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Systematic review: what interventions improve dignity for older patients in hospital?

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Listed:
  • Zainab Zahran
  • Marcelle Tauber
  • Holly Howe Watson
  • Phoebe Coghlan
  • Sarah White
  • Sue Procter
  • Gulen Addis
  • Christine Norton

Abstract

Aims and objectives To review the evidence for interventions to improve dignity for older patients in acute care. Background High profile cases have highlighted failure to provide dignified care for older people in hospitals. There is good evidence on what older people consider is important for dignified care and abundant recommendations on improving dignity, but it is unclear which interventions are effective. Design Narrative systematic review. Methods The Cochrane library, MEDLINE, EMBASE, CINAHL, BNI and HMIC electronic databases were searched for intervention studies of any design aiming to improve inpatients’ dignity. The main population of interest was older patients, but the search included all patients. Studies that focused on ‘dignity therapy’ were excluded. Results There were no intervention studies found in any country which aimed to improve patient dignity in hospitals which included evaluation of the effect. A narrative overview of papers that described implementing dignity interventions in practice but included no formal evaluation was, therefore, undertaken. Five papers were identified. Three themes were identified: knowing the person; partnership between older people and health care professionals; and, effective communication and clinical leadership. The effect on dignity of improving these is untested. Conclusions There are currently no studies that have tested interventions to improve the dignity of older people (nor anyone else) in hospitals. Further research using well designed trials of interventions is needed. There is also a need to develop and validate outcome measures for interventions to improve dignity. Relevance to clinical practice At present nurses lack robust evidence on how to improve dignity. There is ample evidence on what undermines patients’ dignity and there is a need to develop and test interventions designed to improve patient dignity.

Suggested Citation

  • Zainab Zahran & Marcelle Tauber & Holly Howe Watson & Phoebe Coghlan & Sarah White & Sue Procter & Gulen Addis & Christine Norton, 2016. "Systematic review: what interventions improve dignity for older patients in hospital?," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(3-4), pages 311-321, February.
  • Handle: RePEc:wly:jocnur:v:25:y:2016:i:3-4:p:311-321
    DOI: 10.1111/jocn.13052
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    References listed on IDEAS

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    1. Valentine, Nicole & Darby, Charles & Bonsel, Gouke J., 2008. "Which aspects of non-clinical quality of care are most important? Results from WHO's general population surveys of "health systems responsiveness" in 41 countries," Social Science & Medicine, Elsevier, vol. 66(9), pages 1939-1950, May.
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    1. Marcelle Tauber‐Gilmore & Gulen Addis & Zainab Zahran & Sally Black & Lesley Baillie & Sue Procter & Christine Norton, 2018. "The views of older people and health professionals about dignity in acute hospital care," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(1-2), pages 223-234, January.
    2. Debra Kerr & Rosie Crone & Trisha Dunning, 2020. "Perspectives about dignity during acute care for older people and their relatives: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(21-22), pages 4116-4127, November.
    3. Marcelle Tauber‐Gilmore & Christine Norton & Sue Procter & Trevor Murrells & Gulen Addis & Lesley Baillie & Pauline Velasco & Preet Athwal & Saeema Kayani & Zainab Zahran, 2018. "Development of tools to measure dignity for older people in acute hospitals," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(19-20), pages 3706-3718, October.

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