Zahran Zainab, Tauber Marcelle, Watson Holly Howe, Coghlan Phoebe, White Sarah, Procter Sue, Addis Gulen, Norton Christine
Department of Postgraduate Research, Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
Education Centre, Charing Cross Hospital, London, UK.
J Clin Nurs. 2016 Feb;25(3-4):311-21. doi: 10.1111/jocn.13052.
To review the evidence for interventions to improve dignity for older patients in acute care.
High profile cases have highlighted failure to provide dignified care for older people in hospitals. There is good evidence on what older people consider is important for dignified care and abundant recommendations on improving dignity, but it is unclear which interventions are effective.
Narrative systematic review.
The Cochrane library, MEDLINE, EMBASE, CINAHL, BNI and HMIC electronic databases were searched for intervention studies of any design aiming to improve inpatients' dignity. The main population of interest was older patients, but the search included all patients. Studies that focused on 'dignity therapy' were excluded.
There were no intervention studies found in any country which aimed to improve patient dignity in hospitals which included evaluation of the effect. A narrative overview of papers that described implementing dignity interventions in practice but included no formal evaluation was, therefore, undertaken. Five papers were identified. Three themes were identified: knowing the person; partnership between older people and health care professionals; and, effective communication and clinical leadership. The effect on dignity of improving these is untested.
There are currently no studies that have tested interventions to improve the dignity of older people (nor anyone else) in hospitals. Further research using well designed trials of interventions is needed. There is also a need to develop and validate outcome measures for interventions to improve dignity.
At present nurses lack robust evidence on how to improve dignity. There is ample evidence on what undermines patients' dignity and there is a need to develop and test interventions designed to improve patient dignity.
回顾关于改善急症护理中老年患者尊严的干预措施的证据。
备受瞩目的案例凸显了医院在为老年人提供有尊严护理方面的不足。有充分证据表明老年人认为有尊严护理的重要因素，也有大量关于改善尊严的建议，但尚不清楚哪些干预措施是有效的。
叙述性系统综述。
检索Cochrane图书馆、MEDLINE、EMBASE、CINAHL、BNI和HMIC电子数据库，查找旨在改善住院患者尊严的任何设计的干预研究。主要关注人群为老年患者，但检索涵盖所有患者。专注于“尊严疗法”的研究被排除。
在任何国家均未找到旨在改善医院患者尊严且包含效果评估的干预研究。因此，对描述在实践中实施尊严干预但未进行正式评估的论文进行了叙述性综述。共识别出五篇论文。确定了三个主题：了解患者；老年人与医护人员之间的伙伴关系；以及有效的沟通和临床领导力。改善这些方面对尊严的影响未经检验。
目前尚无研究测试过改善医院中老年患者（或其他任何人）尊严的干预措施。需要开展设计良好的干预试验进行进一步研究。还需要开发和验证用于改善尊严的干预措施的结果测量方法。
目前护士缺乏关于如何改善尊严的有力证据。有充分证据表明哪些因素会损害患者尊严，因此需要开发和测试旨在改善患者尊严的干预措施。
