From: Dignity of patients with palliative needs in the Middle East: an integrative review
Themes | Subthemes | Papers |
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Maintaining Privacy & Secrecy | Enablers - Personal space/ rooms/ separation curtains - Decent hospital gowns - Knocking at the door before entering patient room - Private space to take care of daily bodily needs - Gender sensitive health care services - Concealment of medical condition and personal information - Secrecy of lifestyle or practices Stressors - Nudity or exposure of body parts during physical examinations - Questioning about personal matters by nurses - Recurrent interaction with health care providers | de Voogd et al., 2020 [34]; Bagherian et al., 2019 [35]; Bidabadi et al., 2019 [36]; Korhan et al., 2018 [37]; Bagheri et al., 2018a,b [38, 39]; Mehdipour-Rabori et al., 2015 [40]; Borhani et al. 2016 [41]; Sharifi et al., 2016 [42]; Borhani et al., 2015 [43]; Avestan et al., 2015 [44]; Bagheri et al., 2012 [45]. |
Gentle Communication | Enablers - Recognizing personal values - Individualized dialogue - Informing the patient about the treatment and required lifestyle changes - Kind & compassionate nursing care - Maintaining /respecting religious rituals during illness and hospitalization - Gentle disclosure of truth - Retaining a glimpse of hope in health-related dialogues. - Empathy: Being in the patient’s shoes - Personal view of self and life - Belief system and relation with God Stressors - Bluntly disclosing the truth about the diagnosis - Excessive treatment of dying patients - Communication that implicates blaming, too much pity, and superior versus inferior relationship - Harassment & abuse | de Voogd et al., 2020 [34] Bagherian et al., 2019 [35]; Bidabadi et al., 2019 [36]; Korhan et al., 2018 [37]; Sharifi et al., 2016 [42]; Borhani et al., 2016 [41]; Borhani et al., 2015 [43]; Hamooleh et al., 2013 [46]; Bagheri et al., 2012 [45]. |
Abundance of Resources | Enablers - Affording the needed medical resources - Availability of basic resources and facilities - Maintaining employability - Education, training, problem-solving skills, prior experience - Purposeful life, being worthwhile, maintaining social role - Charity aids - Maintaining a clean environment in the hospital, clean and private lavatories/ rooms, good lighting Stressors - Shortage of health-sustaining needs like medications - Shortage of medical staff -Economic instability & uncertainty - Depending on family and friends - Young individuals are more vulnerable | Bagherian et al., 2019 [35]; Bagheri et al., 2018a [39] ; Shahhosseini et al., 2017 [47]; Mehdipur et al., 2015 [40]; Avestan et al., 2015 [44]; Sharifi et al., 2016 [42]; Borhani et al., 2016 [41]; Borhani et al., 2016 [41]; Bagheri et al., 2012 [45]. |
Family Support | Enablers - Presence of family during hospitalization - Allowing visitations - Respect to family caregiver’s needs at the hospital - Family involvement in discharge planning, plan of care, and decision making - Adherence to treatment regimen, symptom relief and ability to seek medical help - Presence of social support when living with family and friends - Sense of medical, physical, and spiritual security - Maintaining social role - Community support to patient / empowering policies Stressors - Living alone - Being cared for by professionals instead of family members | de Voogd et al., 2020 [34]; Bagherian et al., 2019 [35]; Bagheri et al., 2018a [39]; Korhan et al., 2018 [37]; Shahhosseini et al., 2017 [48]; Amininasab et al., 2017 [49]; Mehdipur et al., 2015 [40]; Sharifi et al. 2016 [42]; Borhani et al., 2016 [41]; Borhani et al., 2015 [43]; Hamooleh et al., 2013 [46]. |
Physical Fitness | Enablers - Physical independence, being in control - Low burden & minimal medical complications symptom - Higher dependence on others deteriorates communication with friends and family Stressors - Recurrent hospitalization - Uncertainty/ Insecurity - Burden on the family - Stigmatization - Losing social status - Minimizing the chances of getting married | Bagheri et al., 2018a [39]; Bagheri et al., 2018b [38]; Korhan et al., 2018 [37]; Hosseini et al., 2017 [47]; Shahhoseini et al., 2017 [48]; Sharifi et al., 2016 [42]; Mehdipur et al., 2015 [40]; Avestan et al., 2015 [44]; Bagheri et al., 2012 [45]. |
Reliable Health Care | Enablers - Expert medical staff who provide error-free care - Prompt attention to patient needs - Comprehensive care that attends to the whole person - Kind nurses - Well staffed and managed ward - Health care providers who are neatly groomed and follow hygienic measures - Sustaining the physical body till the last days of life - Silence in intensive care units Stressors - Reductionist practice - Lack of motivation from the health care providers -Pointless treatment | Bagherian et al., 2019 [35]; Bidabadi et al., 2019 [36]; Korhan et al., 2018 [37]; Borhani et al., 2016 [41]; Borhani et al., 2015 [43]; Hamooleh et al., 2013 [46]; Bagheri et al., 2012 [45]. |
Social justice | Enablers - Equal care irrespective of social, economic, or medical status - Equal opportunities in life - Mutual respect and trust between patient and health care team - Mindful communication Stressors - Discrimination - Injustice - Discrepancy between perceived values and the actions of health care providers’ - Bureaucracy in the hospital governance/ strict regulations - Use of improper language - Paternalistic attitude | Bidabadi et al., 2019 [36]; Korhan et al., 2018 [37]; Sharifi et al., 2016 [42]; Shahhosseini et al., 2017 [48]. Mehdipur et al., 2015 40; Borhani et al., 2015 [43]; Bagheri et al., 2012 [45] |