Modelos de dignidad en el cuidadocontribuciones para el final de la vida

  1. Errasti Ibarrondo, Begoña
  2. Martínez García, Marina
  3. Carvajal Valcárcel, Ana
  4. Arantzamendi Solabarrieta, María
Journal:
Cuadernos de bioética

ISSN: 1132-1989 2386-3773

Year of publication: 2014

Volume: 25

Issue: 84

Pages: 243-256

Type: Article

More publications in: Cuadernos de bioética

Abstract

Introduction: Social dignity, that is based on the ontological dignity and which is a consequence of its recognition, it is as a fundamental aspect of the care for both, health professionals and patients. Especially, at the end of life, period of time spam in which the person is more vulnerable. Objective: to explore different dignity models that have been elaborated in different healthcare contexts. Method: A review of the literature was carried out in CINAHL, Pubmed and PsycINFO databases, introducing “Dignity Model” as keyword. The only limit of the search was research written in English or Spanish. Results: seven models of dignity elaborated from different contexts and with different perspectives were identified. All of them consider dignity as an intrinsic aspect of the human being, but at the same time they take into account a subjective dimension of the dignity that depends on the persons’ experience. This subjective dimension of dignity is influenced by person´s perception about itself, the impact of illness in the person, the context of the person or even the behavior of the healthcare professionals. Conclusions: all the models included in this review provide to healthcare professional a starting point to reflect and to incorporate practices that may preserve the social dignity of terminally ill patients. One of the models identified has been applied to the clinical practice with positive results.

Bibliographic References

  • Mairis ED. Concept clarification in professional practice--dignity. J Adv Nurs. 1994;19(5):947-953.
  • Haddock J. Towards further clarification of the concept ‘dignity’. J Adv Nurs. 1996;24(5):924-931.
  • Shotton L, Seedhouse D. Practical dignity in caring. Nurs Ethics. 1998;5(3):246-255.
  • Matiti MR, Trorey G. Perceptual adjustment levels: Patients’ perception of their dignity in the hospital setting. Int J Nurs Stud. 2004;41(7):735-744.
  • Clark J. Defining the concept of dignity and developing a model to promote its use in practice. Nurs Times. 2010;106(20):16-19.
  • Aparisi Miralles Á. El principio de la dignidad humana como fundamento de un bioderecho global. Cuadernos de Bioética. 2013;XXIV(2ª):201-221.
  • Burns N, Grove SK. Investigación en enfermería. Versión en español de la 3ª edición de la obra original en inglés ed. Madrid: Elsevier; 2004.
  • Thompson G, Chochinov H. Dignity-based approaches in the care of terminally ill patients. Curr Opin Support Palliat Care. 2008;2(1):49-53.
  • Griffin-Heslin VL. An analysis of the concept dignity. Accid Emerg Nurs. 2005;13(4):251-257.
  • Leung D. Granting death with dignity: Patient, family and professional perspectives. Int J Palliat Nurs. 2007;13(4):170-174.
  • Jacobson N. Dignity and health: A review. Soc SciMed. 2007;64(2):292-302.
  • González AM. La dignidad de la persona, presupuestos de la investigación científica. En: Ballesteros Llompart J, Aparisi Miralles Á, editores. Biotecnología, dignidad y derecho: bases para un diálogo. Barañáin: Eunsa; 2004. p. 17-42.
  • Requena Meana P. Dignidad y autonomía en la bioética norteamericana. Cuadernos de Bioética. 2008;XIX(2ª):255-70.
  • Statman D. Humiliation, dignity and self-respect. Philos Psychol. 2000; 13(4) 523-540.
  • Nordenfelt L, Edgar A. The four notions of dignity. Qual Ageing. 2005;6(1):17-21.
  • Nordenfelt L. The varieties of dignity. Health Care Anal. 2004;12(2):69-81.
  • Leget C. Analyzing dignity: A perspective from the ethics of care. Med Health Care and Philos. 2013;16:945–952.
  • Gallagher A. Dignity and respect for dignity - two key health professional values: Implications for nursing practice. Nurs Ethics. 2004;11(6):587-599.
  • Spaemann R. Sobre el concepto de dignidad humana. Pamplona: Ediciones Universidad de Navarra; 1987. p. 13-33.
  • Slettebø Å, Caspari S, Lohne V, Aasgaard T, Nåden D. Dignity in the life of people with head injuries. J Adv Nurs. 2009;65(11):2426-2433.
  • Brown H, Johnston B, Ostlund U. Identifying care actions to conserve dignity in end-of-life care. Br J Community Nurs. 2011;16(5):238-245.
  • Coenen A, Doorenbos A, Wilson S. Nursing interventions to promote dignified dying in four countries. Oncol Nurs Forum. 2007;34(6):1151-1156.
  • Hack TF, Chochinov HM, Hassard T, Kristjanson LJ, McClement S, Harlos M. Defining dignity in terminally ill cancer patients: A factor-analytic approach. Psychooncology. 2004;13(10):700-708.
  • Chochinov HM, Hack T, McClement S, Kristjanson L, Harlos M. Dignity in the terminally ill: A developing empirical model. Soc Sci Med. 2002;54(3):433-443.
  • Chochinov HM. Dignity-conserving Care—A new model for palliative care. JAMA: J Am Med Assoc. 2002;287(17):2253-2260.
  • Walsh K, Kowanko I. Nurses' and patients' perceptions of dignity. Int J Nurs Pract. 2002;8(3):143-151.
  • Chochinov H, Krisjanson L, Hack T, Hassard T, McClement S, Harlos M. Dignity in the terminally ill: Revisited. J Palliat Med. 2006;9(3):666-672.
  • Chochinov HM, Hassard T, McClement S, Hack T, Kristjanson LJ, Harlos M, et al. The patient dignity inventory: A novel way of measuring dignity-related distress in palliative care. J Pain Symptom Manage. 2008;36(6):559-571.
  • Baillie L. Patient dignity in an acute hospital setting: A case study. Int J Nurs Stud. 2009;46(1):23-37.
  • Lin Y, Tsai Y. Maintaining patients' dignity during clinical care: A qualitative interview study. J Adv Nurs. 2011;67(2):340-348.
  • Lin Y, Tsai Y, Chen H. Dignity in care in the hospital setting from patients' perspectives in taiwan: A descriptive qualitative study. J Clin Nurs. 2011;20(5-6):794-801.
  • van Gennip IE, Pasman HRW, Oosterveld-Vlug MG, Willems DL, Onwuteaka-Philipsen BD. The development of a model of dignity in illness based on qualitative interviews with seriously ill patients. Int J Nurs Stud. 2013;50(8):1080-1089.
  • Calnan M, Tadd W. Dignity and older europeans: Methodology. Qual Ageing. 2005;6(1):10-16.
  • Linköping University. IMH - Institutionen för medicin och hälsa. Lennart nordenfelt. [Internet]. [Consultado el 21 de enero de 2013]. Disponible en: http://www.imh.liu.se/avd_halsa_samhalle/medarbetare1/lennart_nordenfelt?l=en
  • Nordenfelt L. Dignity of the elderly: An introduction. Med Health Care Phil. 2003;6(2):99-101.
  • Social Care Institute for Excellence (SCIE). Dignity in care - overview of selected research: What dignity means. Dignity and Death. [Internet]. [Consultado el 21 de enero de 2013]. Disponible en: http://www.scie. org.uk/publications/guides/guide15/selectedresearch/whatdignitymeans.asp
  • Torralba i Roselló F. Antropología del cuidar. Institut Borja de Bioética, editor. Fundación MAPFRE Medicina; 1998.
  • Cheng JO, Lo RS, Chan FM, Kwan BH, Woo J. An exploration of anticipatory grief in advanced cancer patients. Psycho Oncol. 2010;19(7):693-700.
  • McClement S, Chochinov HM, Hack T, Hassard T, Kristjanson LJ, Harlos M. Dignity therapy: Family member perspectives. J Palliat Med. 2007;10(5):1076-82.
  • Chochinov HM, Kristjanson LJ, Breitbart W, McClement S, Hack TF, Hassard T, et al. Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: A randomised controlled trial. Lancet Oncol. 2011;12(8):753-62.
  • Hall S, Longhurst S, Higginson I. Living and dying with dignity: A qualitative study of the views of older people in nursing homes. Age and Ageing. 2009;38(4):411-6.
  • Chochinov HM, Cann B, Cullihall K, Kristjanson L, Harlos M, McClement SE, et al. Dignity therapy: A feasibility study of elders in long-term care. Palliat Support Care. 2012;10(1):3-15.
  • Houmann L, Rydahl-Hansen S, Chochinov H, Kristjanson L, Groenvold M. Testing the feasibility of the dignity therapy interview: Adaptation for the danish culture. BMC Palliat Care. 2010;9(1):21.
  • Ripamonti CI, Buonaccorso L, Maruelli A, Bandieri E, Pessi MA, Boldini S, et al. Patient dignity inventory (PDI) questionnaire: The validation study in italian patients with solid and hematological cancers on active oncological treatments. Tumori. 2012;98(4):491- 500.