Dignity in End of life Care at Hospice: an Action Research Study

Dorte Toudal Viftrup, Niels Christian Hvidt, Christina Lange Prinds

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Background: Safeguarding the dignity of patients at the end of life is a key objective in palliative care practice in Denmark. The concept of dignity and how it influences a dying persons’ quality of life is thus influential in end of life care at hospices. However, what is meant by dignity, how is dignity understood and practiced by healthcare professionals in Danish hospices, and whether this relates to the patients’ understandings, needs, and experiences concerning dignity remains unanswered.
Aim: The purpose was to explore three areas of concern: 1) How do patients experience and express their needs for dignity at hospice? 2) How do the hospice staff experience and live out meanings and values about dignity in relation to patients? 3) How can there be a better focus on patients’ needs for dignity in care at hospice?
Methods: An action research method was applied combined with semi-structured individual interviews with twelve patients, five staff, and nine focus-group interviews with staff at two different hospices in Denmark were conducted.
Results: Three themes emerged: 1) Patients being meet with (attempts of) understanding, 2) Patients being allowed to contribute, and 3) Patients being treated as whole persons. Deeper analysis indicated staff understandings of dignity mostly focused on preserving patients’ autonomy, whereas patients expressed needs for relational and spiritual aspects of dignity. Staff were highly concerned about preserving patients’ autonomy when providing dignity in care, however, through the action in praxis they began reflecting upon how that also influenced their praxis in ways that were not concerned about patients’ needs for dignity. We hope this has lead to more focus on patients needs for dignity in care at hospice.
TidsskriftScandinavian Journal of Caring Sciences
StatusUdgivet - 17 maj 2020