Patient dignity in an acute hospital setting: A case study
Introduction
Patients in varied settings have identified the importance of dignity to them (Chochinov et al., 2002, Matiti, 2002, Joffe et al., 2003) and respecting people's rights to dignity is inherent in nursing (International Council of Nurses (ICN), 2006). However, dignity has been described as an ambiguous, vague concept (Shotton and Seedhouse, 1998, Tadd et al., 2002, Macklin, 2003). Some studies indicated that patients are vulnerable to a loss of dignity in hospital (Seedhouse and Gallagher, 2002, Matiti, 2002, Jacelon, 2003) but what threatens patients’ dignity and how patients’ dignity can be promoted has been little investigated, particularly in acute hospital settings. In this paper, findings from a qualitative case study are presented which provide insights into the meaning of dignity, how dignity is threatened in hospital and how dignity can be promoted.
Section snippets
The requirement for nurses to respect patients’ dignity
In the United Kingdom (UK), dignity has been on the NHS agenda for some time with health policies supporting dignified care for patients being produced by all four UK countries’ health departments. In England, Department of Health (DH) documents increasingly emphasise that patients’ dignity should be respected, while acknowledging that this is not always the case. In 2001 the DH published the Essence of Care (DH, 2001a) which included benchmarks for best practice in privacy and dignity for all
Method
The aims of the study were to investigate in an acute hospital setting:
- (1)
The meaning of patient dignity;
- (2)
‘How patients’ dignity is threatened;
- (3)
‘How patients’ dignity is promoted.
Findings
The themes presented are: the meaning of patient dignity, patient factors affecting dignity, the impact of the hospital environment on dignity and how staff behaviour affects dignity.
Discussion
The study involved only one English hospital and specifically one ward's staff and patients, although three senior nurses had hospital-wide roles and hospital documents were examined. Ideally, a multiple case study design would have been used with other acute hospitals involved but these require extensive resources and are often beyond the resources of a single researcher (Yin, 2003). The data collection sources focused on patients and staff but relatives’ views might have provided a different
Conclusion
Promoting dignity is central to humanistic nursing theory and nurses have a professional duty to promote patients’ dignity. Increasingly, UK health policies have emphasised the importance of patient dignity. As little research about patient dignity has been conducted in acute hospital settings, this study's findings have contributed to this limited body of knowledge.
Patient dignity in hospital was found to comprise feelings, physical presentation and behaviour and can be promoted or threatened
Acknowledgement
The author would like to express her gratitude to Professor Ann Taket and Dr Dee Burrows for their doctoral supervision, Dr Bob Cant for his support during this paper's preparation, and the patients and staff who participated in the study.
References (77)
- et al.
Dignity in the terminally ill: a developing empirical model
Social Science and Medicine
(2002) An analysis of the concept dignity
Accident and Emergency Nursing
(2005)Attitudes and behaviours of hospital staff towards elders in an acute care setting
Applied Nursing Research
(2002)Dignity and health: a review
Social Science and Medicine
(2007)- et al.
Childbearing women's perceptions of nursing care that promotes dignity
Journal of Obstetrics, Gynaecologic and Neonatal Nursing
(2004) Person–environment congruence in work, school, and health care settings
Journal of Vocational Behaviour
(1987)- et al.
Dignity in situations of ethical difficulty in intensive care
Intensive and Critical Care Nursing
(1997) - et al.
Maintaining patient dignity in intensive care settings
Intensive and Critical Care Nursing
(2001) - et al.
Dignity and older people: the voice of professionals
Quality in Ageing
(2005) The impact of urological conditions on patients’ dignity
International Journal of Urological Nursing
(2007)