Kinnear Deborah, Williams Veronika, Victor Christina
Dundee Dental Hospital and School, University of Dundee, Dundee, UK.
BMC Res Notes. 2014 Nov 27;7:854. doi: 10.1186/1756-0500-7-854.
Despite well established national and local policies championing the need to provide dignity in care for older people, there continues to be a wealth of empirical evidence documenting how we are failing to deliver this. While we have evidence as to what older people and their relatives understand by the term 'dignified care' we have less insight into the perspectives of staff regarding their understanding of this key policy objective. This paper aimed to explore the meaning of dignified care from the perspective of health and social care professionals' working with older people. In-depth interviews and focus groups with health and social care professionals were carried out across four NHS Trusts in England, as part of a larger study, to investigate how dignified care for older people is understood and delivered. A total of 48 health professionals took part in in-depth interviews and 33 health and social care professionals participated in one of eight focus groups.
Health and social care professionals defined the meaning of dignified care as: 'dignity is the backbone of care', 'it's the "little things"', 'feeling safe and secure', 'treat as you want to be treated', 'treat as an individual' and 'Dignity encompasses multiple factors'. 'Hands on' aspects of care were rarely mentioned when defining dignity. This suggests that policies around providing dignified care are being interpreted as an approach towards care and not with direct care provision. This limited interpretation of dignity may be one factor contributing to the continued neglect of older people in acute settings.
These findings highlight that proactive measures are required to ensure that both relational and 'hands on' aspects of care are met for all older people receiving care in NHS trusts.
尽管国家和地方已经制定了完善的政策,倡导在照顾老年人时要给予尊严,但仍有大量实证证据表明我们未能做到这一点。虽然我们有证据表明老年人及其亲属对“尊严护理”一词的理解,但对于工作人员对这一关键政策目标的理解,我们的了解较少。本文旨在从与老年人打交道的健康和社会护理专业人员的角度探讨尊严护理的含义。作为一项更大规模研究的一部分,在英格兰的四个国民保健服务信托基金中,对健康和社会护理专业人员进行了深入访谈和焦点小组讨论,以调查如何理解和提供对老年人的尊严护理。共有48名健康专业人员参与了深入访谈,33名健康和社会护理专业人员参加了八个焦点小组中的一个。
健康和社会护理专业人员将尊严护理的含义定义为:“尊严是护理的核心”、“是‘小事’”、“感到安全”、“以己度人”、“视个体而异”以及“尊严包含多个因素”。在定义尊严时,很少提及护理的“实际操作”方面。这表明围绕提供尊严护理的政策被解释为一种护理方式,而不是直接的护理提供。对尊严的这种有限解释可能是导致急性病环境中老年人持续被忽视的一个因素。
这些发现凸显出需要采取积极措施,以确保在国民保健服务信托基金中接受护理的所有老年人都能在护理的人际关系和“实际操作”方面得到满足。