Conceptualizations of dignity at the end of life: Exploring theoretical and cultural congruence with dignity therapy

TY - JOUR

T1 - Conceptualizations of dignity at the end of life

T2 - Exploring theoretical and cultural congruence with dignity therapy

AU - Liu, Hui-Ching

AU - Richardson, Alison

AU - Speck, Peter

AU - Armes, Jo

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Aim: To explore the conceptualization of patients' dignity in the context of end-of-life care in Taiwan. Background: Dignity therapy - a novel nurse-delivered psychotherapeutic intervention - has been demonstrated to have potential to alleviate terminal patients' psycho-existential distress in western countries. In Taiwan, over half of end-of-life patients experience psychological-spiritual suffering and dignity therapy might be helpful in improving this situation. Hence, a preliminary study to clarify Taiwanese conceptualizations of 'dignity' was conducted prior to planning a feasibility study to gauge the potential cultural fit of an intervention of this type. Design: Qualitative exploration. Methods: Nine people with terminal cancer and ten health professionals were recruited from palliative care services in 2008. In-depth interviews were audiotaped and transcribed verbatim. A hermeneutic approach was employed to analyse and interpret data. Findings: Being a valuable person is the core meaning of patients' dignity and this comprised intrinsic characteristics and extrinsic factors. Intrinsic characteristics of dignity encompassed living a moral life, having peace of mind and a sense of existence involving the perception of resignation to God's will. Extrinsic factors that influenced patients' dignity included illness-related distress, care delivery and the perception of being loved. A dynamic relationship between these elements determined the state of patients' dignity. Conclusion: The concept of dignity is culturally bound and understood differently in the Chinese and Western context; such differences should be considered when planning and delivering care. Modifications should be made to dignity therapy to ensure it is culturally congruent with Taiwanese patients' beliefs.

AB - Aim: To explore the conceptualization of patients' dignity in the context of end-of-life care in Taiwan. Background: Dignity therapy - a novel nurse-delivered psychotherapeutic intervention - has been demonstrated to have potential to alleviate terminal patients' psycho-existential distress in western countries. In Taiwan, over half of end-of-life patients experience psychological-spiritual suffering and dignity therapy might be helpful in improving this situation. Hence, a preliminary study to clarify Taiwanese conceptualizations of 'dignity' was conducted prior to planning a feasibility study to gauge the potential cultural fit of an intervention of this type. Design: Qualitative exploration. Methods: Nine people with terminal cancer and ten health professionals were recruited from palliative care services in 2008. In-depth interviews were audiotaped and transcribed verbatim. A hermeneutic approach was employed to analyse and interpret data. Findings: Being a valuable person is the core meaning of patients' dignity and this comprised intrinsic characteristics and extrinsic factors. Intrinsic characteristics of dignity encompassed living a moral life, having peace of mind and a sense of existence involving the perception of resignation to God's will. Extrinsic factors that influenced patients' dignity included illness-related distress, care delivery and the perception of being loved. A dynamic relationship between these elements determined the state of patients' dignity. Conclusion: The concept of dignity is culturally bound and understood differently in the Chinese and Western context; such differences should be considered when planning and delivering care. Modifications should be made to dignity therapy to ensure it is culturally congruent with Taiwanese patients' beliefs.

KW - Dignity therapy

KW - Nursing

KW - Palliative care

KW - Qualitative research

KW - Taiwan

KW - Terminal illness

UR - http://www.scopus.com/inward/record.url?scp=84909585705&partnerID=8YFLogxK

U2 - 10.1111/jan.12455

DO - 10.1111/jan.12455

M3 - Article

AN - SCOPUS:84909585705

SN - 0309-2402

VL - 70

SP - 2920

EP - 2931

JO - Journal of Advanced Nursing

JF - Journal of Advanced Nursing

IS - 12

ER -