Practices in Human Dignity in Palliative Care

Abstract

Respecting and valuing an individual's existential dignity forms the basis of nursing and medical practice and of nursing care. The objective of the study was to determine the approach to human dignity that nurses and physicians have while providing palliative care. This qualitative study was performed using a phenomenological research design. In-depth semistructured interviews were conducted in 9 nurses and 5 physicians with human dignity approach in palliative care. Following the qualitative Colaizzi method of analyzing the data, the statements made by the nurses and physicians during the interviews were grouped under 8 categories. Consistent with the questionnaire format, 8 themes and 43 subthemes of responses were determined describing the human dignity of the nurse and the physicians. The results of the study showed that in some of the decisions and practices of the nurses giving nursing care and physicians giving medical care to palliative care patients, while they displayed ethically sensitive behavior, on some points, they showed approaches that violated human dignity and showed lack of awareness of ethical, medical, and social responsibilities.

How is Dignity Understood and Preserved in Patients with Palliative Needs in the Middle East? An Integrative Review

“…Maintaining Privacy & Secrecy: Paying attention to patients' privacy during care and being considerate of keeping personal information con dential was seen as respecting patients' sense of dignity. Patients and health care providers agree that having a personal space like a private room in the hospital with separation curtains, personal toilet, a decent hospital gown that does not expose body parts, is considered essential to preserving patient dignity (34,(36)(37)(38)(39). Crowded spaces and proximity to other patients that prevent performing basic self-care activities comfortably such as using the bedpan or washing diminish dignity.…”

“…Patients valued communicating hope and considered it superior to truth-telling, even in conditions of poor prognosis (34,36). Blunt disclosure of diagnosis is undesirable by the patients and health care providers with the belief that maintaining a glimpse of hope promotes patient dignity (34,38). Abstaining from talking about the seriousness of the condition and believing in the person's predestined fate, surrendering to God's will, is a coping mechanism to maintain dignity (36).…”

“…The family members helped patients adhere to treatment and lifestyle regimens, nd symptom relief, and seek medical help when needed (45,52). For this reason, effective communication between health care providers and patient/family, that entails conveying explanations about the disease and its management, is regarded as crucial to empower the ill individual in making informed decisions and achieving improved outcomes thereby maintaining dignity (34,39,(45)(46)(47). Patients with chronic conditions desire the social environment to be responsive, engaged and understanding to their social needs to uphold independence, security, and wellbeing.…”

Onkoloji Palyatif Bakım Hemşirelerinin Mesleki Yaşam Deneyimlerinin İncelenmesi

“…Nitel çalışmalar, esnek olabilme ve gerçek yaşam deneyimlerinin derinlemesine, incelenmesine olanak sağlayan çalışmalar olması özelliği ile nicel çalışmalardan ayrılırlar. Fenomenoloji yalnızca bir betimleme değildir, araştırmacının aynı zamanda paylaşılan deneyimlere ilişkin yorum yaptığı bir süreçtir [11][12][13].…”

“…Geçerliği sağlanmaya yönelik adımlar; sonuçların aktarılabilir olması ve izlenen sürecin çalışılan gerçekliği ortaya çıkarmadaki yeterliliğidir [15]. Güvenirlik adımları; araştırma sonuçlarının benzer ortamlarda aynı şekilde elde edilip edilemeyeceği ve başka araştırmacıların aynı veriyi kullanarak aynı sonuçlara ulaşıp ulaşamayacağı ile ilişkilidir [11,16] "Ben genelde burada yaşadıklarımı aileme pek anlatmam, eşime de anlatmam, sadece böyle bazen genç hasta kayıpları olduğunda onunla paylaşıyorum… onların da üzülmesini istemiyorum… genellikle kendi içimde kalıyor" H1 "Çok yakın paylaşımda bulunduğum hastalar var aslında çok yakın bir zaman önce çok genç bir hastamızı kaybettik … mesela o çok etkileyiciydi, işte iki ay kadar oluyor kaybedeli hastayı ama ben hala atamıyorum o duyguyu, kaybettiğimiz zaman hepimiz çok üzüldük hepimiz çok ağladık, zor bir hasta kaybıydı bizim için (katılımcı anlatırken ağladı)" H2 "Duygusal olarak çok etkileniyoruz, özellikle genç çocuklarını kaybeden anne, babaların durumları çok etkiliyor beni." H1,H3, H4.…”