Dignity and loss of dignity: Experiences of older women living with incurable cancer at home

Staats, Katrine; Grov, Ellen Karine; Husebø, Bettina S.; Tranvåg, Oscar

doi:10.1080/07399332.2020.1797035

Cited by 23 publications

(39 citation statements)

References 36 publications

(46 reference statements)

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“…Most of the participants were familiar with the research project since their wife/mother/sister had participated in the first part of this project. 19 When carrying out participant observations in the home of the women with cancer, first author K.S. strived to be a natural part of the setting, safeguarded the need for privacy and made use of previous experiences as an oncology nurse.…”

Section: Methodsmentioning

confidence: 99%

“…In a previous study 19 , we documented how older women with incurable cancer perceived having control, experiencing hope and meaningfulness and feeling valued as human beings, to be crucial sources for preserving dignity. We also described how losing self-determination, experiencing violation of their personal lives and feeling worthless, all led to dignity loss.…”

Section: Introductionmentioning

confidence: 99%

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Dignity of older home-dwelling women nearing end-of-life: Informal caregivers’ perception

Staats

Grov²,

Husebø

et al. 2020

Nurs Ethics

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Background: Most older people wish to live in the familiar surroundings of their own home until they die. Knowledge concerning dignity and dignity loss of home-dwelling older women living with incurable cancer should be a foundation for quality of care within municipal healthcare services. The informal caregivers of these women can help increase the understanding of sources related to dignity and dignity loss Aim: The aim of this study was to explore informal caregivers’ perceptions of sources related to dignity and dignity loss in end-of-life of older home-dwelling women with incurable cancer. Research design and method: The study was founded upon Gadamer’s philosophical hermeneutics. In-depth interviews with 13 informal caregivers were carried out, and four participant observations were performed during home meetings. Ethical consideration: The study was based on voluntary participation, informed consent, confidentiality and the opportunity to withdraw at any time. The Norwegian Social Science Data Services approved the study. Results: Three main sources important in preserving the older women’s dignity were identified: maintaining one’s self-concept, remaining hopeful and sustaining freedom of choice. We also identified three main sources that lead to dignity loss: Sensing loss of human value, experiencing absence of gentleness and feelings of being treated as an object. Discussion and final considerations: On the individual level, the opportunity to maintain one’s self-concept and control in life, preserved dignity, while feelings of existential loneliness led to dignity loss. On the relational level, being confirmed as worthy human beings promoted the women’s dignity, whereas dignity loss was related to uncaring behaviours from healthcare professionals. On the societal level, individual decisions concerning travel situations and the place to stay when nearing end-of-life were of crucial importance. Constituting these women’s living space, these perspectives should be emphasized in healthcare professionals’ educational training and in the municipal end-of-life care of these patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dignity of older home-dwelling women nearing end-of-life: Informal caregivers’ perception

Staats

Grov²,

Husebø

et al. 2020

Nurs Ethics

Self Cite

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show abstract

“…Studies have also described that a patient-centered positive approach and a focus on spirituality are factors leading to dignity within institutional care (Bovero et al, 2018;Da Rocha Rodrigues et al, 2019). As gender influences health throughout people's lifespan, we have documented crucial sources enhancing dignity-preserving care seen from the perspective of older women and their informal caregivers (Staats, Grov, Husebø, Tranvåg, 2020a;2020bblinded). We found that having control, experiencing hope and meaningfulness, and maintaining one's self-concept were crucial sources to preserve dignity for older women, while losing self-determination, feeling treated as an object, experiencing violation or an absence of gentleness, all led to dignity loss.…”

Section: Introductionmentioning

confidence: 98%

“…Public narratives and policies often describe the aging population as a societal challenge and a burden due to increasing dependency upon the welfare state (Christensen, 2018). With modern societies making independency a central concept, aging people are easily presented as unwanted in society (Christensen & Waerness, 2021;Staats et al, 2020a). In the 1950s, the main role for a woman was to be a housewife.…”

Section: Introductionmentioning

confidence: 99%

“…During their lives, many women have experienced challenges related to being both a spouse and a caregiver; when being older women, there is a perception that they are still occupying the caregiver role (Holtslander & Duggleby, 2010). When nearing end-of-life, older women themselves prefer a treasured and nurturing environment, with quality of care being more important than the physical place (Staats et al, 2020a). It is therefore crucial to learn more about current healthcare services for older, home-dwelling women nearing end-of-life.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare professionals’ perceptions of dignity-preserving care for older home-dwelling women with incurable cancer in Norway

Staats

Christensen

Grov

et al. 2021

Journal of Women & Aging

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Municipal end-of-life care for older home-dwelling patients with cancer is a complex matter requiring healthcare professionals (HCPs) to recognize gender differences in a social, historical and organizational context. A qualitative approach was chosen to explore and identify HCPs valuebased principles and organizational conditions promoting dignitypreserving care practice for these women. HCPs recognized the importance of sheltering the women's identity, their sense of being home and acknowledged their personal preferences as value-based principles, whereas creating a flexible culture of care, establishing a functional professional collaboration and developing individualized plans of care, were crucial organizational conditions influencing the practice of dignity-preserving care.

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How patients with cancer experience dignity: An integrative review

Xiao

Yan

et al. 2021

Psycho-Oncology

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Background A diagnosis of cancer and its treatments can be associated with a prominent issue of loss of dignity or an undermined sense of dignity for patients. Research is increasingly being conducted into how patients with cancer experience dignity, with the aim to build clinical foundations for care that preserves patients' sense of dignity. Aim This review summarises and synthesises the available empirical literature on the experience of dignity in patients with cancer regarding both the perception of dignity and associated factors. Method An integrative review method was used. A literature search was conducted in 11 databases using the search terms ‘dignity’ OR ‘existential’ OR ‘existentialism’ combined with ‘cancer’. The Mixed Methods Appraisal Tool (version 2011) was adopted to appraise the methodological quality of the included studies. Results Nine qualitative studies and 13 quantitative studies met the selection criteria and were included in the review. The ways that patients with cancer perceived dignity include autonomy/control, respect, self‐worth, family connectedness, acceptance, hope/future and God/religious. Factors associated with dignity include demographics, physical and psychosocial distress, experiences of suffering and coping strategies. Conclusion Dignity‐conserving care should respect patients' human autonomy to strengthen their sense of self‐worth, acceptance, hope, reinforce family connectedness, and foster coping strategies to control the physical, psychosocial factors and experience of sufferings that threaten their sense of dignity.

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Dignity and loss of dignity: Experiences of older women living with incurable cancer at home

Cited by 23 publications

References 36 publications

Dignity of older home-dwelling women nearing end-of-life: Informal caregivers’ perception

Dignity of older home-dwelling women nearing end-of-life: Informal caregivers’ perception

Healthcare professionals’ perceptions of dignity-preserving care for older home-dwelling women with incurable cancer in Norway

How patients with cancer experience dignity: An integrative review

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