Threats to patient dignity in clinical care settings: A qualitative comparison of Indonesian nurses and patients

Abstract

Aims and objectives To explore and compare nurses’ and patients’ viewpoints of disrespectful behaviours that threaten patient dignity during hospitalised care. Background Patient's dignity is an important ethical consideration for nursing care practice. In clinical settings, nurse–patient interactions can generate behaviour considered disrespectful and undignified, often due to a disruptive hospital atmosphere and emotional frustrations of nurses and patients. How behaviours and attitudes threaten patient dignity in Indonesian clinical care settings has not been well studied. Design Qualitative descriptive study. Methods This multi‐site study purposively recruited nurses and inpatients from six public hospitals in four districts in Eastern Java, Indonesia. Individual, face‐to‐face semi‐structured interviews were conducted with 35 inpatients and 40 registered nurses from medical and surgical wards. Data from verbatim transcriptions of digital audio recordings were analysed with inductive content analysis. The COREQ checklist for qualitative research was used for reporting this study. Results Five categories emerged which described disrespectful behaviours that threaten patient dignity. Three categories were important for both nurses and patients: negligence, impoliteness and dismissal. Descriptions of the behaviours were comparable for both groups. The forth category, inattentiveness, was highlighted by nurses, while the fifth category, discrimination, was highlighted by patients. Conclusions Examining behaviours considered to be disrespectful in an Indonesian healthcare setting expand on perspectives towards dignity in care. The comparable viewpoints of nurses and patients provide knowledge of how undignified behaviours could be reduced in cross‐cultural healthcare settings. Behaviours perceived as undignified primarily by nurses or patients might result from differences in social roles and responsibilities. Relevance to clinical practice Understanding nurses’ and patients’ perspectives of undignified care is an important step in reducing behaviours that violate patient dignity in clinical practice. Nurses’ commitment to patient‐centred care should include being responsive, compassionate, communicative and attentive, which could ameliorate instances of undignified behaviours.

Patient dignity and dignified care: A qualitative description of hospitalised older adults perspectives

“…The participants also linked unprofessional nurses’ attitudes to loss of dignity, reporting that when nurses and other HCPs were insensitive to their sufferings, or paid little attention to their needs they felt less regarded as humans. Consistent with this finding, Asmaningrum et al (2020) found that inattentiveness to patient needs and failure to monitor patients’ progress do not only affect quality of care, but also threaten patients’ dignity. Delays in accessing healthcare services was also cited as a barrier to dignity in our study.…”

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

“…Delay in response to patients' needs, increased frequency of treatment errors, exposure to violence and overcrowding, are some of the experiences of patients in emergency departments (Morley et al, 2018), that have the tendency to undermine dignity (Asmaningrum et al, 2020).…”

“…Levels of dignity also differed based on the type of hospital ward, with the highest dignity in ICU and ENT wards and lowest dignity in emergency surgical and female surgical wards. Delay in response to patients' needs, increased frequency of treatment errors, exposure to violence and overcrowding, are some of the experiences of patients in emergency departments (Morley et al, 2018 ), that have the tendency to undermine dignity (Asmaningrum et al, 2020 ).…”

The Healthcare Needs of International Clients in China: A Qualitative Study

“…Nurses’ responsive, compassionate, communicative and attentive behaviors could promote clients’ perceived respectfulness from the healthcare professionals in cross-cultural healthcare settings. 40 Therefore, healthcare professionals should respect and trust international clients without any forms of discrimination or injustice. At the studied hospital, mutual respect between doctors, nurses and patients was emphasized to build a warm atmosphere and provide high-quality services.…”