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Older people's views of dignity and how it can be promoted in a hospital environment.

AIM
The study investigated the lived experiences of older patients who had been in hospital, to explore their views on dignity and the factors which promote dignity.


BACKGROUND
The UK government's new ambition for old age (New Ambition for Old Age: Next Steps in implementing the National Service Framework for Older People: A Report from Professor Ian Philip, DH) states that older people should be treated with dignity. The dignity in Care Campaign ('Dignity in Care'Public Survey, October 2006: Report of the Survey, DH) highlighted the need to raise staff's awareness and understanding of dignity.


DESIGN
A purposive sample of older people took part in semi- structured interviews which focussed on their recent experiences of hospital admission. Qualitative data analysis was used.


METHOD
Ten participants aged 73-83 were interviewed by a nurse researcher at home. All of the participants had an unplanned admission and were discharged home.


RESULTS
The participants although generally satisfied with their care had strong views on dignity. The following factors had the potential to promote dignity; privacy for the body, cleanliness, independence and being able to exert control, sufficient time from staff, attitudes to older people and communication.


CONCLUSIONS
This study suggests that independence and effective communication are of central importance in maintaining dignity through achieving control of their situation. The participants observed that factors such as speaking inappropriately and waiting for personal care undermined older people's perceptions of dignity. Several participants feared for their own dignity should they have cognitive problems later in their lives.


RELEVANCE TO CLINICAL PRACTICE
Staff need to be aware that communicating in a way that conveys empathy and responds to the individual as a valued person is an important factor in maintaining dignity. Nurses on hospital wards particularly need to take measures to safeguard the dignity of older people with cognitive problems who have difficulty in making their needs known.