“It’s Like Opening a Can of Worms”: Evaluating a Dignity Care Intervention for People with Life Limiting Illness in the Community Setting

Research output: Contribution to journalArticle

Abstract

Background: Evidence indicates that people nearing endof life fear loss of dignity and a central tenet of palliativecare is to help people die with dignity. The Dignity CareIntervention (DCI), based on the Chochinov theoreticalmodel of dignity care, comprises four components: educationmanual; patient dignity inventory, reflective questionsand care actions.Aim: To evaluate the usability and acceptability of a DignityCare Intervention (DCI) delivered by communitynurses for people with advanced and life limitingconditions.Method: Mixed methods research design, with threephases.Phase 1: Semi-structured, face-to-face interviews withpatient/carer dyads (n=18),Phase 2: four focus groups with (n=24) and an onlinesurvey with community nurses (n=27),Phase 3: analysis of completed DCI tools (n=27). Datawere analysed using thematic analysis of verbatim transcriptsand descriptive statistical analysis.Results: The DCI was acceptable to the communitynurses. It contributed to the overall assessment of palliativecare patients; identified areas that might not otherwisehave been identified; supported communication andassisted the nurses to provide holistic end of life care. Concernshowever were expressed that the tool ‘opened a canof worms’ initiating difficult conversations for which thenurses felt unprepared. The patients however found thatthe tool helped them to identify and consider future needsand were happy to discuss death and dying.Conclusion: The DCI helped nurses to delivered individualisedholistic care. Whilst all the nurses wished to continueto use the DCI, there were barriers identified such asthe time taken to complete; the identification of suitablepatients and the need for more training to enable them toinitiate difficult conversations on dignity conserving careand end of life care.
Original languageEnglish
Pages (from-to)NP273-NP273
JournalPalliative Medicine
Volume30
Issue number6
Early online date11 May 2016
DOIs
Publication statusPublished - 1 Jun 2016

Keywords

  • dignity
  • community nurse
  • assessment

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