Evaluating a dignity care intervention for palliative care in the community setting: community nurses’ perspectives

McIlfatrick, Sonja; Connolly, Michael; Collins, R; Murphy, Tara; Johnston, Bridget; Larkin, Philip

doi:10.1111/jocn.13757

Cited by 23 publications

(28 citation statements)

References 44 publications

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“…As such, the DCI covers a range of dignity-related concerns, including physical, psychological, social, and existential issues. 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].…”

Section: Introductionmentioning

confidence: 99%

“…Multiple types of input were used because effective, evidence-based nursing should be drawn from a range of sources [28]. The use of DCI has been studied in Scotland and Ireland [16, 23, 24] but not yet in Sweden as no Swedish version exists. We are currently adapting the DCI to fit a Swedish context, following a similar method approach as where it was developed, with the addition of language translation.…”

Section: Introductionmentioning

confidence: 99%

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How to conserve dignity in palliative care: suggestions from older patients, significant others, and healthcare professionals in Swedish municipal care

et al. 2019

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

How to conserve dignity in palliative care: suggestions from older patients, significant others, and healthcare professionals in Swedish municipal care

et al. 2019

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“…Palliative care is progressively documented as an important community service for end‐of‐life patients (Guo & Jacelon, ; Pringle, Johnston, & Buchanan, ), and palliative care nurses play a primary role in assisting care recipients (Johnston et al, ; McIlfatrick et al, ). Hence, nurses’ engagement and organisational commitment are pivotal to attentive caring for end‐of‐life patients (Freeney & Tiernan, ).…”

Section: Relevance To Clinical Practice: Nurses’ Work Engagement To Hmentioning

confidence: 99%

Nursing’s professional dignity in palliative care: Exploration of an Italian context

Stıevano¹,

Sabatino²,

Affonso³

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To determine the relevance of nursing's professional dignity in palliative care. Background Dignity is a valued concept in the ethical discourse of health disciplines. Nursing's professional dignity, a concept related to professional identity, is not clearly defined nor have its characteristics been delineated for its clinical relevance in palliative care. Design A qualitative methodological approach. Methods Focus groups elicited dialogues of nursing's professional dignity among 69 nurses working in hospices and home‐care in Italy. Data were content‐analysed via an inductive process. The COREQ checklist for qualitative studies was used for reporting this research. Results A central theme related to (a) “Intrinsic dignity of persons” was embedded in the essence of palliative care. Several corollary themes underscored this central theme: (b) Professional (intra‐ and inter) relationships and teamwork; (c) Nursing professionalism; (d) Ethical dilemmas; and (e) Relationships with patients and their significant persons. Conclusions Nurses valued the essence of respect as persons and the essence of respect for their work as coherent with intrinsic dignity and work dignity in palliative care. Nurses perceived their psycho‐social relationships with patients and their families as rewarding incentives amidst disputatious interactions with peers and/or other healthcare professionals. They experienced ethical dilemmas, which they perceived as inherent in palliative care. Relevance to clinical practice Study findings corroborate the literature regarding the concept of nursing's professional dignity which is intrinsic in respect of the human person. The intrinsic dignity in palliative care manifests as nurses are working in juxtaposition of a demanding yet rewarding care ambience.

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“…He was aware of his illness and adverse prognosis and often discussed these issues with a psychologist. A strong and well-established relationship with the therapist was deemed an essential factor in discussing the end-of-life issues with the patient [4].…”

Section: Case Reportmentioning

confidence: 99%

Application of dignity therapy in an advanced cancer patient — wider therapeutic implications

et al. 2019

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Aim: Dignity therapy is a short-term, individualized, patient-focused form of therapy reducing stress and helping both the patient and his family appreciate the end-of-life situation. The present study describes the impact of dignity therapy on an advanced cancer patient within a Polish hospital setting. Methods: MH. Chochinov's dignity therapy protocol was applied. A session was conducted during which an interview with the patient was recorded; subsequently subjected to a statistical analysis. The competent judges' approach was used to effectively preclude subjective interpretation of the patient's statement by an investigator. The judges' appraisal was then checked for concordance (W Kendall). The patient was also asked to complete a survey questionnaire designed to assess the therapeutic effectiveness of dignity therapy in the intervention. Results: The patient indicated that family epitomized the most crucial values. He also highlighted other issues, i.e. his work and life's passion -playing the drums. The survey questionnaire indicated that by far the greatest benefit consisted in an overall improvement of his mental well-being (4.67). Benefits for the family followed (4), including his hope for recovering family ties (4). An unexpected therapeutic effect consisted in re-establishing a broken relationship with his daughters. Conclusions: Dignity therapy proved effective not only as a method of enhancing the patient's own sense of dignity in the face of impending death but also tangibly instrumental in overcoming a dramatic communication break within a family.

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Evaluating a dignity care intervention for palliative care in the community setting: community nurses’ perspectives

Cited by 23 publications

References 44 publications

How to conserve dignity in palliative care: suggestions from older patients, significant others, and healthcare professionals in Swedish municipal care

How to conserve dignity in palliative care: suggestions from older patients, significant others, and healthcare professionals in Swedish municipal care

Nursing’s professional dignity in palliative care: Exploration of an Italian context

Application of dignity therapy in an advanced cancer patient — wider therapeutic implications

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