The Portuguese versions of the This Is ME Questionnaire and the Patient Dignity Question: tools for understanding and supporting personhood in clinical care

Julião, Miguel; Courelas, Carla; Costa, Manuel João; Santos, Nadine Correia; Antunes, Bárbara; Magalhães, Susana; Sousa, Paulo; Chochinov, Harvey Max

doi:10.21037/apm.2018.04.04

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…Chochinova: Co powinienem o Panu/Pani wiedzieć, żeby się lepiej Panem/Panią opiekować? [5], które wydaje się być krótką, prostą i skuteczną interwencją [6]. Pytanie pomaga lepiej poznać pacjenta i podkreśla humanistyczny aspekt kontaktu pomiędzy pacjentem a klinicystą [7].…”

Section: Discussionunclassified

“…One of the ways to ensure the patient's well-being and dignity is H.M. Chochinov's dignity question: "What do I need to know about you as a person to take the best care of you that I can?" [5], which seems to be a brief, simple and effective intervention [6]. The question helps to get to know the patient better and stresses the humanistic aspect of contact between the patient and the clinician [7].…”

Section: Introductionmentioning

confidence: 99%

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The meaning of dignity patient question and changes in the approach to this issue of cancer patients during home hospice care

2020

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Introduction M.H. Chochinov's dignity question: What do I need to know about you as a person to take the best care of you that I can? is a brief diagnostic and therapeutic intervention. The aim of the study was to assess how cancer patients assess the relevance of the question, how they answer and whether the evaluation of this method changes with the duration of home palliative care. Patients and methods. The study involved 200 patients of the home hospice, who were divided into 2 groups. Group A comprised 100 patients receiving palliative care for up to 7 days, group B included 100 patients under care exceeding 7 days. All patients were posed a dignity question and 2 related ones: whether they consider this question important and whether it should be recommended in practice. In group A, the study was repeated after at least 21 days. Competent judges were then selected and the answers were assigned to specific categories. Results. The most frequently chosen answer was the one from the category of request for medical staff's help or support, which was characterised by the greatest variability under the influence of time-exchange for an answer: nothing, you already know everything about me. The vast majority of the surveyed patients answered affirmatively to the question about the significance of interventions regarding the care for patients and agreed that the question should be recommended in practice. Conclusions. In most patients the answers to the dignity question change with the duration of home palliative care, which may be related to deepening relations with medical staff. The dignity question has been considered significant regarding the patient care.

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Section: Discussionunclassified

Section: Introductionmentioning

confidence: 99%

The meaning of dignity patient question and changes in the approach to this issue of cancer patients during home hospice care

2020

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“…Dignity is an important concept for medical practice, especially in the field of palliative care. To understand and promote patient dignity, Chochinov et al (2015) developed a single item tool designed to probe patient personhood, the Patient Dignity Question (PDQ) — “What do I need to know about you as a person to give you the best care possible?” This tool has been translated and validated to European Portuguese (PDQ-PT) — “O que precisamos saber sobre si enquanto pessoa para podermos dar-lhe o melhor cuidado possível?” (Julião et al, 2018). The PDQ was designed to elicit a brief conversation (10–20 min), after which a one to three paragraph written summary are prepared.…”

Section: Introductionmentioning

confidence: 98%

“…In the same study, 90% of HCPs indicated that they learned something new about their patients, and 59% indicated that the PDQ influenced their degree of empathy (Chochinov et al ., 2015). A Portuguese study by Julião et al (2018) performed in non-institutionalized active elderly showed that answering the PDQ-PT captured their essence as a person, heightened their sense of dignity, and prompted HCPs to gain appreciation regarding their patient's suffering.…”

Section: Introductionmentioning

confidence: 99%

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Portuguese Patient Dignity Question: A cross-sectional study of palliative patients cared for in primary care

Caldas

Julião²,

Santos

et al. 2020

Pall Supp Care

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Introduction The Patient Dignity Question (PDQ) is a clinical tool developed with the aim of reinforcing the sense of personhood and dignity, enabling health care providers (HCPs) to see patients as people and not solely based on their illness. Objective To study the acceptability and feasibility of the Portuguese version of the PDQ (PDQ-PT) in a sample of palliative care patients cared for in primary care (PC). Method A cross-sectional study using 20 palliative patients cared for in a PC unit. A post-PDQ satisfaction questionnaire was developed. Results Twenty participants were included, 75% were male; average age was 70 years old. Patients found the summary accurate, precise, and complete; all said that they would recommend the PDQ to others and want a copy of the summary placed on their family physician's medical chart. They felt the summary heightened their sense of dignity, considered it important that HCPs have access to the summary and indicated that this information could affect the way HCPs see and care for them. The PDQ-PT's took 7 min on average to answer, and 10 min to complete the summary. Significance of results The PDQ-PT is well accepted and feasible to use with palliative patients in the context of PC and seems to be a promising tool to be implemented. Future trials are now warranted.

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“Truly holistic?” Differences in documenting physical and psychosocial needs and hope in Portuguese palliative patients

Julião¹,

Sobral²,

Calçada³

et al. 2020

Pall Supp Care

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Objective Palliative care (PC) aims to improve patients' and families' quality of life through an approach that relieves physical, psychosocial, and spiritual suffering, although the latter continues to be under-assessed and under-treated. This study aimed to describe the prevalence of physical, psychosocial, and hope assessments documented by a PC team in the first PC consultation. Method The retrospective descriptive analysis of all first PC consultations registered in our anonymized database (December 2018–January 2020), searching for written documentation regarding (1) Edmonton Symptom Assessment Scale (ESAS) physical subscale (pain, tiredness, nausea, drowsiness, appetite, shortness of breath, constipation, insomnia, and well-being), (2) the single question “Are you depressed?” (SQD), (3) the question “Do you feel anxious?” (SQA), (4) feeling a burden, (5) hope-related concerns, (6) the dignity question (DQ), and (7) will to live (WtL). Results Of the 174 total of patients anonymously registered in our database, 141 PC home patients were considered for analysis; 63% were male, average age was 70 years, the majority had malignancies (82%), with a mean performance status of 52%. Evidence of written documentation was (1) ESAS pain (96%), tiredness (89%), nausea (89%), drowsiness (79%), appetite (89%), shortness of breath (82%), constipation (74%), insomnia (72%), and well-being (52%); (2) the SQD (39%); (3) the SQA (11%); (4) burden (26%); (5) hope (11%); (6) the DQ (33%); and (7) WtL (33%). Significant differences were found between the frequencies of all documented items of the ESAS physical subscale (29%), and all documented psychosocial items (SQD + SQA + burden + DQ) (1%), hope (11%), and WtL (33%) (p = 0.0000; p = 0.0005; p = 0.0181, respectively). Significance of results There were differences between documentation of psychosocial, hope, and physical assessments after the first PC consultation, with the latter being much more frequent. Further research using multicenter data is now required to help identify barriers in assessing and documenting non-physical domains of end-of-life experience.

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The Portuguese versions of the This Is ME Questionnaire and the Patient Dignity Question: tools for understanding and supporting personhood in clinical care

Cited by 8 publications

References 16 publications

The meaning of dignity patient question and changes in the approach to this issue of cancer patients during home hospice care

The meaning of dignity patient question and changes in the approach to this issue of cancer patients during home hospice care

Portuguese Patient Dignity Question: A cross-sectional study of palliative patients cared for in primary care

“Truly holistic?” Differences in documenting physical and psychosocial needs and hope in Portuguese palliative patients

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