Development of tools to measure dignity for older people in acute hospitals.

Autor: Tauber-Gilmore M; Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK., Norton C; Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK., Procter S; School of Health and Social Science, Buckinghamshire New University, High Wycombe, Buckinghamshire, UK., Murrells T; Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK., Addis G; Department of Applied Health and Exercise Science, School of Health & Social Science, Buckingham New University, Uxbridge, Middlesex, UK., Baillie L; Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK., Velasco P; Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK., Athwal P; Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK., Kayani S; Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK., Zahran Z; Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
Jazyk: angličtina
Zdroj: Journal of clinical nursing [J Clin Nurs] 2018 Oct; Vol. 27 (19-20), pp. 3706-3718. Date of Electronic Publication: 2018 Aug 13.
DOI: 10.1111/jocn.14490
Abstrakt: Background: Dignity is a concept that applies to all patients. Older patients can be particularly vulnerable to experiencing a loss of dignity in hospital. Previous tools developed to measure dignity have been aimed at palliative and end-of-life care. No tools for measuring dignity in acute hospital care have been reported.
Objectives: To develop tools for measuring patient dignity in acute hospitals.
Setting: A large UK acute hospital. We purposively selected 17 wards where at least 50% of patients are 65 years or above.
Methods: Three methods of capturing data related to dignity were developed: an electronic patient dignity survey (possible score range 6-24); a format for nonparticipant observations; and individual face-to-face semi-structured patient and staff interviews (reported elsewhere).
Results: A total of 5,693 surveys were completed. Mean score increased from 22.00 pre-intervention to 23.03 after intervention (p < 0.001). Staff-patient interactions (581) were recorded. Overall 41% of interactions (239) were positive, 39% (228) were neutral, and 20% (114) were negative. The positive interactions ranged from 17%-59% between wards. Quality of interaction was highest for allied health professionals (76% positive), lowest for domestic staff (22% positive) and pharmacists (29% positive), and intermediate for doctors, nurses, healthcare assistants and student nurses (40%-48% positive). A positive interaction was more likely with increased length of interaction from 25% (brief)-63% (longer interactions) (F[2, 557] = 28.67, p < 0.001).
Conclusions: We have developed a simple format for a dignity survey and observations. Overall, most patients reported electronically that they received dignified care in hospital. However, observations identified a high percentage of interactions categorised as neutral/basic care, which, while not actively diminishing dignity, will not enhance dignity. There is an opportunity to make these interactions more positive.
(© 2018 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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