Abstract
Background: The literature on professionals’ perceptions of dignity at the end-of-life (EOL) shows that there is a need for studies set in different cultural contexts. Lithuania represents one of these little-studied contexts. The aim of this study is to understand professionals’ attitudes, experiences, and suggestions concerning EOL dignity to provide knowledge upon which efforts to improve EOL care can be grounded. The research questions are “How do Lithuanian health care professionals understand the essence of dignity at the end-of-life of terminally ill patients?” and “How do they believe that dignity at the EOL can be enhanced?”. Materials and Methods: The study was exploratory and descriptive. It employed an interpretive phenomenological method to understand the essence of the phenomenon. Lightly structured interviews were conducted with professionals who had EOL experience, primarily with elderly and late middle-aged patients. from medicine, nursing, social work, and spiritual services. The interviews were primarily conducted by audiovisual means due to pandemic restrictions. Using a constant comparative method, the research team systematically codified text and developed themes by consensus after numerous analytic data iterations. Results: Four primary themes about EOL dignity were identified: Physical Comfort, Place of Care and Death, Effects of Death as a Taboo Topic, and Social Relations and Communication. A fifth, overarching theme, Being Heard, included elements of the primary themes and was identified as a key component or essence of dignity at the EOL. Conclusions: Patient dignity is both a human right and a constitutional right in Lithuania, but in many settings, it remains an aspiration rather than a reality. Being Heard is embedded in internationally recognized patient-centered models of EOL care. Hearing and acknowledging individuals who are dying is a specific skill, especially with elderly patients. Building the question “Is this patient being heard?” into practice protocols and conventions would be a step toward enhancing dignity at the EOL.
Highlights
All studies concerning dignity at the end-of-life (EOL) are set in the context of country and culture
How do Lithuanian health care professionals understand the essence of dignity at the EOL? How do they believe that dignity at the EOL can be enhanced? The aim of this study is to understand professionals’ attitudes of mind, experiences, and suggestions to provide knowledge upon which efforts to improve EOL care can be grounded
In seeking to understand the phenomenological essence of dignity at the end-of-life as perceived by professionals who provide care, four themes recurred with sufficient frequency and effect to become primary themes
Summary
All studies concerning dignity at the end-of-life (EOL) are set in the context of country and culture. On the Numbeo subscale entitled Health Care Index, Lithuania ranks 28th of the 83 countries studied. The literature on professionals’ perceptions of dignity at the end-of-life (EOL) shows that there is a need for studies set in different cultural contexts. The research questions are “How do Lithuanian health care professionals understand the essence of dignity at the end-of-life of terminally ill patients?” and “How do they believe that dignity at the EOL can be enhanced?”. Structured interviews were conducted with professionals who had EOL experience, primarily with elderly and late middle-aged patients. Results: Four primary themes about EOL dignity were identified: Physical Comfort, Place of Care and Death, Effects of Death as a Taboo Topic, and Social Relations and Communication. Building the question “Is this patient being heard?” into practice protocols and conventions would be a step toward enhancing dignity at the EOL
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