The dignified approach to care: a pilot study using the patient dignity question as an intervention to enhance dignity and person-centred care for people with palliative care needs in the acute hospital setting

Johnston, B., Pringle, J., Gaffney, M., Narayanasamy, M., McGuire, M. and Buchanan, D. (2015) The dignified approach to care: a pilot study using the patient dignity question as an intervention to enhance dignity and person-centred care for people with palliative care needs in the acute hospital setting. BMC Palliative Care, 14, 9. (doi:10.1186/s12904-015-0013-3) (PMID:25883533) (PMCID:PMC4399754)

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Abstract

Background: Providing person-centred, dignity-conserving care for hospitalised patients is central to many healthcare policies and essential to the provision of effective palliative care. The Patient Dignity Question (PDQ) “What do I need to know about you as a person to take the best care of you that I can?” was designed from empirical research on patients’ perceptions of their dignity at end of life to help healthcare professionals (HCPs) understand the patient as a person. Methods: This mixed method pilot study was designed to inform a larger multisite study in the future. It tests the hypothesis that the PDQ intervention could be used to enhance a more person-centred climate for people with palliative care needs in the acute hospital setting, and provide evidence regarding its acceptability. Outcome measures pre and post intervention Person-centred Climate Questionnaire – patient version (PCQ-P), and the Consultation and Relational Empathy (CARE) measure; PDQ feedback questionnaires were used for all participants post intervention, in addition to qualitative interviews. Results: 30 patients, 17 HCPs, and 4 family members participated. Results showed a positive correlation between higher PCQ-P scores and higher CARE scores, indicating that the PDQ can make improvements to a person-centred environment and levels of empathy perceived by patients. Individual results from the PCQ-P and the CARE indicated overall improvements in the majority of fields. The PDQ supported disclosure of information previously unknown to HCPs, has implications for improving person-centred care. Positive results from PDQ feedback questionnaires were received from all participants. Qualitative findings indicated patients’ appreciation of staff (Attributes and attitudes), that patients wanted staff to have awareness of them (Know me as a person), take the time to talk, and work flexibly, to allow for patient individuality (Time and place). Conclusion: The PDQ has potential to improve patients’ perceptions of care, and HCP attitudes. Furthermore, it was well received by participants. The PDQ could be incorporated into clinical practice for the care of palliative care patients in the acute setting to the benefit of personalized and dignified care. Further research using the PDQ across wider geographical areas, and more diverse settings, would be beneficial.

Item Type:Articles
Additional Information:This study was funded by Macmillan Cancer Support and NHS Tayside (endowment fund grant 2013/14).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Johnston, Professor Bridget and McGuire, Dr Margaret
Authors: Johnston, B., Pringle, J., Gaffney, M., Narayanasamy, M., McGuire, M., and Buchanan, D.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:BMC Palliative Care
Publisher:BioMed Central
ISSN:1472-684X
ISSN (Online):1472-684X
Copyright Holders:Copyright © 2015 Johnston et al
First Published:First published in BMC Palliative Care 14: 9
Publisher Policy:Reproduced under a Creative Commons License

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