Abstract:The delivery of palliative care in the community setting has been recognized as a valued and challenging aspect of nursing care. To this end, care pathways have been shown to support nurses in a variety of settings to deliver individualized patient care. This study provides a qualitative evaluation of an end-of-life intervention known as the Dignity Care Intervention (DCI) based on patients' perspectives. The DCI consists of four sections: a manual, the Patient Dignity Inventory, reflective questions, and evid… Show more
“…Due to the lack of concrete communication outcomes in this review, an exploration of communication must in the future receive more attention and must be given equal emphasis in care and research. Not evaluating this outcome could jeopardize the delivery of high-quality care, as communication skills are required for dignity-conserving care (Johnston et al, 2017b).…”
Section: Palliative and Supportive Care 15mentioning
Objectives. With people living longer, palliative care may be required for lengthier periods of time. This puts demands on healthcare organizations to provide optimal palliative care. Maintaining dignity is central for any person's health and quality of life, but especially for a person with palliative care needs. Dignity-conserving care needs to be evaluated to increase knowledge about outcomes and how to assess these. The purpose of this integrative review was to identify outcomes studied within dignity-conserving care and how these have been operationalized.Methods. An integrative review was conducted in 26 quantitative or mixed-method studies and study protocols. Thematic synthesis with an abductive approach was used for analysis. Results. Seven themes of studied outcomes were identified, as well as four cluster themes: themes related to Illness-Related Concerns, themes related to the Dignity-Conserving Repertoire, themes related to the Social Dignity Inventory, and themes regarding Overarching Dignity Issues. Most outcomes studied dealt with Illness-Related Concerns within the themes of "Performance, symptoms and emotional concerns" and "End-of-life and existential aspects". Themes linked to the Social Dignity Inventory had the lowest number of outcomes studied. Outcomes regarding overarching dignity issues such as "Dignity-related distress" and "Quality of life" were common. However, the results lacked concrete communication outcomes. Significance of results. The results will underpin future research in which dignity-conserving care is implemented and evaluated, and contribute to the provision of evidence-based palliative care. A greater focus on outcomes within cluster themes related to the Dignity-Conserving Repertoire and the Social Dignity Inventory is needed, as is more focus on communication outcomes.
“…Due to the lack of concrete communication outcomes in this review, an exploration of communication must in the future receive more attention and must be given equal emphasis in care and research. Not evaluating this outcome could jeopardize the delivery of high-quality care, as communication skills are required for dignity-conserving care (Johnston et al, 2017b).…”
Section: Palliative and Supportive Care 15mentioning
Objectives. With people living longer, palliative care may be required for lengthier periods of time. This puts demands on healthcare organizations to provide optimal palliative care. Maintaining dignity is central for any person's health and quality of life, but especially for a person with palliative care needs. Dignity-conserving care needs to be evaluated to increase knowledge about outcomes and how to assess these. The purpose of this integrative review was to identify outcomes studied within dignity-conserving care and how these have been operationalized.Methods. An integrative review was conducted in 26 quantitative or mixed-method studies and study protocols. Thematic synthesis with an abductive approach was used for analysis. Results. Seven themes of studied outcomes were identified, as well as four cluster themes: themes related to Illness-Related Concerns, themes related to the Dignity-Conserving Repertoire, themes related to the Social Dignity Inventory, and themes regarding Overarching Dignity Issues. Most outcomes studied dealt with Illness-Related Concerns within the themes of "Performance, symptoms and emotional concerns" and "End-of-life and existential aspects". Themes linked to the Social Dignity Inventory had the lowest number of outcomes studied. Outcomes regarding overarching dignity issues such as "Dignity-related distress" and "Quality of life" were common. However, the results lacked concrete communication outcomes. Significance of results. The results will underpin future research in which dignity-conserving care is implemented and evaluated, and contribute to the provision of evidence-based palliative care. A greater focus on outcomes within cluster themes related to the Dignity-Conserving Repertoire and the Social Dignity Inventory is needed, as is more focus on communication outcomes.
“…Community nurses in Scotland and Ireland have found that the DCI helps them identify the dignity-related needs of their patients and provides a holistic, person-centred care at the end-of-life [16, 23]. Patients have also described that the DCI enables them to engage in dialogues with their community nurses about important issues that they might not otherwise raise [24]. Fig.…”
Section: Introductionmentioning
confidence: 99%
“…The DCI consists of several components [24]. The DCI provides an education programme and instructional manual for its implementation.…”
Section: Introductionmentioning
confidence: 99%
“…Finally, suggestions of specific care actions– to conserve the patient’s dignity in relation to identified concerns – are used in accordance with the patient’s preferences. The circle of care is continued by the reuse of the PDI and reflective questions to evaluate the response to care actions and to identify potential new issues requiring care actions [24].…”
BackgroundAn essential aspect of palliative care nursing is to conserve the dignity of the patient. A Dignity Care Intervention (DCI) has been developed in Scotland to facilitate this role for nurses. The DCI is now being adapted to a Swedish context (DCI-SWE) and a central step is to identify culturally relevant, dignity-conserving care actions. These care actions will be incorporated into the DCI-SWE. Therefore, the aim of this study was to suggest care actions for conserving dignity in palliative care from the perspectives of the patients, significant others (SOs), and health care professionals (HPs) in municipality care in Sweden.MethodsThis study used a descriptive design with a qualitative approach. Data from 20 participants were collected through semi-structured individual interviews with patients (n = 3), SOs (n = 4), two focus groups with nurses (n = 9) and one focus group with physicians (n = 4) in two Swedish municipalities. These data were deductively analysed using qualitative content analysis with the Chochinov model of dignity as framework.ResultsWith the Chochinov model of dignity as a framework, care actions based on suggestions from the participants were identified and presented under three themes: Illness related concerns, Dignity conserving repertoire, and Social dignity inventory. The study found both specific concrete care actions and more general approaches. Such general approaches were found to be relevant for several dignity related issues as all-embracing attitudes and behaviours. However, these general approaches could also be relevant as specific care actions to conserve dignity in relation to certain issues. Care actions were also found to be linked to each other, showing the importance of a holistic perspective in conserving dignity.ConclusionsAs part of the adaption of the DCI from a Scottish to a Swedish context, this study added relevant care actions for collaborative planning of individualised care in mutual dialogues between nurses and those they care for. The adapted intervention, DCI-SWE, has the potential to help the nurses in providing palliative care of evidence-based quality.
“…Publicly, to preserve their socially identified gender role and the traditional portrayals of men's masculine traits as active and energetic occasionally interrupted their adherence to therapeutic regimen. According to Johnston et al (), conserving the sense of normality is a way patients adapt to illness to feel in control to maintain their dignity.…”
Aim
The aim of this study was to explore the perception and understanding of men with type 2 diabetes about their illness control, risk for CVD and their adherence to healthcare management plans in Jordan.
Design
A qualitative descriptive design was used, recruiting a purposive sample of 13 men diagnosed with type 2 diabetes.
Methods
Data were collected between February and April 2019 through in‐depth semi‐structured interviews and analysed using content analysis.
Results
Data analysis revealed four themes: (a) Perception of diabetes control; (b) Perception of cardiovascular disease risk; (c) Coping with disease‐imposed limitations; and (d) Information validation.
Conclusion
The study concludes that the perception of disease control does not necessarily coincide with actual disease control. Examining patients with diabetes perception and knowledge of their healthcare management and increased CVD risks is essential. An individualized culture and gender‐sensitive health education and counselling involving spouses are recommended. Social media to disseminate scientific valid health instructions can enhance adherence.
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