title: What facilitates the delivery of dignified care to older people? A survey of health care professionals.
abstract: BACKGROUND
  Whilst the past decade has seen a growing emphasis placed upon ensuring dignity in the care of older people this policy objective is not being consistently achieved and there appears a gap between policy and practice. We need to understand how dignified care for older people is understood and delivered by the health and social care workforce and how organisational structures and policies can promote and facilitate, or hinder, the delivery of such care.
  
  
  METHODS
  To achieve our objective of understanding the facilitators and to the delivery of dignified care we undertook a survey with health and social care professionals across four NHS Trusts in England. Participants were asked provide free text answers identifying any facilitators/barriers to the provision of dignified care. Survey data was entered into SPSSv15 and analysed using descriptive statistics. These data provided the overall context describing staff attitudes and beliefs about dignity and the provision of dignified care. Qualitative data from the survey were transcribed verbatim and categorised into themes using thematic analysis.
  
  
  RESULTS
  192 respondents were included in the analysis. 79% of respondents identified factors within their working environment that helped them provide dignified care and 68% identified barriers to achieving this policy objective. Facilitators and barriers to delivering dignified care were categorised into three domains: 'organisational level'; 'ward level' and 'individual level'. Within the these levels, respondents reported factors that both supported and hindered dignity in care including 'time', 'staffing levels', training',' 'ward environment', 'staff attitudes', 'support', 'involving family/carers', and 'reflection'.
  
  
  CONCLUSIONS
  Facilitators and barriers to the delivery of dignity as perceived by health and social care professionals are multi-faceted and range from practical issues to interpersonal and training needs. Thus interventions to support health and social care professionals in delivering dignified care, need to take a range of issues into account to ensure that older people receive a high standard of care in NHS Trusts.
authors.affiliation: Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK. deborah.kinnear@glasgow.ac.uk.
authors.forename: Deborah
authors.initials: D
authors.lastname: Kinnear
authors.affiliation: College of Health and Life Sciences, Brunel University London, Uxbridge, UK. christina.victor@brunel.ac.uk.
authors.forename: Christina
authors.initials: C
authors.lastname: Victor
authors.affiliation: Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, University of Oxford, Oxford, UK. veronika.williams@phc.ox.ac.uk.
authors.forename: Veronika
authors.initials: V
authors.lastname: Williams
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000592:standards*; D004739:England; D005260:Female; D006282:Health Personnel / Q000592:standards*; D006299:Health Services for the Aged / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged