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Dignity in the terminally ill: a developing empirical model

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  • Chochinov, Harvey Max
  • Hack, Thomas
  • McClement, Susan
  • Kristjanson, Linda
  • Harlos, Mike

Abstract

Despite use of the term dignity in arguments for and against a patient's self-governance in matters pertaining to death, there is little empirical research on how this term has been used by patients who are nearing death. The objective of this study was to determine how dying patients understand and define the term dignity, in order to develop a model of dignity in the terminally ill. A semi-structured interview was designed to explore how patients cope with their advanced cancer and to detail their perceptions of dignity. Interviews were audiotaped and transcribed verbatim. A consecutive sample of 50 consenting patients with advanced terminal cancer were recruited over a 15-month period of time from an urban extended care hospital housing a specialized unit for palliative care. This unit provides both inpatient services, and coordinates end-of-life care community based programming. Data were analysed using latent content analysis and constant comparison techniques. Four members of the research team independently coded the transcribed data, to develop conceptually meaningful categories of responses. Operational definitions were written for major categories, themes and sub-themes. Three major categories emerged from the qualitative analysis, including illness-related concerns; dignity conserving repertoire; and social dignity inventory. These broad categories and their carefully defined themes and sub-themes form the foundation for an emerging model of dignity amongst the dying. The concept of dignity and the dignity model offer a way of understanding how patients face advancing terminal illness. This will serve to promote dignity and the quality of life of patients nearing death.

Suggested Citation

  • Chochinov, Harvey Max & Hack, Thomas & McClement, Susan & Kristjanson, Linda & Harlos, Mike, 2002. "Dignity in the terminally ill: a developing empirical model," Social Science & Medicine, Elsevier, vol. 54(3), pages 433-443, February.
  • Handle: RePEc:eee:socmed:v:54:y:2002:i:3:p:433-443
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    Citations

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    Cited by:

    1. Carlos Laranjeira & Marília Dourado, 2022. "“Dignity as a Small Candle Flame That Doesn’t Go Out!”: An Interpretative Phenomenological Study with Patients Living with Advanced Chronic Obstructive Pulmonary Disease," IJERPH, MDPI, vol. 19(24), pages 1-18, December.
    2. McPherson, Christine J. & Wilson, Keith G. & Murray, Mary Ann, 2007. "Feeling like a burden: Exploring the perspectives of patients at the end of life," Social Science & Medicine, Elsevier, vol. 64(2), pages 417-427, January.
    3. Fabio Ferretti & Andrea Pozza & Maurilio Pallassini & Lorenzo Righi & Fulvia Marini & Sabrina Adami & Anna Coluccia, 2019. "Gender invariance of dignity in non-terminal elderly patients with chronic diseases: a multicentric study," Quality & Quantity: International Journal of Methodology, Springer, vol. 53(3), pages 1645-1656, May.
    4. Sonja McIlfatrick & Michael Connolly & Rita Collins & Tara Murphy & Bridget Johnston & Philip Larkin, 2017. "Evaluating a dignity care intervention for palliative care in the community setting: community nurses’ perspectives," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(23-24), pages 4300-4312, December.
    5. Street, Annette F. & Love, Anthony, 2005. "Dimensions of privacy in palliative care: views of health professionals," Social Science & Medicine, Elsevier, vol. 60(8), pages 1795-1804, April.
    6. Jacobson, Nora, 2007. "Dignity and health: A review," Social Science & Medicine, Elsevier, vol. 64(2), pages 292-302, January.
    7. Bridget Johnston & Philip Larkin & Michael Connolly & Catriona Barry & Melanie Narayanasamy & Ulrika Östlund & Sonja McIlfatrick, 2015. "Dignity‐conserving care in palliative care settings: An integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(13-14), pages 1743-1772, July.
    8. Tang, Siew Tzuh & Liu, Tsang-Wu & Lai, Mei-Shu & McCorkle, Ruth, 2005. "Discrepancy in the preferences of place of death between terminally ill cancer patients and their primary family caregivers in Taiwan," Social Science & Medicine, Elsevier, vol. 61(7), pages 1560-1566, October.
    9. Marjorie Dobratz, 2004. "A Comparative Study of Variables That Have an Impact on Noncancer End-of-Life Diagnoses," Clinical Nursing Research, , vol. 13(4), pages 309-325, November.

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