title: Defining dignity in end-of-life care in the emergency department.
abstract: BACKGROUND
  Respecting dignity is having a profound effect on the clinical relationship and the care framework for terminally ill patients in palliative care units, hospices and their own homes, with particular consequences for the emergency department. However, dignity is a vague and multifaceted concept that is difficult to measure.
  
  
  OBJECTIVE
  The aim of this study is to define the attributes of dignity in end-of-life care in the emergency department, based on the opinions of physicians and nurses.
  
  
  METHODS
  A hermeneutic phenomenological approach utilising Gadamer's philosophical underpinnings guided the study. Participants and research context: This research was conducted in Spain in 2013-2014. Participants included 10 physicians and 16 nurses with experience working in the emergency department. Two focus groups and 12 in-depth interviews were carried out. Ethical considerations: The study was approved by the Research Centre Ethical Committee (Andalusian Health Service, Spain).
  
  
  RESULTS
  The results point to the person's inherent value, socio-environmental conditions and conscious actions/attitudes as attributes of dignity when caring for a dying patient in the emergency department.
  
  
  CONCLUSIONS
  Dying with dignity is a basic objective in end-of-life care and is an ambiguous but relevant concept for physicians and nurses. In line with our theoretical framework, our results highlight care environment, professional actions and socio-family context as attributes of dignity.
  
  
  CONCLUSIONS
  Quality care in the emergency department includes paying attention to the dignity of people in the process of death. The dignity in the care of a dying person in the emergency department is defined by acknowledging the inherent value in each person, socio-environmental conditions and social and individual acceptance of death. Addressing these questions has significant repercussions for health professionals, especially nurses.
authors.affiliation: University of Almeria, Spain; Autonomous University of Chile, Chile.
authors.forename: Cayetano
authors.initials: C
authors.lastname: Fernández-Sola
authors.affiliation: Complejo Hospitalario Torrecárdenas, Spain.
authors.forename: María Mar Díaz
authors.initials: MM
authors.lastname: Cortés
authors.affiliation: Middlesex University, UK.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Hernández-Padilla
authors.forename: Cayetano José Aranda
authors.initials: CJ
authors.lastname: Torres
authors.affiliation: University of Almeria, Spain.
authors.forename: José María Muñoz
authors.initials: JM
authors.lastname: Terrón
authors.affiliation: University of Almeria, Spain; Autonomous University of Chile, Chile.
authors.forename: José
authors.initials: J
authors.lastname: Granero-Molina
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital / Q000941:ethics* / Q000458:organization & administration; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000941:ethics / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology; D028723:Personhood; D010820:Physicians / Q000941:ethics / Q000523:psychology; D036301:Qualitative Research; D013030:Spain; D013727:Terminal Care / Q000941:ethics / Q000523:psychology*
keywords: Dignity; dying; emergency medicine; palliative care; terminal care