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Patient dignity in nursing : a phemomenological study

Matiti, Miliica Ruth (2002) Patient dignity in nursing : a phemomenological study. Doctoral thesis, University of Huddersfield.

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    Abstract

    This research is concerned with patient dignity in nursing. It proposes the
    introduction of the concept of Perceptual Adjustment Level (PAL) in order to resolve
    the problem of the definition of patient dignity and its maintenance within nursing
    care. The aims of the study are to identify how patients and nurses perceive patient
    dignity, to investigate the extent to which patient dignity is maintained and to identify
    nursing care activities in maintaining patient dignity. The implications of the findings
    of this study for nursing education and the development of policy on clinical practice
    are also examined.

    The literature review revealed a paucity of research on patient dignity. There
    was no clear definition of dignity that could be understood by both nurses and patients
    during their day to day interaction. Little was known of the maintenance of patient
    dignity and its influencing factors. A qualitative methodology utilising a
    phenomenological approach was used. A total of 102 patients and 94 nurses from
    medical and surgical wards in three hospitals within the United Kingdom were
    interviewed using semi-structured interview techniques.

    Although neither patients nor nurses specifically defined patient dignity, they
    came up with similar categories in terms of how they perceived patient dignity:
    privacy, respect, communication, the need for information, involvement in care,
    independence, patients' choice, form of address, decency and confidentiality. Control
    was only mentioned by patients. Although there was congruence between how the
    patients and nurses described patient dignity, it emerged that nurses tended to operate
    on different levels from how patients perceived the maintenance of their dignity.
    While nurses utilised primarily their own perception of dignity to maintain patient
    dignity, it was discovered that hospitalised patients went through a process of
    adjustment of their notion of dignity and came to a level they could accept. As a
    result a new concept termed Perceptual Adjustment Level (PAL) is proposed. Patients
    felt dignified if events matched with this level. This research has, therefore, proposed
    a tentative definition of patient dignity as the fulfilment of patients' expectations or
    needs in terms of values within each patient's perceptual adjustment level taking into
    account the hospital environment.

    The need for assessing patients to discover their perceptual adjustment level
    has been highlighted. A number of patients were satisfied with how their dignity was
    maintained but a significant number were not. Ways of improving the maintenance of
    patient dignity have also been proposed. In order to maintain patient dignity, nurses
    should consider six questions: "what?" signifies the needs of dignity which should be
    met. "Why?" highlights the importance of full explanations of the purpose of tasks
    carried out on patients, and whether it matters to the patient. "Who?" relates to who is
    going to perform the task on her or him? "Where?" considers whether privacy will be
    ensured when the tasks will be done and "how?" sensitively the tasks will be done? It
    is also important to make the patient aware "when?" tasks will be carried out. The
    main factors that influenced the maintenance of patient dignity are revealed and
    implications for nursing practice, management, education and research are discussed.

    Item Type: Thesis (Doctoral)
    Additional Information: EThOS Persistent ID uk.bl.ethos.270444
    Uncontrolled Keywords: Perceptual adjustment level, Medical care
    Subjects: R Medicine > RT Nursing
    R Medicine > RA Public aspects of medicine
    Schools: School of Education and Professional Development
    Depositing User: Graham Stone
    Date Deposited: 03 Jun 2009 12:28
    Last Modified: 28 Jul 2010 19:37
    URI: http://eprints.hud.ac.uk/id/eprint/4599

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