Status Of Dignity Research Articles

Workshop 5: Mitigating Ageism in Everyday Clinical Care

Learning objectives:At the end of this workshop, participants will be able to: -Integrate a human rights and dignity-based strategies into daily clinical care for older persons with mental health conditions-Identify the effects of intersections of ageism, ableism, mentalism and elder abuse on the care provided to older persons with mental health conditions-Describe and support the need for an international (UN) Convention on the rights of older persons to improve the care of older persons with mental health conditionsBackground:Our world faces rapid population aging. Based on the WHO estimates, nearly 20% of older persons will have mental health conditions such as dementia, depression, anxiety and substance use, often complicated by physical and psychosocial comorbidities. Various mental health inequalities exist in this vulnerable population negatively influencing their healthcare and social status. This includes the ‘triple jeopardy’ of ageism, ableism and mentalism. The ongoing COVID-19 crisis has only widened the marginalization of older persons and especially those with mental health conditions.Methods:Even though there has been a paradigm-shift in neurobiological understanding of psychogeriatrics, dignity-based mental healthcare is still silent in research as well as practice. This workshop brings in recommendations to include the principles of rights, dignity, equality, equity and respect in clinical care for older persons living with mental health conditions, including dementia. These suggestions are based on literature review, position statements of global organizations working in this area, the Decade enablers of the UN Decade of Healthy Aging (2021-2030) and also clinical experience of the authors. Special focus will be on end-of-life care, advance directives and those in institutionalized settings.Mode of conduction:The workshop will involve a strategic and interactive discussion based on real-life case vignettes. Feedback will be sought on the perceived status of dignity and human rights in current clinical practice. Focus will be on ensuring dignity and promoting human rights in routine clinical care and patient-physician communication, age-friendly healthcare settings for older persons and the role of dignity therapy. The need for an International Convention for the rights of older persons will also be highlighted with evidence.Elder abuse and inadequate end-of-life care as two of the many common manifestations of the implicit bias and core root cause of the phenomenon of the “ageism spectrum”. Ensuring dignity and human rights in older persons can combat ageism and prevent elder abuse. Adequate sensitivity and training of professionals in this area will set the future pathway for dignified mental health interventions in the older persons with mental health conditions that are devoid of age-based discrimination and prejudice.

Exploring perceived dignity among AIDS/HIV patients in behavioral disease counseling centers in Iran

Background and aims: People with HIV/AIDS may encounter several problems, such as discrimination and social challenges, which affect their perceived dignity. The purpose of this study was to evaluate the perception of dignity among HIV/AIDS patients in a healthcare setting in Iran. Methods: This cross-sectional study was done on HIV/AIDS patients referring to behavioral disease consulting centers affiliated with a mainstay of health and medical education, Iran, in 2023. The study sample consisted of 220 patients selected using the available sampling method. A patient dignity questionnaire was used to collect data. The validity and reliability of the questionnaire were confirmed. The collected data were analyzed by SPSS 25 software using parametric tests. Results: Findings showed that the mean age of patients was 37; 51.1% of participants were men, 46.1% were married, 4.2% had primary education, 55.9% were employed, and 66.7% were in the asymptomatic stage of the disease. The overall score for perceived dignity was 1/96 out of 5 and was evaluated well. The mean scores for mental abilities and perceptions, personal and social concerns were 1.37 (SD: 0.44), 2.85 (SD: 0.94), and 1.37 (SD: 0.48), respectively. There was also a statistically significant relationship between perceived dignity score and the levels of education and being under treatment. Conclusion: Although the studied patients had a well-perceived status of dignity and were satisfied with their abilities and social communication, their greatest concern was personal concerns. It is recommended that psychological support and therapies be provided to these patients.

The Relationship between Dignity Status and Quality of Life in Iranian Terminally Ill Patients with Cancer.

Background:Palliative care is an approach that has been used to care for terminally ill patients. The current study was performed to assess the association between the status of patient dignity and quality of life (QOL) in Iranian terminally ill patients with cancer.Materials and Methods:This descriptive correlational study was conducted on 210 end-stage cancer patients (102 men and 108 women) who were referred to Seyed Al-Shohada Hospital, Isfahan, Iran, in 2015. To assess dignity status, we used the Patient Dignity Inventory. The Persian version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was used for QOL assessment.Results:There was a significant negative association between total dignity status and QOL scales. In addition, significant negative relationship was observed between dignity-related domains (loss of worth sense: r = −0.50, P < 0.001; anxiety and uncertainty: r = −0.51, P < 0.001; symptom distress: r = −0.62, P < 0.001; and loss of autonomy: r = −0.61, P < 0.001) and functional scale and some subscales of the QOL scale. In contrast, a significant positive relationship was found between dignity-related domains, and total symptom scale and fatigue. No significant relationship was observed between different items of dignity and global health status/QOL scale.Conclusions:High dignity status in terminally ill patients was associated with higher QOL in terms of functional intactness and lower symptom distress. Further studies are necessary to shed light to our findings.

A Direct Observation Checklist to Measure Respect and Dignity in the ICU

Treating patients and family members with respect and dignity is a core objective of health care, yet it is unclear how best to measure this in the ICU setting. Accordingly, we sought to create a direct observation checklist to assess the "respect and dignity status" of an ICU. A draft checklist based on previous work was iteratively revised to enhance accuracy and feasibility. Seven ICUs within the Johns Hopkins Health System. A total of 351 patient-clinician encounters with 184 different patients. Four study team members pilot tested the checklist between January and August 2015. Standard psychometric analyses were performed. The direct observation checklist exhibits strong content and face validity as well as high reliability and internal consistency. All items load on one factor that supports the unidimensionality of the total index. Furthermore, concurrent validity of the direct observation checklist is demonstrated by statistically significant differences in mean scores between ICUs, between types of clinicians, and between patients' clinical status and mood. We rigorously developed, pilot tested, and analyzed a direct observation checklist designed to assess the extent to which patients and families in the ICU setting are treated with respect and dignity. Future research should validate this checklist in other settings and compare its results with other measures. Data gathered about individual items on the direct observation checklist could be used to target areas for training and education; doing so should help facilitate more respectful treatment of patients and their families.

Kopaonik school of natural law perception of dignity and legal discourse in Europe

This article explores divergences between Serbian and regional European legal discourse on human dignity and its scope. The main feature of the Serbian approach as described by the Kopaonik School of Natural law with recent reflections in the positive law is the recognition of the dignity status only to persons, and not beyond that formal category. The Serbian position on human dignity has been examined from the perspective of contemporary legal theory and European regional regulation in the field of biomedicine, human rights case law and case law from the field of patent law. The objectives of the research are to demonstrate that insular understanding of the agents of dignity is not tenable. The conclusions that were reached trough discussion are: Serbian restrictive legal discourse on dignity cannot escape a criticism that includes the lack of an adequate definition, elitist undertones, discriminatory foundations as well as incompatibleness with international obligations of Serbia.

“What dignity is there in that?”: The crisis of dignity in selected late‐twentieth‐century novels

Summary This article offers an investigation of the concept of dignity and of some of the ways in which it has been represented in a number of late‐twentieth‐century novels. Discussions of dignity centre, on the one hand, upon qualities which the personality reveals in and of itself, and, on the other, upon ethical imperatives relating to how the individual should behave in relation to others. Debates about dignity thus open up questions of ontology, selfhood and the obligations of people towards one another. Two works in particular, in which the concept and status of dignity are explicitly and substantially addressed, are focused upon, Kazuo Ishiguro's The Remains of the Day (1989) and Nadine Gordimer's July's People (1981). Significantly, both these texts explore the notion of dignity in relation to servitude. What the analysis reveals is that Ishiguro's and Gordimer's novels do not present dignity as an absolute good or as something which may be considered in isolation from the tensions, imperfections and imbalances of human society. Instead, it is shown to be affected by and implicated in the exercise of power, especially in relation to class and race.

The Popularization of Science in Nineteenth-Century America

THE POPULARIZATION OF SCIENCE in nineteenth-century America is inseparable from the democratization of Western society in the early modern era. The contempt for labor that characterized the medieval attitude was gradually replaced by a new spirit whose roots go back to at least the twelfth century and which accompanied the rise in economic importance of the skilled craftsman and mechanic in a modernizing economy. The new importance of the artisan-mechanic to the economy forced a reconsideration of the proper relationship between the artisan and the scientist. The association of knowledge with its applications its utility was interwoven with a growing self-conception that the productions of the craftsman and the mechanic made possible a grasp of regularities and order in nature hitherto not even so conceptualized. Advances in techniques and in the material conditions of life were accompanied by corresponding changes in the perception and conceptualization of nature and society. (1) The artisan achieved a new and elevated status of dignity and place. He worked in close collaboration with scientists, and frequently the distinctions between them were blurred and undefined. (2) Taking their cue from the work of the artisan and his methods, the new men of science now raised the possibility that nature could not only be understood but could be altered to meet the needs of man. In the words of Paolo Rossi: