A systematic review of patient‐reported dignity and dignified care during acute hospital admission

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.

Methodological quality of dignity‐related patient reported outcome measures used in acute hospital settings: A systematic review using the COSMIN methodology

“…The aim of the current systematic review was to identify PROMs used to measure patient dignity and/or dignified care during acute hospital admission, and to examine their methodological quality using the Consensus‐based Standards for the selection of health Measurement Instruments (COSMIN) methodology for systematic review of PROMs (Mokkink et al, 2018; Prinsen et al, 2018). The study was part of a larger project that synthesised quantitative evidence on levels of patients' dignity and/or dignified care during acute hospitalisation that has been published previously (Fuseini, Ley, et al, 2022).…”

“…Hospitalised patients are at risk for loss of dignity in acute hospital settings that can be stressful and busy environments that limit opportunities for individualised and patient‐centred care (Calnan et al, 2013; Hirshon et al, 2013). Previous studies have reported moderate to severe loss of dignity (Liu et al, 2020; Wang et al, 2019) for patients in acute care settings, with loss of dignity associated with factors including hospitalisation (Chochinov, Hack, Hassard, et al, 2002; Fuseini, Ley, et al, 2022), type of hospital ward (Karimi et al, 2019), patients' functional status (Monforte‐Royo et al, 2018) and demographic variables (Karimi et al, 2019; Salehi et al, 2020). Bláhová et al (2020) posited that care in acute hospital settings is often routinised with a tacit neglect to person‐centred care.…”

Development and psychometric validation of the hospitalized older adults' dignity scale for measuring dignity during acute hospitalization

“…A recent systematic review on patient‐reported dignity during acute hospitalization demonstrates few quantitative studies on hospitalized older adults' dignity and paucity of suitable validated dignity‐related PROMs for hospitalized older adults (Fuseini, Ley, et al, 2022), particularly for the Ghanian population. The few existing dignity‐related PROMs were developed and validated for patients in long‐term care (Dong et al, 2021; Oosterveld‐Vlug et al, 2014; Ostaszkiewicz et al, 2020), end‐of‐life care (Chochinov et al, 2008; Periyakoil et al, 2009; Vlug et al, 2011) or for community‐dwelling older adults (Jacelon & Choi, 2014).…”

The experiences of psychiatric patients, their caregivers and companions in upholding patient dignity during hospitalization: A qualitative study

“…Furthermore, human dignity is unique to each person and is shaped by their relationships with others. Additionally, there is a sense that human dignity is a comprehensive concept that extends beyond the sum of its components 11–13 …”

“…Additionally, there is a sense that human dignity is a comprehensive concept that extends beyond the sum of its components. [11][12][13] Maintaining patient dignity is a fundamental part of providing quality care. 14 Patients recognize dignity as one of the most important aspects of care and make a direct connection between their sense of dignity and respect and the overall quality of their care.…”