Wachholz Patrick, Giacomin Karla
Programa de Pós-Graduação em Pesquisa Clínca, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, 18618687, Brazil.
Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil.
F1000Res. 2023 Oct 30;11:1208. doi: 10.12688/f1000research.126144.3. eCollection 2022.
Depending on the fields and actors involved, dignity may involve, signify, and encompass different meanings. This fundamental right can be subjectively experienced and rooted in a person's perception of being treated and cared for. Care refers to a set of specific activities combined in a complex life-sustaining network, including long-term Care, which involves various services designed to meet a person's health or personal care needs. However, older residents' human rights have been disrespected and widened the gaps between theory and practice regarding the precarious protection of their rights and dignity inside long-term facilities and nursing homes. This paper aims to discuss threats to dignity and elucidate some strategies to promote and conserve dignity in care, including the person-centered practice in long-term care. Some barriers to the dignity of older residents involve the organizational culture, restraints of time, heavy workload, burnout, and lack of partnership between the residents, their families, and the long-term care homes' staff. Person-centered integrated care quality frameworks are core components of a good quality of care in these spaces in high-income countries. Unfortunately, the COVID-19 pandemic highlighted how weak long-term care policies were and demonstrated that much progress in the dignity of care in long-term care facilities and nursing homes is needed. In low- and middle-income countries, long-term care policies do not accompany the accelerated and intense aging process, and there are other threats, like their invisibility to the public sector and the prejudices about this service model. It's urgent to create strategies for designing and implementing sustainable and equitable long- term care systems based on a person-centered service with dignity to everyone who needs it.
根据所涉及的领域和行为主体,尊严可能包含、象征并涵盖不同的含义。这项基本权利可以被主观体验,并且植根于一个人对被对待和被照顾的感知。护理是指在一个复杂的维持生命的网络中结合在一起的一系列特定活动,包括长期护理,它涉及旨在满足个人健康或个人护理需求的各种服务。然而,老年居民的人权受到了侵犯,在长期护理机构和养老院中,他们的权利和尊严得不到可靠保护,这进一步扩大了理论与实践之间的差距。本文旨在探讨对尊严的威胁,并阐明一些在护理中促进和维护尊严的策略,包括长期护理中的以人为本的实践。老年居民尊严面临的一些障碍包括组织文化、时间限制、工作量大、职业倦怠以及居民、其家人与长期护理机构工作人员之间缺乏合作关系。在高收入国家,以人为本的综合护理质量框架是这些场所优质护理的核心组成部分。不幸的是,新冠疫情凸显了长期护理政策的薄弱之处,并表明在长期护理机构和养老院的护理尊严方面仍需取得很大进展。在低收入和中等收入国家,长期护理政策并未跟上加速且剧烈的老龄化进程,并且还存在其他威胁,比如公共部门对其视而不见以及对这种服务模式的偏见。迫切需要制定战略,设计并实施基于以人为本的服务、面向每个有需求者的尊严的可持续且公平的长期护理系统。