Background: Physical impairment and dependency on others may be a threat to dignity. Research questions: The purpose of this study was to explore dignity as a core concept in caring, and how healthcare personnel focus on and foster dignity in nursing home residents. Research design: This study has a hermeneutic design. Participants and research context: In all, 40 healthcare personnel from six nursing homes in Scandinavia participated in focus group interviews in this study. Ethical considerations: This study has been evaluated and approved by the Regional Ethical Committees and the Social Science Data Services in the respective Scandinavian countries. Findings: Two main themes emerged: dignity as distinction (I), and dignity as influence and participation (II). Discussion: A common understanding was that stress and business was a daily challenge. Conclusion: Therefore, and according to the health personnel, maintaining human dignity requires slow caring in nursing homes, as an essential approach.

The aim of this study was to answer the question “What do nursing home residents do themselves in order to maintain their dignity?” Twenty-eight residents, 8 men and 20 women, aged 62 to 103 years, from 6 different nursing homes in Scandinavia were interviewed. The results showed that the residents tried to expand their life space, both physical and ontological, in order to experience health and dignity.

The aim of this study was to answer the question "What do nursing home residents do themselves in order to maintain their dignity?" Twenty-eight residents, 8 men and 20 women, aged 62 to 103 years, from 6 different nursing homes in Scandinavia were interviewed. The results showed that the residents tried to expand their life space, both physical and ontological, in order to experience health and dignity.

BACKGROUND:Living in a nursing home may be challenging to the residents' experience of dignity. Residents' perception of how their dignity is respected in everyday care is important.AIM:To examine how nursing home residents experience dignity through the provision of activities that foster meaning and joy in their daily life.METHOD:A qualitative design was used and 28 individual semistructured interviews conducted with nursing home residents from six nursing homes in Denmark, Norway and Sweden. The data were analysed with qualitative content analysis. Independent ethical committees in all participating countries granted their approval for the study.FINDINGS:The participants highlight two dimensions of the activities that foster experiences of dignity in nursing homes in Scandinavia. These two categories were (i) fostering dignity through meaningful participation and (ii) fostering dignity through experiencing enjoyable individualised activities.CONCLUSION:Activities are important for residents to experience dignity in their daily life in nursing homes. However, it is important to tailor the activities to the individual and to enable the residents to take part actively. Nurses should collect information about the resident's preferences for participation in activities at the nursing home.

Dignity is a core concept in nursing care. In earlier theories on dignity, close links have been drawn between dignity and autonomy, and autonomy has been closely related to independence. These traditional understandings of dignity and autonomy may be challenged when an individual moves into a nursing home. Our findings show that negative views about dependence, institutional frames and structures in the nursing home, and the attitudes and actions of healthcare personnel may diminish independence and lead to a lack of autonomy. Each of these areas can be experienced as a serious threat to the residents’ dignity. Findings are interpreted and discussed in the light of a theory of relational autonomy, which represents an alternative to the traditional individualistic understanding of dignity and autonomy.

This study describes different perspectives of dignity in the care of residents experienced by family caregivers. Both patients and family caregivers express existential concerns about dignity in care, but differences between these experiences are out of phase with each other. Individual interviews with 28 family caregivers were conducted between January and February 2010. Data were analyzed using the philosophical hermeneutic method; reflection, preunderstanding, interpretation, and new understanding played an important role in the ongoing process of analysis. The findings describe the family caregivers’ experiences in daily life to receive dignifying care for their relatives and also how struggling with their own vulnerability opens up the existential dimension of dignity.

This qualitative study focused on dignity in nursing homes from the perspective of family caregivers. Dignity is a complex concept and central to nursing. Dignity in nursing homes is a challenge, according to research. Family caregivers are frequently involved in their family members' daily experiences at the nursing home. Twenty-eight family caregivers were included in this Scandinavian cross-country, descriptive, and explorative study. A phenomenological-hermeneutic approach was used to understand the meaning of the narrated text. The interpretations revealed two main themes: "One should treat others as one would like others to treat oneself" and "Uneasiness due to indignity. "Dignity was maintained in experiences of respect, confidence, security, and charity. Uneasiness occurred when indignity arose. Although family caregivers may be taciturn, their voices are important in nursing homes. Further investigation of family caregivers' experiences in the context of nursing homes is warranted.

Background: As part of an ongoing Scandinavian project on the dignity of care for older people, this study is based on ‘clinical caring science’ as a scientific discipline. Clinical caring science examines how ground concepts, axioms and theories are expressed in different clinical contexts. Central notions are caring culture, dignity, at-home-ness, the little extra, non-caring cultures versus caring cultures and ethical context – and climate. Aim and assumptions: This study investigates the individual variations of caring cultures in relation to dignity and how it is expressed in caring acts and ethical contexts. Three assumptions are formulated: (1) the caring culture of nursing homes influences whether dignified care is provided, (2) an ethos that is reflected on and appropriated by the caregiver mirrors itself in ethical caring acts and as artful caring in an ethical context and (3) caring culture is assumed to be a more ontological or universal concept than, for example, an ethical context or ethical person-to-person acts. Research design: The methodological approach is hermeneutic. The data consist of 28 interviews with relatives of older persons from Norway, Denmark and Sweden. Ethical considerations: The principles of voluntariness, confidentiality and anonymity were respected during the whole research process. Findings: Three patterns were revealed: dignity as at-home-ness, dignity as the little extra and non-dignifying ethical context. Discussion: Caring communion, invitation, at-home-ness and ‘the little extra’ are expressions of ethical contexts and caring acts in a caring culture. A non-caring culture may not consider the dignity of its residents and may be represented by routinized care that values organizational efficiency and instrumentalism rather than an individual’s dignity and self-worth. Conclusion: An ethos must be integrated in both the organization and in the individual caregiver in order to be expressed in caring acts and in an ethical context that supports these caring acts.

Aims and objectives: The aim of this cross-country Scandinavian study was to explore how residents in nursing homes experience that their dignity is promoted and attended to. This is one part of the Scandinavian project in which we interviewed residents, relatives and staff members. Background: The main subject concerns the dignity of residents of nursing homes for older people. This article brings forward results from interviews of relatives on how they experience that the dignity is met, promoted and attended to for their next of kin. Design: The study was qualitative with a hermeneutic approach. Methods: Qualitative research interviews of 28 relatives of residents at six participating nursing homes in Scandinavia. The results derive from analysis of the interviews using Kvale’s three levels of interpretation; self-understanding, common sense and a theoretical understanding. Results: The following themes emerged, from the perspective of the relatives, concerning what was deemed important to the resident according his existential needs and concerns: a). To have a comfortable, homely and practical room. b). To have close contact with family, friends and with the staff. c).To have aesthetic needs and concerns attended to. d). To have ethical needs and intrinsic values attended to. e). To have cultural and spiritual needs and concerns attended to. Conclusion: The results provide more substance to the theme and are all important in terms of the residents’ feeling of worthiness and dignity. In general it seemed that the relatives experienced a positive encounter with the staff, but it was also mentioned that staff members were not confronted about episodes that were undignified and disgraceful. This could be a sign or expression that they were worried that negative responses or complaints could lead to a kind of reprisal against the resident and to indignity.

AIMS AND OBJECTIVES:To explore how healthcare personnel comprehend the term dignity and what they do to attend to, preserve and promote the dignity of patients in the rehabilitation context.BACKGROUND:Literature reveals that knowledge exists concerning the nature of dignity. Literature is scant on how health personnel think the reasons may be when patients do not maintain their dignity or how caregivers might improve and strengthen their concern in preserving and promoting the patients' dignity in a rehabilitation context.DESIGN:The study was explorative and descriptive, with content analysis of gathered empirical data.METHODS:Qualitative focus group interviews with representatives from the staff at three different rehabilitation centres were carried out. Professionals within different occupations were represented at the meeting: nurses, ergonomists, physiotherapists, psychologists, medical doctors, social workers, auxiliary nurses and speech therapists.RESULTS:Dignity is promoted when the patient himself becomes an active agent, when the patient's feelings and thoughts are respected, when the family of the patient is included and listened to, when the patient is free to make critical comment, when members of staff are able to cope with the patient's disabilities and when the aesthetic environment is attended to and enhanced. Dignity is not promoted when health personnel override or dominate patients, when health personnel focus merely on the patient's diagnosis and not the sick person and when health personnel and/or relatives try to impose their own values.CONCLUSION:The staff working in institutions to rehabilitate patients with head injuries and multiple sclerosis must be aware and sensitive to the importance of maintaining and supporting the patient's dignity and self-respect.RELEVANCE FOR CLINICAL PRACTICE:The results from this project confirm the importance of acknowledging the patient's self-worth as a human being, unconditionally. This might be essential in promoting and preserving the patients' dignity.

The overall purpose of this cross-country Nordic study was to gain further knowledge about maintaining and promoting dignity in nursing home residents. The purpose of this article is to present results pertaining to the following question: How is nursing home residents’ dignity maintained, promoted or deprived from the perspective of family caregivers? In this article, we focus only on indignity in care. This study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods in this part of this study consisted of individual research interviews. Altogether, the sample consisted of 28 family caregivers of nursing home residents. The empirical material was interpreted using a hermeneutical approach. The overall theme that emerged was as follows: ‘A feeling of being abandoned’. The sub-themes are designated as follows: deprived of the feeling of belonging, deprived of dignity due to acts of omission, deprived of confirmation, deprived of dignity due to physical humiliation, deprived of dignity due to psychological humiliation and deprived of parts of life.

Much is known about the phenomenon of dignity, yet there is still a need for implementing this understanding in clinical practice. The main purpose of this study was to find out how persons suffering from multiple sclerosis experience and understand dignity and violation in the context of a rehabilitation ward. A phenomenological-hermeneutic approach was used to extract the meaningful content of narratives from 14 patients with multiple sclerosis. Data were collected by personal research interviews. The findings revealed three main themes: (1) 'invisibly captured in fatigue'; (2) 'fighters' law: one who does not ask will not receive'; and (3) 'dignity is humanity'. The essence of the findings in this study is that dignity is humanity. According to the participants, dignity requires time and is experienced only in a context of empathy and mutual confidence.

TITLE Dignity in the life of people with head injuries. AIM This paper is a report of a study conducted to determine how people who suffer from head injuries perceive respect for their dignity and to discover what patients mean by the concept of 'dignity'. BACKGROUND We know something about what the phenomenon of dignity means. However, we still lack knowledge about how patients perceive dignity in their lives and how dignity may be fostered and supported. METHODS Qualitative interviews were carried out during 2007 with 14 patients suffering from head injuries, diagnosed as having mild to moderate disability. The study was explorative and descriptive, with a content analysis. FINDINGS Patients experienced their dignity as maintained when they were taken seriously, received appropriate information and were reality-oriented. They experienced their dignity as violated if they had been neglected or had encountered healthcare personnel who lacked knowledge, were sceptical about their stories, and where the patient experienced extra burden when they were mistrusted. The importance of adequate information was underscored. As interviewees said, head injuries do not show on the outside and people with head injuries do not have a high status in society. CONCLUSION Patients living with head injuries should be informed about consequences and be taught strategies for how to live with head injuries as early as possible after the injury in order to maintain dignity.

Et liv i verdighet : En klinisk studie med hensikt a fremme pasientens verdighet i sykehjem