Sage Journals: Discover world-class research

Abstract

Aim

To synthesize qualitative research on perspectives and understandings of Intensive Care Unit (ICU) patients, family members, and staff regarding respect and dignity in ICU, in order to explore the connotations and meanings of respect and dignity in ICU.

Design

A qualitative meta-synthesis.

Methods

The Chinese and English databases were systematically searched, including PubMed, Web of Science, CINAHL, Embase, Cochrane Library, CNKI, Wangfang Data, VIP, and CBM from each database’s inception to July 22, 2023. Studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta-synthesized. (PROSPERO: CRD42023447218).

Results

A total of 9 studies from 6 countries were included in the meta-synthesis. Thirty-six main themes and 67 sub-themes were extracted, which were eventually integrated into 9 categories and 4 themes: (1) integrity of humanity; (2) autonomy; (3) equality; (4) environmental support.

Conclusion

To maintain patient dignity, it is necessary to create an environment of respect within the ICU where healthcare professionals uphold the concept of preserving human integrity and respect patients' autonomy and equality. Healthcare professionals need to value the dignity of ICU patients and treat them as unique individuals during treatment and care. Hospital managers should also strive to create a respectful environment to provide environmental support for dignity care implementation.

Keywords

Dignity respect Intensive Care Unit meta-synthesis patients

Get full access to this article

View all access options for this article.

References

Gazarian

Morrison

CRC

Lehmann

, et al. Patients’ and care partners' perspectives on dignity and respect during acute care hospitalization. J Patient Saf 2021; 17: 392–397.

Brown

Azoulay

Benoit

, et al. The practice of respect in the ICU. Am J Respir Crit Care Med 2018; 197: 1389–1395.

Geller

Schell-Chaple

Turner

, et al. Measuring patient respect in the intensive care unit: validation of the ICU-RESPECT instrument. J Crit Care 2018; 46: 63–66.

Lele

Xiaoya

Hong

. Current status and related factors of dignity among patients in intensive care unit. J Nurs Adm 2017; 17: 29–31.

Kostopoulou

Parpa

Tsilika

, et al. Advanced cancer patients' perceptions of dignity: the impact of psychologically distressing symptoms and preparatory grief. J Palliat Care 2018; 33: 88–94.

Pronovost

Bo-Linn

Sapirstein

. From heroism to safe design: leveraging technology. Anesthesiology 2014; 120: 526–529.

Sugarman

. Toward treatment with respect and dignity in the intensive care unit. Narrat Inq Bioeth 2015; 5: 1A–4A.

Zhang

. The effectiveness of dignity therapy on hope, quality of life, anxiety, and depression in cancer patients: a meta-analysis of randomized controlled trials. Int J Nurs Stud 2022; 132: 104273.

Xiao

MSN

Yan

, et al. How patients with cancer experience dignity: an integrative review. Psycho Oncol 2021; 30: 1220–1231.

10.

Lindwall

Lohne

. Human dignity research in clinical practice - a systematic literature review. Scand J Caring Sci 2021; 35: 1038–1049.

11.

Fuseini

Ley

Rawson

, et al. A systematic review of patient-reported dignity and dignified care during acute hospital admission. J Adv Nurs 2022; 78: 3540–3558.

12.

Geller

Branyon

Forbes

, et al. Health care professionals' perceptions and experiences of respect and dignity in the intensive care unit. Narrat Inq Bioeth 2015; 5: 27A–42A.

13.

Moen

Naden

. Intensive care patients' perceptions of how their dignity is maintained: a phenomenological study. Intensive Crit Care Nurs 2015; 31: 285–293.

14.

Geller

Branyon

Forbes

, et al. ICU-RESPECT: an index to assess patient and family experiences of respect in the intensive care unit. J Crit Care 2016; 36: 54–59.

15.

Carrese

Geller

Branyon

, et al. A direct observation checklist to measure respect and dignity in the ICU. Crit Care Med 2017; 45: 263–270.

16.

Beach

Topazian

Chan

, et al. Climate of respect evaluation in ICUs: development of an instrument (ICU-CORE). Crit Care Med 2018; 46: e502–e507.

17.

Henry

Rushton

Beach

, et al. Respect and dignity: a conceptual model for patients in the intensive care unit. Narrat Inq Bioeth 2015; 5: 5A–14A.

18.

Lockwood

Munn

Porritt

. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. Int J Evid Base Healthc 2015; 13: 179–187.

19.

Aboumatar

Forbes

Branyon

, et al. Understanding treatment with respect and dignity in the intensive care unit. Narrative inquiry in bioethics 2015; 5: 55A–67A.

20.

Beach

Forbes

Branyon

, et al. Patient and family perspectives on respect and dignity in the intensive care unit. Narrative inquiry in bioethics 2015; 5: 15A–25A.

21.

Bidabadi

Yazdannik

Zargham-Boroujeni

. Patient's dignity in intensive care unit: a critical ethnography. Nurs Ethics 2019; 26: 738–752.

22.

Jacelon

Henneman

. Dignity in the older critically ill adult: the family member's perspective. Heart Lung 2014; 43: 432–436.

23.

Nyholm

Koskinen

. Understanding and safeguarding patient dignity in intensive care. Nurs Ethics 2017; 24: 408–418.

24.

Rafiq

Arthur

Rahim

, et al. Nurses’ perceptions about the dignity of intubated patients. Nurs Ethics 2021; 28: 980–995.

25.

Soderberg

Gilje

Norberg

. Dignity in situations of ethical difficulty in intensive care. Intensive Crit Care Nurs 1997; 13: 135–144.

26.

Turnock

Kelleher

. Maintaining patient dignity in intensive care settings. Intensive Crit Care Nurs 2001; 17: 144–154.

27.

Koksvik

. Dignity in practice: day-to-day life in intensive care units in western Europe. Med Anthropol 2015; 34: 517–532.

28.

Mohammadi

Peyrovi

Mahmoodi

. The relationship between professional quality of life and caring ability in critical care nurses. Dimens Crit Care Nurs 2017; 36: 273–277.

29.

Hall

Mitchell

. Dignity and respect in midwifery education in the UK: a survey of Lead Midwives of Education. Nurse Educ Pract 2016; 21: 9–15.

30.

Yan

Qingna

Rui

, et al. Construction of nursing quality evaluation index system for ICU patients.pdf. Chin J Nurs 2020; 55: 177–181.

31.

Topcu

Turkmen

Sahiner

, et al. Physicians’ and nurses’ medical errors associated with communication failures. J Pakistan Med Assoc 2017; 67: 600–604.

32.

Museux

Dumont

Careau

, et al. Improving interprofessional collaboration: the effect of training in nonviolent communication. Soc Work Health Care 2016; 55: 427–439.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.13 MB

0.00 MB