Concept analysis of dignity‐centered care for people with chronic progressive disease

Abstract

Aim This concept analysis describes attributes, antecedents, and consequences of dignity‐centered care for people with chronic progressive disease. Methods Rodgers' method of concept analysis was used to clarify the concept's defining attributes. Databases searched were PubMed, MEDLINE, EMBASE, CINAHL, and Ichushi‐Web by NPO Japan Medical Abstracts Society, in English and Japanese, from 1976 to 2017. The combination of MESH and keywords used were (dignity), and (care), and (chronic disease) or (chronic illness). Results Three antecedents were identified: loss of physical function and reduced psychological capacity, independence and role; living with uncertainty of illness; and multi‐faceted distress. There were four attributes identified: bolstering self‐esteem, reducing multi‐faceted distress, continued relationship, and protecting individual's rights. Four consequences were identified: improved self‐esteem, relief from multi‐faceted distress, deepening the purpose and meaning of life, and maintaining and/or improving the quality of life. Conclusion Dignity‐centered care is defined as: care that results in improvement of self‐esteem, deepens purpose and meaning of life, maintains and improves quality of life and provides relief from multi‐faceted distress. This happens through protecting the individual's rights, bolstering self‐esteem and reducing multi‐faceted distress through continued relationships with family, friends, and providers. There is a need for continued involvement with those individuals who have lost physical function, psychological capacity, autonomy, and role. They live with uncertainty of illness and exhibit multi‐faceted distress. This concept is a fulcrum for patient and nurse reciprocity enabling both to realize greater integrity and respect, and is useful for nursing practice and research.

Sunkiomis ir nepagydomomis ligomis sergančių asmenų orumo apsaugos reikalavimas – tarptautinės ir nacionalinės teisės normos bei praktiniai jų taikymo aspektai

“…33 Tokio pobūdžio pagalba yra orumą puoselėjančios pagalbos esmė. 34 Vis tik pastebima, kad Lietuvoje dėl nepakankamo finansavimo trūksta paliatyviosios pagalbos lovų, ypač mažuosiuose regionuose, atitinkamai, nėra sąlygų tinkamai organizuoti efektyvios specialistų komunikacijos ir komandinio darbo -Rekomendacijose įvardijamų kaip itin svarbių paliatyviosios pagalbos aspektų, bei teikti paliatyviąją pagalbą namuose. Įvairios asociacijos ir draugijos viešina šias problemas ir skatina valstybės institucijas pripažinti paliatyviosios pagalbos paslaugų būtinybę, tinkamai finansuoti ir plėtoti šią sritį.…”

Development and applicability of a dignity‐centred palliative care programme for people with idiopathic pulmonary fibrosis: A qualitative‐driven mixed methods study

“…A concept analysis of dignity based on Rodgers's evolutionary method of concept analysis (Rodgers & Knafl, 2000 ) revealed the relevance of addressing self‐esteem as part of dignity‐centred palliative care (Igai, 2020 ). Self‐esteem includes components of how one feels about one's self and how others view one; in other words, it is a perception of one's self not necessarily a reality.…”

“…From the afore‐mentioned concept analysis (Igai, 2020 ), a conceptual framework was developed that provided “interlinked concepts” for a comprehensive understanding (Jabareen, 2009 ) (see Figure 1 ). The conceptual framework for dignity‐centred palliative care included patients' needs, role of the nurse, nursing actions and patient outcomes.…”

“…Patients' needs were as follows: (a) a need for nurses' continued involvement because of lost physical function, (b) maintain psychological capacity and (c) retain autonomy. The nurse' role in dignity‐centred care included four actions: protecting the individual's rights, bolstering self‐esteem, reducing multifaceted distress and supporting continued relationships with family, friends and providers (Igai, 2020 ) (see Tables 1 and 2 ). Nursing actions aimed to improve patient's self‐esteem, relieve multi‐faceted distress, assist patient to deepen the purpose and meaning of life, and maintain or improve patient's quality of life.…”

Psychosocial Factors and Chronic Illness as Predictors for Anxiety and Depression in Adolescence

“…The literature has highlighted how adequate self-esteem and social support can buffer the emotional distress associated with the CD (Igai, 2020). Similarly, it has been pointed out how emotional regulation skills can facilitate the adjustment of adolescents with CD (Trindade et al, 2017;Finlay-Jones et al, 2020) psychosocial risk and protective variables are critical to the medical and psychological adjustment of adolescents with CD, as emotional or personal difficulties can impact the control of CD, worsening the course and outcome of the disease (Kenowitz et al, 2020;Valero-Moreno et al, 2020).…”