Patient dignity in psychiatric nursing practice

Professional nurses have an ethical responsibility to protect and preserve the patients' dignity. The aim of this study was to describe how nurses experienced incidents relating to patients' dignity in a psychiatric nursing practice. A hermeneutic approach was used and data were collected using the critical incident technique. Data included 77 written critical incidents, which were interpreted by using a hermeneutic text interpretation. The findings show preserved dignity--caregivers have the courage to be present, and offended dignity - caregivers create powerlessness taken away by the patient. These findings show that patients' dignity in a psychiatric nursing practice can be preserved when caregivers act on their ethical responsibility. When patients' dignity is offended, the caregiver has become an inner value conflict, something they have been a part of against their own will.     

Patient dignity and its related factors in heart failure patients

Maintenance and promotion of patient dignity is an ethical responsibility of healthcare workers. The aim of this study was to investigate patient dignity and related factors in patients with heart failure. In this qualitative study, 22 patients with heart failure were chosen by purposive sampling and semi-structured interviews were conducted until data saturation. Factors related to patient dignity were divided into two main categories: patient/care index and resources. Intrapersonal features (inherent characteristics and individual beliefs) and interpersonal interactions (communication, respect, enough information, privacy, and authority) were classified as components of the patient/care index category. Human resources (management and staff) and environmental resources (facilities and physical space) were classified as components of the resources category. The results will increase healthcare staff's understanding of patient dignity and its related factors, and provide information regarding the development of systems and processes that support patients in ways that are consistent with these values.     

Patient dignity in an acute hospital setting: a case study

Background

Nurses have a professional duty to respect patients’ dignity. There is a dearth of research about patients’ dignity in acute hospital settings.

Objective

The study investigated the meaning of patient dignity, threats to patients’ dignity, and how patient dignity can be promoted, in acute hospital settings.

Design

A qualitative, triangulated single case study design (one acute hospital), with embedded cases (one ward and its staff, and 24 patients).

Setting

The study was based on a 22-bedded surgical ward in an acute hospital in England.

Participants

Twenty-four patients, aged 34-92 years were purposively selected. There were 15 men and 9 women of varied socio-economic backgrounds. They could all communicate verbally and speak English. Twelve patients, who had stayed in the ward at least 2 days, were interviewed following discharge. The other 12 patients were observed and interviewed on the ward. The ward-based staff (26 registered nurses and healthcare assistants) were observed in practice. 13 were interviewed following observation. Six senior nurses were purposively selected for interviews.

Methods

The data were collected during 2005. The Local Research Ethics Committee gave approval. Unstructured interviews using topic guides were conducted with the 24 patients, 13 ward-based staff and 6 senior nurses. Twelve 4-h episodes of participant observation were conducted. The data were analysed thematically using the framework approach.

Findings

Patient dignity comprised feelings (feeling comfortable, in control and valued), physical presentation and behaviour. The environment, staff behaviour and patient factors impacted on patient dignity. Lack of environmental privacy threatened dignity. A conducive physical environment, dignity-promoting culture and other patients’ support promoted dignity. Staff being curt, authoritarian and breaching privacy threatened dignity. Staff promoted dignity by providing privacy and interactions which made patients feel comfortable, in control and valued. Patients’ impaired health and older age rendered them vulnerable to a loss of dignity. Patients promoted their own dignity through their attitudes (rationalisation, use of humour, acceptance), developing relationships with staff and retaining ability and control.

Conclusion

Patients are vulnerable to loss of dignity in hospital. Staff behaviour and the hospital environment can influence whether patients’ dignity is lost or upheld.     

All about dignity

Inadequate education and training are important factors when patient dignity falls short of expectations, according to a new report.     

Death with dignity

The concept of death with dignity evolves over a nurse's career. A new nurse focuses on the patient as a person. As the nurse gains experience, she facilitates family grieving. As a seasoned professional, the nurse emphasizes the dignity that, through effective nursing, can be restored to dying. Preservation of dignity is found in the way we honor death.