title: Nursing home staff's views on residents' dignity: a qualitative interview study.
abstract: BACKGROUND
  Maintaining dignity is an important element of end-of-life care and also of the care given in nursing homes. Factors influencing personal dignity have been studied from both nursing home residents' and staff's perspective. Little is however known about the way nursing home staff perceive and promote the personal dignity of individual residents in daily practice, or about staff's experiences with preserving dignity within the nursing home. The aim of this study is to gain more insight in this.
  
  
  METHODS
  A qualitative descriptive interview study was designed, in which in-depth interviews were performed with 13 physicians and 15 nurses. They expressed their views on the personal dignity of 30 recently admitted nursing home residents on the general medical wards of four nursing homes in The Netherlands. Interviews were transcribed and analyzed following the principles of thematic analysis.
  
  
  RESULTS
  According to both physicians and nurses, physical impairment and being dependent on others threatened the residents' dignity. Whether or not this led to a violation of an individual resident's dignity, depended--in staff's opinion--on the resident's ability to show resilience and to keep his/her individuality. Staff mentioned treating residents with respect and taking care of their privacy as most important elements of dignity-conserving care and strived to treat the residents as they would like to be treated themselves. They could often mention aspects that were important for a particular resident's dignity. But, when asked what they could contribute to a particular resident's dignity, they often mentioned general aspects of dignity-conserving care, which could apply to most nursing home residents. By attempting to give dignity-conserving care, physicians and nurses often experienced conflicting values in daily care and barriers caused by the lack of resources.
  
  
  CONCLUSIONS
  Tailoring dignity-conserving care to an individual nursing home resident appears hard to bring about in daily practice. Both attention to solve contextual barriers within the nursing home as well as more awareness of staff members for their own values, which they take as a reference point in treating residents, is needed to promote personal dignity in the nursing home setting.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Expertise Center for Palliative Care, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. eol@vumc.nl.
authors.forename: Mariska G
authors.initials: MG
authors.lastname: Oosterveld-Vlug
authors.forename: H Roeline W
authors.initials: HR
authors.lastname: Pasman
authors.forename: Isis E
authors.initials: IE
authors.lastname: van Gennip
authors.forename: Dick L
authors.initials: DL
authors.lastname: Willems
authors.forename: Bregje D
authors.initials: BD
authors.lastname: Onwuteaka-Philipsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007326:Institutionalization; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology; D009735:Nursing Homes / Q000592:standards; D028723:Personhood; D010820:Physicians / Q000523:psychology; D036301:Qualitative Research; D000078329:Workforce
references.citation: J Adv Nurs. 2004 Jan;45(1):63-71
references.pmid: 14675302
references.citation: BMJ. 2009 Nov 16;339:b4362
references.pmid: 19917578
references.citation: J Pain Symptom Manage. 2012 Aug;44(2):192-205
references.pmid: 22704058
references.citation: Int J Nurs Pract. 2011 Aug;17(4):336-41
references.pmid: 21781212
references.citation: Age Ageing. 2007 Mar;36(2):197-202
references.pmid: 17208924
references.citation: Palliat Med. 2011 Mar;25(2):125-38
references.pmid: 21282349
references.citation: Nurs Ethics. 2004 Nov;11(6):587-99
references.pmid: 15597939
references.citation: Nurs Ethics. 2006 Mar;13(2):130-46
references.pmid: 16526148
references.citation: J Adv Nurs. 2014 Jan;70(1):97-106
references.pmid: 23711199
references.citation: Age Ageing. 2009 Jul;38(4):411-6
references.pmid: 19460857
references.citation: J Med Ethics. 2002 Dec;28(6):368-72
references.pmid: 12468656
references.citation: Accid Emerg Nurs. 2005 Oct;13(4):251-7
references.pmid: 16298291
references.citation: CA Cancer J Clin. 2006 Mar-Apr;56(2):84-103; quiz 104-5
references.pmid: 16514136
references.citation: Int J Older People Nurs. 2009 Sep;4(3):185-93
references.pmid: 20925775
references.citation: J Adv Nurs. 2007 Sep;59(6):635-43
references.pmid: 17727405
references.citation: J Am Med Dir Assoc. 2004 May-Jun;5(3):207-12
references.pmid: 15115583
references.citation: Med Health Care Philos. 2008 Jun;11(2):191-208
references.pmid: 17939059
references.citation: JAMA. 2002 May 1;287(17):2253-60
references.pmid: 11980525
references.citation: Nurs Times. 2005 Aug 16-22;101(33):38-41
references.pmid: 16130500
references.citation: Res Nurs Health. 2000 Aug;23(4):334-40
references.pmid: 10940958
references.citation: Nurs Ethics. 2010 May;17(3):289-300
references.pmid: 20444771
references.citation: Curr Opin Support Palliat Care. 2008 Mar;2(1):49-53
references.pmid: 18685395
references.citation: Int J Nurs Stud. 2009 Jan;46(1):23-36
references.pmid: 18790477
references.citation: J Adv Nurs. 2004 Oct;48(1):76-83
references.pmid: 15347413
references.citation: J Palliat Med. 2013 Sep;16(9):1108-14
references.pmid: 23941564
references.citation: Eur J Oncol Nurs. 2012 Sep;16(4):353-67
references.pmid: 21917517