title: Evaluation of the Dignity Care Pathway for community nurses caring for people at the end of life.
abstract: BACKGROUND
  People nearing the end of life fear loss of dignity, and a central tenet of palliative care is to help people die with dignity. The Dignity Care Pathway (DCP) is an intervention based on the Chochinov theoretical model of dignity care. It has four sections: a manual, a Patient Dignity Inventory, reflective questions, and care actions.
  
  
  METHODS
  The feasibility and acceptability of the DCP were evaluated using a qualitative design with a purposive sample of community nurses. Data was collected from April to October 2010 using in-depth interviews, reflective diaries, and case studies and then analysed using framework analysis.
  
  
  RESULTS
  The DCP was acceptable to the community nurses, helped them identify when patients were at the end of life, identified patients' key concerns, and aided nurses in providing holistic end-of-life care. It requires the nurse to have excellent communication skills. Some of the nurses found it hard to initiate a conversation on dignity-conserving care.
  
  
  CONCLUSIONS
  The DCP helps nurses to deliver individualised care and psychological care, which has previously been identified as a difficult area for community nurses. All of the nurses wished to continue to use the DCP and would recommend it to others.
authors.affiliation: School of Nursing and Midwifery, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, Scotland. b.johnston@dundee.ac.uk
authors.forename: Bridget
authors.initials: B
authors.lastname: Johnston
authors.forename: Ulrika
authors.initials: U
authors.lastname: Östlund
authors.forename: Hilary
authors.initials: H
authors.lastname: Brown
mesh_terms: D003152:Community Health Nursing; D004989:Ethics; D006801:Humans; D012297:Right to Die; D013727:Terminal Care