Experiences with dignity among older people confined to beds living in a nursing home: A qualitative descriptive study

Dignity and Human Rights-Survey Findings on Undergraduate Nursing Students' Conceptualisation and Operationalisation of Dignity

AIM

The aim of the study was to explore how students conceptualise and operationalise dignity with confidence in practice through a human rights lens.

DESIGN

A quantitative study using an online survey questionnaire.

METHODS

Data were collected using an online survey with 33 questions in three parts: students' conceptualisation of dignity, understanding of human rights and human rights law; students' operationalisation of dignity using a case study designed for this purpose [a fictional character named John]; lastly, students' preferred approaches to dignity education.

RESULTS

Survey findings revealed students' ambiguity or lack of agreement around dignity being associated with human rights and person-centred care. There was a sense of students feeling disempowered or lacking confidence in responding to dignity breaches in care, whilst some participants felt equipped to challenge this by most usually referring to clinical staff such as mentors and charge nurses due to the hierarchy in nursing systems within clinical contexts.

CONCLUSION

Informed by the findings from this survey, the research team has developed DigniSpace (2024), the first online interactive space for Dignity Education co-produced with students focusing on the concept of dignity (through a consideration of human rights) that has been designed to help students learn more about the concept and to confidently promote and advocate dignity in practice. This is the first such resource to empower students to interrogate the concept of Dignity using the human rights lens and become change agents to promote and advocate dignity in care as a fundamental human right in any practice context.

IMPLICATIONS FOR NURSING

Findings and outputs from this research have used the context of nursing education as a critical opportunity by placing students at the heart of developing DigniSpace (2024) to support the sustainable development of a culture of confidence to provide person-centred care embedded with dignity.

PATIENT OR PUBLIC CONTRIBUTIONS

Findings from this first phase of the study were presented to our project advisory group that included experts with lived experience and their family care partners, who then participated in the co-design workshops in the second phase of the study to develop DigniSpace-a key output from this project.

Emily's struggle for dignity: An idiographic case study of a woman with multiple sclerosis

Dignity is one of the essential values and central concepts in nursing care. Dignity can be threatened due to radical life changes; therefore, this idiographic case study aimed to explore the sense of dignity experienced by a woman with multiple sclerosis. An interpretative phenomenological analysis was adopted, using data collected through a face-to-face semistructured interview with Emily, a 45-year-old woman. The study was approved by the local ethics committee. Six personal experiential themes were identified: To be ruled by a sick body; Silent progression; Loss of independence as a burden for the family; Will to fight for the meaning of life; Maintaining dignity-in-relation; Dignified care in a period of greater vulnerability. Emily's dignity is based on the effort to fight for a meaningful life, utilization of her full potential, maintain independence in activities of daily living and support in relationships. Continuous changes in functional ability, loss of self-control and an uncertain future have a negative impact on the experience of her dignity. In the context of dignified health care, she considers individual care and maintaining autonomy important. The idiographic case study can contribute to a better understanding of the experience of a woman suffering from multiple sclerosis. It is possible to carry out interventions that aim to support her dignity, improve her quality of life and contribute to individually oriented health care.