The dignified approach to care: a pilot study using the patient dignity question as an intervention to enhance dignity and person-centred care for people with palliative care needs in the acute hospital setting

BMC Palliative Care

Research Article

Margaret McGuire¹  Deans Buchanan²  Marion Gaffney³  Jan Pringle⁴  Bridget Johnston⁵  Melanie Narayanasamy⁵ 

[1] NHS Tayside Headquarters, Ninewells Hospital and Medical School, DD1 9SY,, Dundee, Scotland, UK;Ninewells Hospital, NHS Tayside, DD1 9SY,, Dundee, Scotland, UK;Royal Victoria Hospital, Roxburghe House, Jedburghe Road, DD2 1SP,, Dundee, Scotland, UK;School of Education, Social Work and Community Education, University of Dundee, C.2.16 Carnelley Building, DD1 4HN,, Dundee, Scotland, UK;Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, School of Health Sciences, The University of Nottingham, Queen’s Medical Centre, NG7 2HA,, Nottingham, England, UK;

关键词: Palliative care;    Dignity;    Acute care;    Mixed methods;   

DOI  :  10.1186/s12904-015-0013-3

 received in 2014-09-04, accepted in 2015-03-20,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundProviding person-centred, dignity-conserving care for hospitalised patients is central to many healthcare policies and essential to the provision of effective palliative care. The Patient Dignity Question (PDQ) “What do I need to know about you as a person to take the best care of you that I can?” was designed from empirical research on patients’ perceptions of their dignity at end of life to help healthcare professionals (HCPs) understand the patient as a person.MethodsThis mixed method pilot study was designed to inform a larger multisite study in the future. It tests the hypothesis that the PDQ intervention could be used to enhance a more person-centred climate for people with palliative care needs in the acute hospital setting, and provide evidence regarding its acceptability. Outcome measures pre and post intervention Person-centred Climate Questionnaire – patient version (PCQ-P), and the Consultation and Relational Empathy (CARE) measure; PDQ feedback questionnaires were used for all participants post intervention, in addition to qualitative interviews.Results30 patients, 17 HCPs, and 4 family members participated. Results showed a positive correlation between higher PCQ-P scores and higher CARE scores, indicating that the PDQ can make improvements to a person-centred environment and levels of empathy perceived by patients. Individual results from the PCQ-P and the CARE indicated overall improvements in the majority of fields. The PDQ supported disclosure of information previously unknown to HCPs, has implications for improving person-centred care. Positive results from PDQ feedback questionnaires were received from all participants.Qualitative findings indicated patients’ appreciation of staff (Attributes and attitudes), that patients wanted staff to have awareness of them (Know me as a person), take the time to talk, and work flexibly, to allow for patient individuality (Time and place).ConclusionThe PDQ has potential to improve patients’ perceptions of care, and HCP attitudes. Furthermore, it was well received by participants. The PDQ could be incorporated into clinical practice for the care of palliative care patients in the acute setting to the benefit of personalized and dignified care.Further research using the PDQ across wider geographical areas, and more diverse settings, would be beneficial.

【 授权许可】

CC BY   
© Johnston et al.; licensee BioMed Central. 2015