which could assist clinicians to routinely detect end-of-life dignity-related distress. Identifying these sources of distress is a critical step toward understanding human suffering and should help clinicians deliver quality, dignity-conserving end-of-life care.     

An urban geography of dignity

This paper uses the phenomenon of dignity as a lens through which to explore the relationship between cities and the health of people living in them. We describe a “taxonomy of dignity,” developed using grounded theory, that explicates the social processes and contexts of dignity violation and dignity promotion. We then explore two intersections at which the urban setting and the dignity experience meet: the quest for resources and places and spaces. Finally, we posit that social and spatial processes of dignity violation and promotion constitute mechanisms through which the city affects mental and physical health.     

生命尊严视域下的医患伦理

依据生命尊严的深刻内涵和现实意义对医患关系进行剖析,认为对医患伦理的思考应着眼于生命尊严这一核心概念,在生命尊严的视域下进行综合考察。着眼于此,逐步体现对生命更高意义上的尊重和爱护,科学地构建现时代医学伦理学思想的新篇章。     

Dignity and respect in midwifery education in the UK: A survey of Lead Midwives of Education

In the UK respect, dignity and compassion are the underpinning values which must determine service user care in the National Health Service (NHS). In midwifery education it is unclear how students are being taught these values. We created a study that aimed to explore how learning about dignity and respect is facilitated and assessed within pre-registration midwifery curricula. An online survey was devised and distributed to all Lead Midwives for Education in the UK. The findings are presented under the three main themes of understanding the meaning of dignity and respect, teaching and assessment and experiences. The study concludes that, though there are some good areas of education practice there is inconsistency in how Nursing and Midwifery Council (NMC) guidelines are transferred into curricula. This leads to students receiving differing emphasis of education on the values of dignity and respect.