Skip to main content

Table 4 Analytical framework of the developed themes on patient dignity

From: Dignity of patients with palliative needs in the Middle East: an integrative review

Themes

Subthemes

Papers

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]