Conceptualizations of dignity at the end of life: exploring theoretical and cultural congruence with dignity therapy
Conceptualizations of dignity at the end of life: exploring theoretical and cultural congruence with dignity therapy
Aim: To explore the conceptualization of patients' dignity in the context of end-of-life care in Taiwan.
Background: Dignity therapy – a novel nurse-delivered psychotherapeutic intervention – has been demonstrated to have potential to alleviate terminal patients' psycho-existential distress in western countries. In Taiwan, over half of end-of-life patients experience psychological-spiritual suffering and dignity therapy might be helpful in improving this situation. Hence, a preliminary study to clarify Taiwanese conceptualizations of ‘dignity’ was conducted prior to planning a feasibility study to gauge the potential cultural fit of an intervention of this type.
Design: Qualitative exploration.
Methods: Nine people with terminal cancer and ten health professionals were recruited from palliative care services in 2008. In-depth interviews were audiotaped and transcribed verbatim. A hermeneutic approach was employed to analyse and interpret data.
Findings: Being a valuable person is the core meaning of patients' dignity and this comprised intrinsic characteristics and extrinsic factors. Intrinsic characteristics of dignity encompassed living a moral life, having peace of mind and a sense of existence involving the perception of resignation to God's will. Extrinsic factors that influenced patients' dignity included illness-related distress, care delivery and the perception of being loved. A dynamic relationship between these elements determined the state of patients' dignity.
Conclusion: The concept of dignity is culturally bound and understood differently in the Chinese and Western context; such differences should be considered when planning and delivering care. Modifications should be made to dignity therapy to ensure it is culturally congruent with Taiwanese patients' beliefs.
Taiwan, dignity therapy, nursing, palliative care, qualitative research, terminal illness
2920-2931
Li, Hui-Ching
7336f18e-bf77-4625-97ba-eab23c4bd3ed
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Speck, Peter
9bf64da2-145c-4dbb-92db-2d52976580fd
Armes, Jo
d72d1004-457a-4f30-bec7-329e696fe34f
December 2014
Li, Hui-Ching
7336f18e-bf77-4625-97ba-eab23c4bd3ed
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Speck, Peter
9bf64da2-145c-4dbb-92db-2d52976580fd
Armes, Jo
d72d1004-457a-4f30-bec7-329e696fe34f
Li, Hui-Ching, Richardson, Alison, Speck, Peter and Armes, Jo
(2014)
Conceptualizations of dignity at the end of life: exploring theoretical and cultural congruence with dignity therapy.
Journal of Advanced Nursing, 70 (12), .
(doi:10.1111/jan.12455).
(PMID:24866233)
Abstract
Aim: To explore the conceptualization of patients' dignity in the context of end-of-life care in Taiwan.
Background: Dignity therapy – a novel nurse-delivered psychotherapeutic intervention – has been demonstrated to have potential to alleviate terminal patients' psycho-existential distress in western countries. In Taiwan, over half of end-of-life patients experience psychological-spiritual suffering and dignity therapy might be helpful in improving this situation. Hence, a preliminary study to clarify Taiwanese conceptualizations of ‘dignity’ was conducted prior to planning a feasibility study to gauge the potential cultural fit of an intervention of this type.
Design: Qualitative exploration.
Methods: Nine people with terminal cancer and ten health professionals were recruited from palliative care services in 2008. In-depth interviews were audiotaped and transcribed verbatim. A hermeneutic approach was employed to analyse and interpret data.
Findings: Being a valuable person is the core meaning of patients' dignity and this comprised intrinsic characteristics and extrinsic factors. Intrinsic characteristics of dignity encompassed living a moral life, having peace of mind and a sense of existence involving the perception of resignation to God's will. Extrinsic factors that influenced patients' dignity included illness-related distress, care delivery and the perception of being loved. A dynamic relationship between these elements determined the state of patients' dignity.
Conclusion: The concept of dignity is culturally bound and understood differently in the Chinese and Western context; such differences should be considered when planning and delivering care. Modifications should be made to dignity therapy to ensure it is culturally congruent with Taiwanese patients' beliefs.
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Conceptualizations of dignity at the end of life - exploring theoretical.mht
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More information
e-pub ahead of print date: 27 May 2014
Published date: December 2014
Keywords:
Taiwan, dignity therapy, nursing, palliative care, qualitative research, terminal illness
Organisations:
Faculty of Health Sciences
Identifiers
Local EPrints ID: 371604
URI: http://eprints.soton.ac.uk/id/eprint/371604
ISSN: 0309-2402
PURE UUID: 68b35270-eb67-4afe-97fb-8bc7fc849483
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Date deposited: 10 Nov 2014 14:04
Last modified: 18 Mar 2024 03:14
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Author:
Hui-Ching Li
Author:
Peter Speck
Author:
Jo Armes
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