Abstract

BackgroundDignity is related to a patient’s respect, privacy, information and autonomy. Maintaining dignity is defined as ethical goal of care. Although the importance of dignity has been widely recognized, there is limited research that investigates if dignity is really maintained in clinical practice and few studies have been conducted in acute hospital settings with adults across the age range. The aim of the study was to explore inpatients’ perception of dignity in an hospital setting.MethodsThis descriptive cross-sectional study was carried out in 10 medical and surgical wards of a General Hospital in Modena (Italy). We collected a purposive sample of 100 patients by selecting 10 participants from each ward who met following criteria: hospitalized for more than three days, at least 18 years old, not mentally ill, willing to participate and able to speak Italian. We developed a 15-item anonymous questionnaire divided into three sections: “physical privacy”, “information and autonomy”, “nurse-patients respectful interaction”.ResultsThe percentages of positive (preserved dignity perception) were more frequent than negative (not preserved dignity perception) and no answers with a statistically significantly difference among the three sections (Pearson chi2 = 150.41, p < 0.0001). The frequency of positive or negative answers was statistically significantly related to the preservation of dignity according to the following questions (p < 0.005, multivariate logistic regression): “privacy to use the bathroom” and “respectful interaction”, as protective factors and “maintaining of body privacy”, “involvement in the care process”, “correct communication” as risk factors.ConclusionsDignity was quite but not completely maintained according to the standards expected by patients. According to patients’ views, privacy of the body during medical procedures and respectful nurse-patient interactions were preserved more than information and verbal communication. Listening to patients’ views on the specific factors they consider useful to maintaining their dignity can help in this process. Recognizing and focusing on these factors will help professionals to establish practical measures for preserving and promoting patients' dignity and providing more dignified care. Dignity should be extensively and systematically pursued as other important clinical goals.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0704-8) contains supplementary material, which is available to authorized users.

Highlights

  • Dignity is related to a patient’s respect, privacy, information and autonomy

  • The importance of dignity has been widely recognized, there is limited research that investigates if dignity is really maintained in clinical practice [4] and few studies have been conducted in acute hospital settings with adults across the age range [9,17]

  • The multivariate logistic regression analysis highlighted that the frequency of positive or negative answers to 5 questions was statistically significantly related to the preservation of dignity (p < 0.005, p < 0.0001), as: Statistical analysis The percentage of positive and negative answers was analyzed and correlated to the questions, in order to identify the risk or protective factors related to dignity

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Summary

Introduction

Maintaining dignity is defined as ethical goal of care. The importance of dignity has been widely recognized, there is limited research that investigates if dignity is really maintained in clinical practice and few studies have been conducted in acute hospital settings with adults across the age range. Respecting human rights and maintaining dignity were defined as ethical goals of nursing care [15], which should not differ because of a patient’s race, age, religion, sickness or handicap, gender, or political, social and economic status [16,17]. The third article of the Italian Nursing Code of Ethics (2009) is referred to human dignity: “The responsibility of nurses consists of treating and caring people in respect of life, health, freedom and dignity of each person” [18]

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