Nursing research using concept analysis plays a critical role for knowledge development, particularly when concerning to broad and foundational concepts for nursing practice, such as dignity. This study aimed to synthesize research concerning concept analysis of dignity in nursing care. Based on a literature review, electronic databases were searched using the terms “dignity,” “human dignity,” “concept analysis,” and nurs*. Papers in Portuguese or English were included. The research synthesis was conducted independently by two reviewers. A total of 35 citations were (...) identified and seven papers were included. Six studies were elected using Walker and Avant concept analysis methodology while one applied the Beth Rodgers evolutionary model. The concept of dignity has been studied by nurses, and its attributes, antecedents, consequences, and similar concepts were synthesized into a definition. Dignity emerged as a fundamental concept in nursing ethics and the main attributes synthesized were personhood, sociability, respect, and autonomy. The antecedents identified were: facilitators—patient focus care, recognition, education, and ethical competence; threats—vulnerability and organizational environment. The consequences were positive coping, empowerment, and dignity preservation. The synthesis of these seven studies using concept analysis provided a clear definition of dignity. These findings challenge future research and education, particularly for the study of undergraduate and postgraduate nursing education programs to enhance skills for preserving patient dignity in clinical practice. (shrink)

Background Patient dignity is sometimes neglected in intensive care unit (ICU) settings, which may potentially cause psychological harm to critically ill patients. However, no instrument has been specifically developed to evaluate the behaviors of dignified care among critical care nurses. Aim This study aimed to develop and evaluate ICU Dignified Care Questionnaire (IDCQ) for measurement of self-assessed dignity-conserving behaviors of critical care nurses during care. Methods The instrument was developed in 3 phases. Phase 1: item generation; phase 2: a two-round (...) Delphi survey and a readability pilot study; phase 3: cross-sectional survey with model estimation. The questionnaire was evaluated by item analysis, exploratory and confirmatory factor analysis, assessment of internal consistency reliability, and test-retest reliability. The investigation was conducted using a convenience sample of 392 critical care nurses from 6 cities in Zhejiang Province, China, of which 30 participated in the test-retest reliability survey 2 weeks later. Ethical considerations The study was approved by ethics committee. All participants provided written informed consent before the survey. The questionnaire survey was anonymous. Results The results showed acceptable reliability and validity of the IDCQ. The 17-item final version questionnaire was divided into 2 dimensions: absolute dignity and relative dignity. These two factors accounted for 62.804% of the total variance, and model fitting results were acceptable. The Cronbach’s alpha coefficient of the questionnaire was 0.94, and the test-retest intraclass correlation coefficient (ICC) was 0.88 after 2 weeks. Conclusions This study developed a brief and reliable instrument (IDCQ) to assess dignified care in ICU nursing. It can help critical care nurses identify their behaviors in maintaining patient dignity and discover their deficiencies. It may also serve as a clinical nursing management tool to help reduce patient disrespect experience in ICU. (shrink)

The studies of health care systems are conducted intensively on various levels. They are important because the systems suffer from numerous pathologies. The health care is analyzed, first of all, in economic aspects but their functionality in the framework of systems theory is studied, as well. There are also attempts to work out some general values on which health care systems should be based. Nevertheless, the aforementioned studies, however, are fragmentary ones. In this paper holistic approach to the philosophical basis (...) of health care is presented. The levels on which the problem can be considered are specified explicitly and relations between them are analyzed, as well. The philosophical basis on which the national health care systems could be based is proposed. Personalism is the basis for the proposal. First of all, the values, that are derived from the personalistic philosophy, are specified as the basic ones for health care systems. Then, general organizational and functional properties of the system are derived from the assumed values. The possibility of adaptation of solutions from other fields of social experiences are also mentioned. The existing health care systems are analyzed within the frame of the introduced proposal. (shrink)