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Nurse Perspectives of Maintaining Patient Dignity in Indonesian Clinical Care Settings: A Multicenter Qualitative Study

PURPOSE
Nurses have a professional obligation to maintain patient dignity when providing nursing care. The concept of dignity, however, is dependent on cultural context. The aim of this study was to elicit nurses' perspectives for maintaining patient dignity in Indonesian clinical care settings.


DESIGN
A qualitative descriptive study was performed.


METHODS
A total of 40 clinical nurse participants were recruited by purposive sampling from six general public hospitals in Eastern Java, Indonesia, including six medical and six surgical units. Data were collected in 2017 using individual face-to-face semistructured interviews. Inductive content analysis was employed.


FINDINGS
The interview data revealed nurses considered three main elements were necessary to maintain patient dignity in clinical care: personalized care, which included prioritizing patients and treating as individuals; compassionate care, which included empathizing and providing emotional support; and patient care advocacy, which included protecting patient rights and being a representative for the patient.


CONCLUSIONS
This study provided knowledge on how to maintain patient dignity from the cultural perspective of clinical nurses in Indonesia. Our findings highlight the importance of providing dignified care in a manner that is congruent with culture. The nurses in our study considered compassion and beneficence necessary values for providing dignified patient-centered care, which might be qualities that are culturally sensitive for an Indonesian population.


CLINICAL RELEVANCE
Strategies should be developed to improve dignity of care for hospitalized patients in Indonesia as well as other cultural settings, which could be incorporated into patient care. These should include improving patients' health literacy to increase patient-centered communication, eliminating mixed-gender wards to enhance patient privacy, and involving family members as partners in health care.