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The experiences of psychiatric patients,their caregivers and companions in upholding patient dignity during hospitalization: A qualitative study
Authors:Amirahmad Shojaei PhD  Yosra Raziani MSc  Colleen Bernstein PhD  Ali Asgari MD  Farshid Alazmani-Noodeh PhD  Mohammadreza Arab MD  Hadi Ranjbar PhD
Affiliation:1. Medical Ethics and History of Medicine Research Center, Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;2. Department of Nursing, Al-Mustaqbal University College, Hillah, Babylon, Iraq;3. Department of Psychology, University of the Witwatersrand, Johannesburg, South Africa;4. Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran;5. Critical Care Nursing Department, Faculty of Nursing, AJA University of Medical Sciences, Tehran, Iran;6. Department of Surgery, School of Medicine, Bam University of Medical Sciences, Bam, Iran;7. Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
Abstract:

Introduction

The quality of care and patient satisfaction is closely linked with dignity, which is a crucial component of therapy and care. However, there is very little study on dignity in the context of mental health care. Planning for ongoing patient care might benefit from an understanding of the notion of dignity by exploring the experiences of patients, caregivers and companions of patients who have a history of hospitalization in mental health institutions. To retain patients' dignity while they were being treated in mental wards, this study sought to understand the experiences of patients, caregivers and companions of patients.

Materials and Methods

This investigation was qualitative. Semistructured interviews and focus groups were utilized to collect the data. The purposeful sampling method was employed for participant recruitment, which continued until data saturation. Two focus group discussions and 27 interviews were conducted. Participants included 8 patients, 2 patients' family members (companions), 3 psychologists, 4 nurses and 11 psychiatrists. Two focus group discussions were held with seven family members or companions of patients. Thematic analysis was used for data analysis.

Results

The primary theme that emerged was the infringement of patients' dignity, through negative guardianship, dehumanization and violations of their rights. Subthemes included dehumanization, worthlessness and namelessness, patient rights violations and stripping patients of authority.

Conclusion

Our results suggest that, regardless of the severity of the illness, the nature of psychiatric illness significantly compromises patients' dignity. Mental health practitioners, due to their sense of guardianship, may unintentionally treat patients with mental health disorders, thus compromising the patient's dignity.

Patient or Public Contribution

The research team's experiences as a psychiatrist, doctor and nurse informed the study's objectives. Nurses and psychiatrists who work in the healthcare industry designed and conducted the study. The primary authors, who are healthcare providers, collected and analysed the required data. Furthermore, the entire study team contributed to the writing of the manuscript. Study participants were involved in the data collection and analysis.
Keywords:dignity  hospitalization  negative guardianship  psychiatric patient
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