BACKGROUND: While knowledge on factors affecting personal dignity of patients nearing death is quite substantial, far less is known about how patients living with a serious disease understand dignity. OBJECTIVE: To develop a conceptual model of dignity that illuminates the process by which serious illness can undermine patients' dignity, and that is applicable to a wide patient population. DESIGN: Qualitative interview study. PARTICIPANTS: 34 patients with either cancer, early stage dementia, or a severe chronic illness were selected from an extensive cohort study into advance directives. METHOD: In-depth interviews were carried out exploring the experiences of seriously ill patients with regard to their personal dignity. The interview transcripts were analyzed using thematic analysis and a conceptual model was constructed based on the resulting themes. RESULTS: We developed a two-step dignity model of illness. According to this model, illness related conditions do not affect patients' dignity directly but indirectly by affecting the way patients perceive themselves. We identified three components shaping self-perception: (a) the individual self: the subjective experiences and internally held qualities of the patient; (b) the relational self: the self within reciprocal interaction with others; and, (c) the societal self: the self as a social object in the eyes of others. CONCLUSIONS: The merits of the model are two-folded. First, it offers an organizing framework for further research into patients' dignity. Secondly, the model can serve to facilitate care for seriously ill patients in practice by providing insight into illness and dignity at the level of the individual patient where intervention can be effectively targeted.
BACKGROUND: While knowledge on factors affecting personal dignity of patients nearing death is quite substantial, far less is known about how patients living with a serious disease understand dignity. OBJECTIVE: To develop a conceptual model of dignity that illuminates the process by which serious illness can undermine patients' dignity, and that is applicable to a wide patient population. DESIGN: Qualitative interview study. PARTICIPANTS: 34 patients with either cancer, early stage dementia, or a severe chronic illness were selected from an extensive cohort study into advance directives. METHOD: In-depth interviews were carried out exploring the experiences of seriously ill patients with regard to their personal dignity. The interview transcripts were analyzed using thematic analysis and a conceptual model was constructed based on the resulting themes. RESULTS: We developed a two-step dignity model of illness. According to this model, illness related conditions do not affect patients' dignity directly but indirectly by affecting the way patients perceive themselves. We identified three components shaping self-perception: (a) the individual self: the subjective experiences and internally held qualities of the patient; (b) the relational self: the self within reciprocal interaction with others; and, (c) the societal self: the self as a social object in the eyes of others. CONCLUSIONS: The merits of the model are two-folded. First, it offers an organizing framework for further research into patients' dignity. Secondly, the model can serve to facilitate care for seriously ill patients in practice by providing insight into illness and dignity at the level of the individual patient where intervention can be effectively targeted.
Authors: Keith Zi Yuan Chua; Elaine Li Ying Quah; Yun Xue Lim; Chloe Keyi Goh; Jieyu Lim; Darius Wei Jun Wan; Simone Meiqi Ong; Chi Sum Chong; Kennan Zhi Guang Yeo; Laura Shih Hui Goh; Ray Meng See; Alexia Sze Inn Lee; Yun Ting Ong; Min Chiam; Eng Koon Ong; Jamie Xuelian Zhou; Crystal Lim; Simon Yew Kuang Ong; Lalit Krishna Journal: BMC Palliat Care Date: 2022-07-04 Impact factor: 3.113
Authors: R Philipp; A Mehnert; C Lehmann; K Oechsle; C Bokemeyer; A Krüll; S Vehling Journal: Support Care Cancer Date: 2016-01-27 Impact factor: 3.603
Authors: Mariska G Oosterveld-Vlug; H Roeline W Pasman; Isis E van Gennip; Dick L Willems; Bregje D Onwuteaka-Philipsen Journal: PLoS One Date: 2013-09-12 Impact factor: 3.240
Authors: Mariska G Oosterveld-Vlug; H Roeline W Pasman; Isis E van Gennip; Henrica C W de Vet; Bregje D Onwuteaka-Philipsen Journal: Health Qual Life Outcomes Date: 2014-02-11 Impact factor: 3.186