Assessment of Patient Dignity in Geriatric Palliative Care

Association between patient dignity and anxiety in geriatric palliative care

“…We previously reported results of a pilot study using Chochinov’s Patient Dignity Inventory 1 in a Geriatric Palliative Care Unit (PCU). 2 While greater dignity-related distress was experienced amongst geriatric PCU patients, the specific PDI items identified as concerns were remarkably consistent with studies of cancer patients across the adult lifespan in community and hospital settings. 3,4 We extend our previous findings with a report on associations amongst dignity-related concerns and clinical severity of mood, anxiety, and physical symptomatology.…”

“…Mean total score on the PDI was 51.7 (SD = 22.5). One-third of the PDI items were rated by patients as being problematic, falling primarily within Dependency (42%), Symptom Distress (38.9%), and Existential Distress (34.6%) domains (see table in the study by Mah et al 2 for mean item ratings). Approximately one-fifth of the patients reported moderate to severe anxiety and depressive symptomatology (HADS score > 11; HADS-A: 19%; HADS-D: 22%).…”

Dignity and patient-centred care for people with palliative care needs in the acute hospital setting: A systematic review

“…A total of 33 papers were included in the final review. Two papers 33,34 involved the same cohort of participants, with results from different perspectives; unless otherwise specified, these papers will be treated as one study. Similarly, the studies by Chochinov et al 35 and Hack et al 36 reported differing analysis of the same cohort/dataset, which will be treated as one study; this gives a total of 31 studies from 33 papers.…”

“…The majority of papers achieved a moderate quality score; one paper 35 was considered to be of high methodological quality. The remaining six papers scored low for methodological quality; in three cases, this was due to the paper being published as a letter to the editor 33,34,38 with limited detail being available. In the other three cases, 49,58,61 insufficient methodological information was provided in the article.…”

“…The PDI may assist in symptom identification and subsequent considerations of the appropriateness of palliative sedation for existential distress. 33,34 However, the nature of existential distress, or spiritual pain, is poorly understood by many healthcare professionals. 71 As the findings identified, this may be particularly so in the acute hospital setting, where specialist palliative care knowledge may not be available, and staff may feel inadequately trained to care for dying patients.…”