title: The dignified approach to care: a pilot study using the patient dignity question as an intervention to enhance dignity and person-centred care for people with palliative care needs in the acute hospital setting.
abstract: BACKGROUND
  Providing person-centred, dignity-conserving care for hospitalised patients is central to many healthcare policies and essential to the provision of effective palliative care. The Patient Dignity Question (PDQ) "What do I need to know about you as a person to take the best care of you that I can?" was designed from empirical research on patients' perceptions of their dignity at end of life to help healthcare professionals (HCPs) understand the patient as a person.
  
  
  METHODS
  This mixed method pilot study was designed to inform a larger multisite study in the future. It tests the hypothesis that the PDQ intervention could be used to enhance a more person-centred climate for people with palliative care needs in the acute hospital setting, and provide evidence regarding its acceptability. Outcome measures pre and post intervention Person-centred Climate Questionnaire--patient version (PCQ-P), and the Consultation and Relational Empathy (CARE) measure; PDQ feedback questionnaires were used for all participants post intervention, in addition to qualitative interviews.
  
  
  RESULTS
  30 patients, 17 HCPs, and 4 family members participated. Results showed a positive correlation between higher PCQ-P scores and higher CARE scores, indicating that the PDQ can make improvements to a person-centred environment and levels of empathy perceived by patients. Individual results from the PCQ-P and the CARE indicated overall improvements in the majority of fields. The PDQ supported disclosure of information previously unknown to HCPs, has implications for improving person-centred care. Positive results from PDQ feedback questionnaires were received from all participants. Qualitative findings indicated patients' appreciation of staff (Attributes and attitudes), that patients wanted staff to have awareness of them (Know me as a person), take the time to talk, and work flexibly, to allow for patient individuality (Time and place).
  
  
  CONCLUSIONS
  The PDQ has potential to improve patients' perceptions of care, and HCP attitudes. Furthermore, it was well received by participants. The PDQ could be incorporated into clinical practice for the care of palliative care patients in the acute setting to the benefit of personalized and dignified care. Further research using the PDQ across wider geographical areas, and more diverse settings, would be beneficial.
authors.affiliation: Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, School of Health Sciences, The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, England UK.
authors.forename: Bridget
authors.initials: B
authors.lastname: Johnston
authors.affiliation: School of Education, Social Work and Community Education, University of Dundee, C.2.16 Carnelley Building, Dundee, DD1 4HN, Scotland UK.
authors.forename: Jan
authors.initials: J
authors.lastname: Pringle
authors.affiliation: Royal Victoria Hospital, Roxburghe House, Jedburghe Road, Dundee, DD2 1SP, Scotland UK.
authors.forename: Marion
authors.initials: M
authors.lastname: Gaffney
authors.affiliation: Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, School of Health Sciences, The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, England UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Narayanasamy
authors.affiliation: NHS Tayside Headquarters, Ninewells Hospital and Medical School, Dundee, DD1 9SY, Scotland UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: McGuire
authors.affiliation: Ninewells Hospital, NHS Tayside, Dundee, DD1 9SY, Scotland UK.
authors.forename: Deans
authors.initials: D
authors.lastname: Buchanan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005190:Family / Q000523:psychology*; D005260:Female; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D018802:Patient-Centered Care / Q000458:organization & administration*; D010865:Pilot Projects; D012606:Scotland; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: Acute care; Dignity; Mixed methods; Palliative care