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How to conserve dignity in palliative care: suggestions from older patients, significant others, and healthcare professionals in Swedish municipal care
Uppsala University.
Örebro University.
Örebro University.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Carina Werkander Harstäde. (Ctr Collaborat Palliat Care)ORCID iD: 0000-0003-2606-6289
2019 (English)In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 18, article id 10Article in journal (Refereed) Published
Abstract [en]

Background: An essential aspect of palliative care nursing is to conserve the dignity of the patient. A Dignity CareIntervention (DCI) has been developed in Scotland to facilitate this role for nurses. The DCI is now being adapted toa Swedish context (DCI-SWE) and a central step is to identify culturally relevant, dignity-conserving care actions.These care actions will be incorporated into the DCI-SWE. Therefore, the aim of this study was to suggest careactions for conserving dignity in palliative care from the perspectives of the patients, significant others (SOs), andhealth care professionals (HPs) in municipality care in Sweden.Methods: This study used a descriptive design with a qualitative approach. Data from 20 participants were collectedthrough semi-structured individual interviews with patients (n = 3), SOs (n = 4), two focus groups with nurses (n = 9)and one focus group with physicians (n = 4) in two Swedish municipalities. These data were deductively analysedusing qualitative content analysis with the Chochinov model of dignity as framework.Results: With the Chochinov model of dignity as a framework, care actions based on suggestions from the participantswere identified and presented under three themes: Illness related concerns, Dignity conserving repertoire, and Socialdignity inventory. The study found both specific concrete care actions and more general approaches. Such generalapproaches were found to be relevant for several dignity related issues as all-embracing attitudes and behaviours.However, these general approaches could also be relevant as specific care actions to conserve dignity in relation tocertain issues. Care actions were also found to be linked to each other, showing the importance of a holisticperspective in conserving dignity.Conclusions: As part of the adaption of the DCI from a Scottish to a Swedish context, this study added relevant careactions for collaborative planning of individualised care in mutual dialogues between nurses and those they care for. Theadapted intervention, DCI-SWE, has the potential to help the nurses in providing palliative care of evidence-based quality.Keywords: Care actions, Community nursing, DCI-SWE, Dignity, Dignity care intervention, End of life care, Palliative care,Person centred, Sweden

Place, publisher, year, edition, pages
BioMed Central, 2019. Vol. 18, article id 10
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-80017DOI: 10.1186/s12904-019-0393-xISI: 000457121700002PubMedID: 30678669Scopus ID: 2-s2.0-85060556337OAI: oai:DiVA.org:lnu-80017DiVA, id: diva2:1283746
Available from: 2019-01-29 Created: 2019-01-29 Last updated: 2019-08-29Bibliographically approved

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