Missel Malene, Bergenholtz Heidi Maria
Author Affiliations: Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet (Dr Missel); Medical and Surgical Department, Holbaek Sygehus, and The Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Odense (Dr Bergenholtz).
Cancer Nurs. 2021;44(6):E429-E437. doi: 10.1097/NCC.0000000000000859.
Dignity is an inherent value in palliative care, but understanding dignity among people living with and hospitalized for incurable esophageal cancer has not been explored.
The aim of this study was to empirically explore the meaning of dignity in people hospitalized with incurable esophageal cancer.
A qualitative hermeneutic approach, inspired by Gadamer, guided the research process and interpretation of the transcribed interviews. Eighteen patients participated in the study.
The meaning of dignity was revealed as reverential response in care relationships and eating as an undignifying activity. A balance of the healthcare system's framework with the lifeworld of the patient was significant in preserving dignity and gave patients a sense of reverent response. Patients were unable to eat ordinary daily meals, which affected their perception of own body and identity, including interactions with others. The resulting bodily changes and social consequences were of crucial importance to the perceived dignity.
A dialogical and understanding approach is significant in making the patient feel worthy, consequently helping to uphold a sense of dignity. The changing and decaying body due to eating difficulties bears witness to illness, altering the individual's sense of self, in turn threatening the dignity of identity.
The care should be based on a reverential response based on the patients' lifeworld. In doing so, storytelling might be a way. Palliative care for these people needs to stress that patients share other aspects of life that is not totally dominated by their illness, inability to eat, and unrecognizable body.
尊严是姑息治疗中的固有价值，但对于患有无法治愈的食管癌并住院治疗的患者的尊严理解尚未得到探索。
本研究旨在实证探索患有无法治愈的食管癌并住院患者的尊严含义。
受伽达默尔启发的质性诠释学方法指导了研究过程以及对转录访谈的解读。18名患者参与了该研究。
尊严的含义被揭示为护理关系中的崇敬回应以及进食是一种有失尊严的活动。医疗系统框架与患者生活世界的平衡对于维护尊严至关重要，并给予患者一种崇敬回应感。患者无法进食日常普通餐食，这影响了他们对自身身体和身份的认知，包括与他人的互动。由此产生的身体变化和社会后果对于所感知到的尊严至关重要。
对话和理解的方法对于让患者感到有价值具有重要意义，从而有助于维护尊严感。因进食困难而不断变化和衰弱的身体见证了疾病，改变了个体的自我认知，进而威胁到身份尊严。
护理应基于对患者生活世界的崇敬回应。这样做的话，讲故事可能是一种方式。对这些人的姑息治疗需要强调患者还拥有生活的其他方面，这些方面并非完全由他们的疾病、无法进食和难以辨认的身体所主导。
