Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital, Corso Bramante 88, 10126, Turin, Italy.
J Cancer Educ. 2020 Dec;35(6):1184-1192. doi: 10.1007/s13187-019-01577-4.
The studies on terminally ill patients' dignity as perceived by health care providers (HCPs) in palliative care are growing. The comparison of different HCPs' perspectives in particular is necessary to explore how HCPs perceive patients' dignity in order to promote reflection on this core issue. This study aimed to investigate the perspectives on end-of-life patients' sense of dignity among four different categories of professionals: nurse assistants, nurses, psychologists, and physicians. A sample of 306 HCPs completed the Patient Dignity Inventory-Italian Version (PDI-IT) adapted for them and an ad hoc semi-structured written interview. Their responses were then analyzed using frequencies of the answers to the PDI-IT, a multivariate analysis of variance, Pearson's correlation index, t tests, and content analysis. All HCPs scored the relevance to the dignity-related physical aspects highly, followed by the psychological distress. Nurse assistants and nurses provided higher scores on the psychological and existential and spiritual PDI subscales than the other HCP groups. The social sphere was evaluated as the least salient for the patients' sense of dignity. Physicians who attended a course on dignity considered the psychological and existential dignity dimensions more. Differences in role and expertise could lead to different HCPs' perspectives on dignity, while the multidisciplinary work could favor their aligning. Therefore, it is essential to encourage HCPs' communicative exchange and reflective awareness through training, i.e., courses, seminars, and focus groups. These developments could promote increasingly adequate patient-centered care.
临终患者尊严的研究在姑息治疗医护人员中越来越多。特别是比较不同医护人员的观点，对于探索医护人员如何感知患者的尊严是必要的，以便对这一核心问题进行反思。本研究旨在调查护士助理、护士、心理学家和医生四类不同专业人员对终末期患者尊严感的看法。306 名医护人员完成了为他们改编的《患者尊严量表-意大利语版》（PDI-IT）和一份专门的半结构化书面访谈。然后，使用 PDI-IT 的答案频率、方差分析、皮尔逊相关指数、t 检验和内容分析对他们的回答进行分析。所有医护人员对与尊严相关的身体方面的相关性评价较高，其次是心理困扰。护士助理和护士在心理和存在、精神 PDI 分量表上的评分高于其他医护人员群体。社会领域被评估为对患者尊严感的影响最小。参加过尊严课程的医生更关注心理和存在尊严维度。角色和专业知识的差异可能导致医护人员对尊严的看法不同，而多学科工作可以促进他们的协调一致。因此，通过培训（如课程、研讨会和焦点小组）鼓励医护人员进行沟通交流和反思意识是至关重要的。这些发展可以促进越来越以患者为中心的护理。
