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Dignity‐conserving care in palliative care settings: An integrative review

Author

Listed:
  • Bridget Johnston
  • Philip Larkin
  • Michael Connolly
  • Catriona Barry
  • Melanie Narayanasamy
  • Ulrika Östlund
  • Sonja McIlfatrick

Abstract

Aims and objectives To report an integrative review of evidence relating to dignity‐conserving care in palliative care settings. It will also suggest avenues for future research. Background Research suggests that dignity is welcomed by those receiving palliative and end of life care. However, as dignity is a subjective term, it is not always explicit how this may be employed by nurses. Given that the preferred place of care for patients with palliative care needs is the home, the issue of dignity may be particularly important for community nurses. Therefore, synthesising evidence of dignity‐conserving care for community nurses caring for people with palliative care needs provides clarity in a complex area of palliative care research. Design Integrative literature review. Method The review involved key bibliographic and review databases CINAHL, MEDLINE, EMBASE, ASSIA and PsycInfo. Medical Subject Headings and free terms were undertaken for articles published from January 2009–September 2014 and retrieved papers were assessed against inclusion criteria. Final included articles were reviewed for reported dignity‐conserving care actions, which were classified under nine themes of the Dignity Model. Results Thirty‐one articles were included. Nine Dignity Model themes were used to classify care actions: Level of Independence; Symptom Distress; Dignity‐Conserving Perspectives; Dignity‐Conserving Practices; Privacy Boundaries; Social Support; Care Tenor; Burden to Others; and Aftermath Concerns. Reported care actions included listening, conveying empathy, communication and involving patients in care. Conclusion Care actions could be classified under most of Dignity Model themes. However, there were less reported care actions related to Level of Independence and Aftermath Concerns, which meant that these had to be formulated independently. Future research should be structured around these areas to determine appropriate care actions for nurses to give dignity‐conserving care that addresses these specific themes. Relevance to clinical practice Synthesising the available evidence of dignity‐conserving care identifies evidence‐based care actions and provides guidance to nurses in clinical practice caring for patients with palliative care needs. Future opportunities for research are identified to guide promotion of dignity in palliative care.

Suggested Citation

  • 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.
    • Handle: RePEc:wly:jocnur:v:24:y:2015:i:13-14:p:1743-1772
    DOI: 10.1111/jocn.12791
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    References listed on IDEAS

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    1. 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.
    2. May, Peter & Hynes, Geralyn & McCallion, Philip & Payne, Sheila & Larkin, Philip & McCarron, Mary, 2014. "Policy analysis: Palliative care in Ireland," Health Policy, Elsevier, vol. 115(1), pages 68-74.
    3. Siobhan Tranter & Fiona Irvine & Eve Collins, 2012. "Innovations aimed at improving the physical health of the seriously mentally ill: an integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 21(9‐10), pages 1199-1214, May.
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    2. Alessandro Stievano & Laura Sabatino & Dyanne Affonso & Douglas Olsen & Isabelle Skinner & Gennaro Rocco, 2019. "Nursing’s professional dignity in palliative care: Exploration of an Italian context," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(9-10), pages 1633-1642, May.

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