Association between patient dignity and anxiety in geriatric palliative care

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.…”

“…Recognition of existential distress, and appropriate use of sedation in such cases, was considered important. 34 Equally, however, patient sedation as a side effect of palliative analgesia was seen as a barrier to communication and expression of choice, with some staff feeling inadequately trained to cope with dying patients. 39…”

“…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.…”

“…68 Recognition of existential distress, and appropriate use of sedation in such cases, was considered important. 34 Equally, however, patient sedation as a side effect of palliative analgesia was seen as a barrier to communication and expression of choice, with some staff feeling inadequately trained to cope with dying patients. 39 Although privacy for patients was highlighted as a key component of dignified care in many papers, 29,39,46,52 dying alone was also seen as a failing in care in some of the papers under review.…”