Evaluating a dignity care intervention for palliative care in the community setting: community nurses' perspectives.
OBJECTIVE
To evaluate a dignity care intervention provided by community nurses seeking to address dignity concerns for people with advanced and life-limiting conditions.


BACKGROUND
Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking.


METHODS
A mixed methods study using online survey and focus group interviews and thematic analysis to examine data.


METHODS
Twenty four community nurses implemented the dignity care intervention for people with advanced and life-limiting conditions were recruited from four pilot sites across Ireland. Four focus group interviews and on line survey were conducted between March-June 2015.


RESULTS
The community nurses found the dignity care intervention useful. It helped the nurses to provide holistic end-of-life care and assisted in the overall assessment of palliative care patients, identifying areas that might not otherwise have been noted. Whilst it was a useful tool for communication, they noted that it stimulated some emotionally sensitive conversations for which they felt unprepared.


CONCLUSIONS
Implementing the dignity care intervention in practice was challenging. However, the dignity care intervention facilitated holistic assessment and identified patient dignity-related concerns that may not have been otherwise identified. Further support is required to overcome barriers and enable dignity-conserving care.


CONCLUSIONS
Ensuring dignity is a key aspect of palliative and end-of-life care; however, community nurses may not feel equipped to address this aspect of care. Implementing a dignity care intervention can assist in identifying patient dignity-related concerns and provision of holistic care. Community nurses need more training to assist in difficult conversations relating to dignity and end-of-life care.
Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK.|All Ireland Institute of Hospice and Palliative Care, Dublin, Ireland.
Sonja
S
McIlfatrick
School of Nursing, Midwifery & Health Sciences Centre, University College Dublin, Dublin, Ireland.
Michael
M
Connolly
All Ireland Institute of Hospice and Palliative Care, c/o Our Lady's Hospice & Care Services, Dublin, Ireland.
Rita
R
Collins
All Ireland Institute of Hospice and Palliative Care, c/o Our Lady's Hospice & Care Services, Dublin, Ireland.
Tara
T
Murphy
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
Bridget
B
Johnston
School of Nursing, Midwifery & Health Sciences Centre, University College Dublin, Dublin, Ireland.|Education and Research, Our Lady's Hospice & Care Services, Dublin, Ireland.
Philip
P
Larkin
D000328:Adult; D000368:Aged; D003152:Community Health Nursing / Q000379:methods*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D010166:Palliative Care / Q000523:psychology*; D028723:Personhood; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*; D055815:Young Adult
community nursing; dignity; evaluation; mixed methods; palliative care