Table 4 Dignity conserving practices
From: A systematic scoping review on patients’ perceptions of dignity
Rings | Practices | Outcomes | Facilitators | Barriers |
|---|---|---|---|---|
Innate (n = 11) | Respect for spirituality [78, 93, 123, 147, 156, 175, 179, 185, 186] Spiritual comfort [78, 93, 123, 147, 156, 175, 179, 185, 186] | Increased sense of dignity [122, 179] Improvement in quality of life [93, 121, 123, 156, 185,186,187] | ||
Facilitating individualism [156] | ||||
Individual (n = 64) | Physical care [75, 85, 93, 143, 147, 169, 170, 173, 175, 189, 190] Symptomatic management [75, 85, 93, 143, 147, 169, 170, 173, 175, 189] | Increased sense of dignity [143] Improvement in quality of care [189] | ||
Active participation in end of life [75, 78, 87, 93, 98, 101, 116, 125, 141, 147, 170, 175, 189, 191,192,193] Preference for care and death locations [93, 101, 116, 141, 175, 189, 191] Maintaining self-identity [78, 93, 98, 147, 170] Encouraging independence [147, 175] | Increased sense of dignity [110, 140, 141, 144, 194] Improvement in quality of care [124, 144, 164, 194] | Public Allowing patients to be cared for at home [80] Government legislations [145] Allowing advanced care planning [181] End-of-life regulations [145] | ||
Psychosocial care [10, 75, 78, 82, 89, 92, 93, 96,97,98, 101, 102, 110, 112, 115,116,117, 119, 120, 123, 127, 131, 134, 136, 139, 142, 146, 147, 149, 150, 155, 156, 158, 164, 165, 169, 170, 173,174,175,176,177,178,179,180,181, 184,185,186, 188,189,190, 194,195,196,197,198,199,200,201,202,203] Good communication with patients [75, 78, 82, 92, 93, 98, 102, 139, 147, 149, 155, 173, 177,178,179, 188,189,190, 195, 196] Acknowledging personhood [75, 82, 89, 93, 98, 142, 147, 164, 170, 174,175,176,177,178, 188, 195, 196] Maintaining morale [93, 127, 147, 196] Environmental factors [89, 92, 93, 96, 116] Psychotherapy [10, 93, 98, 110, 115, 117, 119, 120, 123, 131, 134, 136, 139, 146, 147, 150, 156, 158, 165, 180, 181, 184,185,186, 194,195,196,197,198,199,200,201,202,203] Improving healthcare systems [97, 101, 112, 142, 169, 176, 190] | Increased sense of dignity [75, 110, 112, 114, 117, 131, 142, 147, 149, 150, 156, 179, 180, 185, 186, 188, 195, 197, 198, 200, 202] Improvement in quality of care [96, 142, 155, 164] Improvement in quality of life [96, 134, 156, 185, 186, 197, 202] Facilitating individualism [156, 180, 199] No significant effect of intervention [117, 120, 156] Long duration of therapy [117] Having a coherent view [131, 150] Improved respect for autonomy [119, 196] Heightened morale [93, 96, 98, 102, 117, 131, 147, 149, 150, 156, 175, 180, 186, 195,196,197,198,199, 201, 202] Feeling valued [93, 96, 102, 150, 156, 175, 180, 198] Increased sense of meaning [117, 131, 149, 150, 180, 186, 197, 198, 201, 202] Increased will to live [147, 149, 186, 198, 199, 202] Improved mood [115, 119, 149, 180, 186, 190, 201, 202] Increased self esteem [93, 98, 195, 196] Increased preparedness for death [75, 98, 119, 131, 147, 156, 175, 180, 194, 195, 198, 199, 202] | Public Conflicting views on patients’ dignity between healthcare providers and patients [204] oSuperstition about discussing death arrangements [161] | ||
Relational (n = 31) | Preservation of familial bonds [98, 103, 122, 147, 188] Care and support from family [98, 103, 122, 188] Addressing aftermath concerns [93, 147] Retaining familial roles [93] | Increased sense of dignity [122] Making patient feel valued [103, 188] Assisting in communication [139] | Public Conflicting views on patients’ dignity between families and patients [204] | |
Improving healthcare accessibility for families [75, 85, 87, 93, 124, 142, 177, 189] Availability to family [85, 93, 142] Good communication with patients’ families [75] Research involving relatives’ perspectives [142] | Increased sense of dignity [75, 87] Improvement in quality of care [142] Consoling patients [85] Improved connectedness with families [124] | |||
Psychosocial care [115, 117, 119, 131, 139, 146, 156, 165, 180, 186, 194, 195, 197,198,199,200,201,202] Psychotherapy [115, 117, 131, 146, 156, 165, 180, 186, 194, 195, 197,198,199,200,201,202] Music therapy with family [139] Supporting patients’ self esteem [195] | Increased sense of dignity [117, 131, 156, 180, 186, 195, 197, 198, 200, 202] Improvement in quality of life [197, 202] Painting a distorted picture of the patient [198] Improved connectedness [139, 156, 180, 194, 195, 199] Within families [139, 156, 194, 195, 199] Discussing hopes and dreams for loved ones [180] More openness about patients’ condition [194] | |||
Societal | Social support [114, 119, 127, 142, 147, 184, 203] Prevention of demoralisation [127] | Increased sense of dignity [142] Improvement in quality of care [142] Awkward social settings [184] | Healthcare systems Good infrastructure Supporting patients’ privacy [93] Quality improvement projects [96] Use of technology [168] | Public Poor social support [118] Healthcare systems Lack of psychosocial support in healthcare services [168] |
Social respect for patients [93, 97, 138, 142, 149] Good communication [149] Mutual respect [97] | Public Conflicting views on patients’ dignity between cultures [197] Patients feeling ostracised in public settings [99, 122] Patients being called an “economic burden to society” [81] | |||
General | Healthcare systems Educational programs for healthcare providers [101] Understanding cultural differences [101] Improving communication techniques among healthcare providers [96] Standardised framework to address patient concerns [155] | Public Poor public policies [99] Healthcare systems Poor infrastructure [6] Poorly maintained physical environment [6] Limited human resource allocations [92, 96, 127] Lack of time for patients [96] Fast paced interactions [96] Use of technology [96] Busy schedules of healthcare workers [97] Long duration for therapy [194] |