Workplace dignity amongst clinical nurses.

BACKGROUND: The workplace environment plays a pivotal role in employees' lives as they spend many hours there. Recently, greater attention has been placed on workplace conditions as a key social determinant of health. One way through which workplace conditions may affect health is workplace dignity. This study aimed to describe clinical nurses' workplace dignity. METHODS: The study design was descriptive and cross-sectional. Clinical nurses within a tertiary institution were randomly sampled. Data collection included the Workplace Dignity scale which is an 18 item-seven-point Likert scale consisting of dignity and indignity questions (α.98, and 0.95, respectively). Data collection commenced with a pilot followed by a final data collection phase. Ethical considerations were included via informed consent, anonymity, and confidentiality. Data analysis included means, standard deviations, and Pearson correlations. RESULTS: The pilot test yielded a reliability coefficient - α 0.93. Two hundred and thirty-six clinical nurses participated in the study resulting in a response rate of 87.4%. The average mean age of participants was 37.966 ± 0.635 (min 25- max 60) years. Most participants were female (92.8%) with a Bachelor of Science in Nursing Degree (77.5%). The overall mean experience as a registered nurse was 16.038 ± 0.589 years. Nationality responses were divided into Saudi (41.5%) and non-Saudi (58.5%). The construct of general dignity had the highest mean score of 5.52 (SD 1.46), with question 14: "I have dignity at work" having the highest overall mean score of 5.63 (SD 1.4). There was a positive correlation and statistical significance with a 'p < 0.000 i.e. as a nurses' experience as a registered nurse increased, workplace dignity scores increased. CONCLUSION: The findings of this study indicated that inherent value and general dignity were the highest-scored constructs while indignity and respectful interaction scored the lowest. This study allows for reflection on the importance of workplace dignity, as an impactful and important organizational phenomenon that affects either positively or negatively on employee well-being and performance, hence workplace dignity must be prioritized within work environmental infrastructures.

Workplace dignity scale in Iranian nurses: translation and psychometric evaluation.

BACKGROUND: Workplace dignity is defined as a person's perception of respect and trust, equal and fair treatment, valuing the person, independence, freedom of expression, and decision-making enjoyed by the employee in the workplace. Therefore, this study aimed to develop the Workplace Dignity Scale (WDS) and evaluate its psychometric properties. METHODS: In this methodological study, WDS was translated based on Beaton et al. Guideline. After assessing face and content validity (using CVI, CVR, modified kappa, and item impact), 250 nurses were selected by random sampling from Kashan hospitals in 2023. Then, WDS was assessed through expletory factor analysis (EFA), known-groups comparison, internal consistency, and stability. The ceiling and floor effects were also examined. Data were analyzed using SPSS v16 by Kruskal-Wallis test, Cronbach's alpha, McDonald's Omega, interclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable changes (MDC). RESULTS: The scale's CVI, CVR, and modified kappa were above 0.79. Item impact was higher than 1.5. EFA extracted three factors, including "general dignity, respect, and indignity", that could explain 70.6% of the total variance in scale. WDS could differentiate between the three groups in terms of occupation satisfaction status. Cronbach's alpha, McDonald's Omega, ICC, SEM, and STC of scale were 0.949, 0.950, 0.970, 2.793, and 7.742, respectively. CONCLUSION: The Persian version of the WDS has shown validity and reliability for measuring workplace dignity among nurses in the Iranian context.

Responsive patient care in Israel: A qualitative study of hospital rules and regulations.

Hospital rules and regulations can contribute to standardizing care, streamlining processes, and improving the quality of care. Over the past decade, hospitals in Israel have introduced written rules and regulations for staff that provide guidance on quality control, patient safety, and the patient-provider relationship. This study aimed to explore how these written guidelines, when implemented, can promote responsive care for inpatients. Using a thematic analysis, the study analyzed the content of staff guidelines from six Israeli hospitals. The analysis found that hospital rules and regulations provide similar, relatively precise instructions with regard to improving the responsiveness to and dignity of care of patients. The guidelines address three essential aspects of responsiveness - disclosing medical information and respecting the patients' autonomy and physical space. The guidelines highlight that healthcare providers should implement security measures to safeguard medical information, respect patients' autonomy, involve patients in decision-making, and provide adequate physical space to maintain their privacy and modesty. The guidelines contribute to ensuring patients' legal and ethical rights. Policymakers should consider introducing and implementing the dimensions of responsiveness that were stressed by Israeli hospitals' rules and regulations. Further research is needed to confirm the relevance of the various rules and regulations for improving the quality of care provided to patients.

Legacy in End-of-Life Care: A Concept Analysis.

Comprehending the significance of legacy in end-of-life (EoL) situations helps palliative care professionals enhance person-centered outcomes for those with a life-threatening illness and their families. Our purpose was to conduct a concept analysis of legacy in EoL care. By employing Walker and Avant's approach, we identified the concept's defining characteristics. Subsequently, we established the antecedents, consequences, and empirical referents. After conducting a thorough review of titles and abstracts, a total of 30 publications were analyzed. These articles were sourced from three databases (CINAHL, Medline via PubMed, and Scopus) from 2002 to 2023. Our analysis identified several core attributes of legacy: (a) leave behind something of value that transcends death; (b) determine how people want to be remembered; (c) build and bestow across generations; (d) integrate advance care planning through EoL conversations and shared decision-making; and (e) develop strategies of dignity-conserving care. The consequences are related to improvements in spiritual and subjective well-being; coping with inevitable EoL existential issues; decreases in EoL suffering; engendering self-awareness, hope, gratitude, and peace; achieving and maintaining dignity; creating good memories; promoting mutually constructive and transformative relationships; and fostering the adjustment of bereaved people. Nevertheless, further effort is required to implement the key attributes of legacy that form the basis for creating legacy-oriented interventions near the EoL.

The association of compassion with dignity and symptoms in end-of-life cancer patients.

OBJECTIVES: Compassion is essential in palliative care; however, there is a lack of evidence of the association between this construct and patients' dignity-related distress. The present study aimed to investigate the association between end-of-life cancer patients' sense of dignity, the level of compassion of the healthcare professionals (HCPs) noticed and perceived by the patients, and levels of compassion that HCPs felt they had toward patients, investigating through specific attitudes and behaviors. Furthermore, the relationship between compassion and patients' physical and psychological symptoms, such as levels of anxiety and depression, was also investigated. METHODS: The study was cross-sectional. The sample consisted of 105 end-of-life cancer patients and 40 HCPs. Patients had a Karnofsky Performance Status of 50 or lower and a life expectancy of less than 4 months. For each patient, sociodemographic data were collected, and a set of rating scales assessing compassion, dignity as well as physical and psychological symptoms were administered. RESULTS: The results showed significant negative associations between patients' perception of compassion and dignity-related distress as well as significant negative associations between patients' perception of compassion and patients' symptoms. SIGNIFICANCE OF RESULTS: Compassion seems to be involved in diminishing dignity-related distress and alleviating physical and psychological symptoms. Other studies are needed to understand whether patients' symptoms or whether specific HCPs' conditions influence compassion. Exploring compassion and at the end-of-life could encourage a dignity-conserving care.

Dignity: the cornerstone of psychological health among victims of child labor, a qualitative study.

BACKGROUND: Respecting the dignity of child labor is one of their most urgent needs. In many cases, the dignity of child labor is not maintained in countries with unfavorable economic conditions. The aim of the present study was understand adolescents' perceptions of their dignity in child labor. METHODS: This study is a qualitative research with conventional content analysis approach. Twenty teenagers who having work experience as child labor were selected from one welfare center and three charity centers in using purposeful sampling method in 2022-2023. Data was generated through individual, deep, and semi-structured interviews. In order to analyze the data was used Granheim and Lundman's method. RESULTS: Three main themes were presented in this study including, "preservation of privacy and security", "honoring individual identity to develop dignity" and "comprehensive support", and 9 categories. CONCLUSION: understand adolescents' perceptions as child labor of their dignity, privacy and security of child labor victims and respect for their identity and all-round support are defined. And in this supportive environment, the dignity of working children is preserved and appropriate behavioral consequences are created. Therefore, it is suggested that a cultural and institutional background be provided in which all components of the child labor's dignity are emphasized.

Healthcare Professionals' Perspectives on Dignity in Dementia: A Qualitative Analysis.

In dementia care, the concept of dignity has garnered substantial attention from both researchers and policymakers. However, the concept often remains vague and open to interpretation, potentially leading to misunderstandings and suboptimal care for people with dementia. As healthcare professionals occupy a critical role in upholding dignity, exploring their viewpoints on this complex concept is paramount. In this study, we explore Danish healthcare professionals' views on the dignity of people with dementia and discuss these perspectives against existing theoretical accounts. We employed thematic analysis of data collected during facilitated discussions with a total of 99 healthcare professionals, including nurses and healthcare workers, during which we posed the question, "What is dignity to you?" and documented their perspectives. Through a systematic process of data coding and interpretation, we identified recurring patterns in their responses. This approach allowed us to uncover the depth and complexity of their viewpoints, providing valuable insights into the multifaceted nature of dignity as perceived by healthcare professionals. Our findings revealed that healthcare professionals possessed a nuanced understanding of dignity, recognizing both a subjective element and a universal aspect applicable to all individuals, aligning with theoretical interpretations. However, conceptual ambiguity remained a challenge.

Effects of Dignity Therapy on Dignity, Anxiety, Depression and Quality of Life for People With Burns: A Randomised Controlled Trial.

AIMS: To evaluate the effect of dignity therapy on dignity, anxiety, depression and overall quality of life for people with burns. DESIGN: A single-blind, double-arm, parallel randomised controlled study. METHODS: The Patient Dignity Scale, Hospital Anxiety and Depression Scale, and Burn-Specific Health Scale-Short were employed to assess the dignity, anxiety, depression and overall quality of life for people with burns. These outcome indicators were measured and analysed at baseline, 2-, 4- and 8-week follow-up. The generalised estimating equations were used to analyse the effect of the intervention during each time point. RESULTS: A total of 99 participants were recruited (50 in the intervention group and 49 in the control group), with a high retention rate of 97 participants (94.95%) completing the 8-week follow-up. All outcome measurement tools met the feasibility criteria related to completeness and responsiveness over time. Dignity was the primary outcome measure, with anxiety, depression and quality of life serving as secondary outcome measures. At the 8-week post-intervention, participants in the intervention group demonstrated a statistically significant decrease in dignity and anxiety and depression, and a statistically significant increase in burn-specific health. CONCLUSIONS: Dignity therapy can effectively reduce the loss of dignity, anxiety and depression, and improve the quality of life for people with burns. This study has a positive impact on burn dignity nursing practice and provides healthcare professionals with a novel approach to help people with burns return to normal social life with dignity. IMPLICATIONS FOR THE PROFESSION: It is important to develop patient-centred care for burns with dignity. Focusing on developing a rational understanding of non-discriminatory dignity care practices among clinical providers and to develop dignity-oriented clinical care practices on the wards. IMPACT: This study validated the feasibility of implementing dignity therapy for people with burns. Dignity therapy is effective in reducing the degree of dignity impairment, reducing anxiety and depressive symptoms, and enhancing the quality of life for people with burns. Our findings can help healthcare professionals to provide personalised dignity care throughout the patient's journey to facilitate a dignified reintegration into society and life for people with burns. REPORTING METHOD: This randomised controlled trial used the CONSORT guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patients or members of the public participated in the study design, data analysis or interpretation. CLINICAL TRIALS: This study has been registered in the Chinese Clinical Trial Registry registration number: ChiCTR2200065145, 29 October 2022.

[Consensus on therapeutic effort limitation, with a palliative care approach]. / Consenso de adecuación de esfuerzo terapéutico con enfoque paliativo.

The National Committee for Palliative Care expressed their commitment to approach the decision of foregoing life sustaining treatment from a palliative care perspective, allowing the implementation of a care program to prevent therapeutic obstinacy, respect the dignity of the patient and their parents, and evaluate a rational, reasonable and adequate use of health and technological resources by focusing on the quality of life of the child, in order to realize their best interest, providing a guide that facilitates the decision-making process in dilemmatic situations in pediatrics.

Desde el Comité Nacional de Cuidados Paliativos surgió la inquietud de aportar una mirada específica a la adecuación del esfuerzo terapéutico que permita implementar un plan de cuidado que prevenga el empecinamiento terapéutico, respete la dignidad del paciente y sus padres, evalúe un uso racional, razonable y adecuado de los recursos sanitarios y tecnológicos, y se focalice en la calidad de vida del niño, en concreción de su interés superior. El objetivo es acercar a los pediatras una guía que facilite el proceso de toma de decisiones en situaciones dilemáticas.

From ontological to relational: A scoping review of conceptions of dignity invoked in deliberations on medically assisted death.

BACKGROUND: Dignity is omnipresent in Western ethics, but it also provokes dissension and controversy. One of the most striking examples is the debate on medically assisted death, where dignity is invoked to support antagonistic positions. While some authors conclude that the concept is useless as an ethical reference, many others invite us to deepen our analysis from a multidimensional perspective, to enrich it and make it useful. This scoping study is intended to provide an overview of the different conceptions of dignity used in the assisted dying debate, to better grasp the multiple facets of the concept. METHODS: The Joanna Briggs Institute's JBI Manual for Evidence Synthesis guided the scoping review. Key words were based on the researchers' expertise and were used to identify relevant literature in French and English. Eleven databases covering the last six decades were consulted. Initially, 2,071 references were found in the databases. After excluding duplicates, screening titles, abstracts, and full texts, and after a specific literature search on the concept of relational dignity, 156 papers were found to match the identified inclusion criteria. RESULTS: The literature highlights the stark confrontation between two dominant conceptions of dignity: ontological and autonomist. However, a lesser-known conceptualization of dignity integrates these two perspectives, underlining the relational and social dimensions of dignity. As a result, dignity emerges as a dynamic, experiential, and dialogical concept, that modulates itself according to circumstances. This raises the possibility of breaking through the binary debate and questioning the current frameworks that define dignity. CONCLUSIONS: This multidimensional conceptualization of dignity could lead to a more complete and nuanced understanding of the concept, as well as open richer normative horizons regarding the issue of medically assisted death.

Prayer and Mental Well-Being in the United States: An Overview of Original and Comprehensive Prayer Data.

The Baylor Religion Survey (Wave 6; 2021) contains the most comprehensive set of prayer questions of any national survey of the USA; it also contains multiple indicators of mental health and well-being, specifically measures of happiness, depression, anxiety, sense of control, mattering, and dignity. This paper provides a complete overview of how various dimensions of prayer correlate with these different aspects of well-being. While many of these relationships will require more intensive investigation, our synopsis provides confirmation of past expectations using new data. Overall, we find that prayer is related to mental well-being in both positive and negative ways. Specifically, we find that praying with others and positive emotions felt during prayer are correlated with greater overall mental health and more positive self-concepts. However, we also find that petitionary prayer topics, belief that God is impersonal, and negative emotions felt during prayer coincide with higher levels of depression, anxiety, and a lack of control. Generally, these conclusions hold after controlling for basic demographics, religious tradition, and church attendance, which confirms that mental well-being is related to the practice of prayer in both beneficial and detrimental ways.

Student radiographers' knowledge and experience of lateral hip X-ray positioning: A survey.

INTRODUCTION: The horizontal beam lateral (HBL) position technique for X-ray imaging has been used for nearly a century; however, this can be challenging for the patient and the practitioner, as it potentially compromises patient dignity. This study explores student radiographers' knowledge and experience of lateral hip positions and their impact on diagnostic quality and patient dignity. METHOD: A cross-sectional mixed-method online survey of undergraduate diagnostic radiography students was completed. Likert scale assessments, rank ordering questions, and free-test qualitative responses were utilised for questions on knowledge and experience of different positioning, ease to obtain, patient dignity, diagnostic quality, and need for repeats. Data analysis included descriptive statistics and cross-tabulation non-parametric analysis against variables of age, gender and year of study. RESULTS: Responses were received by n = 42/158 students, a response rate of 27%. The HBL position was the most commonly repeated image (76.6%); the qualitative themes included HBL image quality issues and difficulty in the HBL positioning for elderly or frail patients, often in discomfort and pain. Analysis of student responses to perceived patient dignity in positioning identified 73.8% found the HBL undignified, and 85.7% agreed the Clements-Nakayama (CN) position would be more dignified for patients. The diagnostic image quality of the HBL position (64.2%) was compared to the CN alternative axiolateral (66.6%). Comparison of ease of obtaining the correct position for HBL (47.6%) was higher than CN position (28.6%); this could be due to the lack of experience n = 3/42 (7.1%) of this position. CONCLUSION: Overall, student radiographers' experience and knowledge of various lateral hip positions observed in clinical practice was good. The CN position scored high for diagnostic image (66.6%) and dignity for the patient (85.7%), over the often repeated HBL position (76.6%), which scored lower for image quality (64.2%) and dignity (76.6%). IMPLICATIONS FOR PRACTICE: Radiographers should advocate for professional autonomy and explore alternative positioning techniques. Further investigation into the CN position's utilisation, image quality and radiation dose in England is recommended.

Novel Approaches Needed: An Experimental Study with an Alternative to Mechanical Restraint.

Despite many calls to reduce or eliminate the use of mechanical restraint, it is still widely used in many countries. Studies using patient interviews have a very clear message: Patients experience mechanical restraint as the most humiliating intervention. There seems to be a lack of alternatives for violent patients if all other approaches to prevent the use of coercion have failed. We developed a method using 30 kg bags, originally designed for fitness purposes, to be attached to a patient's wrist or ankle under 1:1 supervision. The method was tested with 10 experienced nurses and de-escalation trainers. A video was made and presented to six outpatients who had previously experienced mechanical restraint. All participants were interviewed. Transcribed interviews were analysed using qualitative content analysis. All participants approved of the method as a milder and less humiliating alternative to mechanical restraint. The nurses' main concerns were the risk of falls and the use of the bags as weapons. The latter could be controlled by using an additional bag. Patients were generally positive, especially if there was a history of abuse. The method should be further developed to replace at least some mechanical restraints. As with all 'milder means', care should be taken to really replace restraint and not to introduce additional coercion.

Is it really better to "die" than "live"? Reflections on the practice of "death with dignity" in China.

Aim: To analyze the causes of the controversy caused by "death with dignity" in China, and to provide some useful thoughts for the practical exploration of "death with dignity." Subject and methods: By combing the periodical literature, legal texts and practice, we find that the Medical Regulations of Shenzhen Special Economic Zone, which was revised and passed by China in 2022, recognized the legal effect of "living will" for the first time in legislation, which triggered a wide-ranging social discussion on "death with dignity" and brought many controversies. Results: Due to the influence of traditional culture, policies and laws, medical service supply capacity and other factors, death with dignity suffers from great practical resistance. Conclusion: The exploration of "death with dignity" system needs to start with the problems encountered in practice, focusing on cultivating a good system implementation environment, strengthening the top-level design of "death with dignity" system, and improving the national social security system for hospice care.

Organizational silence and hidden threats to patients' dignity with schizophrenia: A qualitative study.

BACKGROUND: Maintaining patients' dignity is a key ethical requirement in healthcare and is emphasized in nursing standards. This issue is particularly significant for patients with schizophrenia because they face unique challenges such as physical and psychological difficulties, dependence on others, and social isolation, making them more vulnerable. Organizational factors can either threaten or preserve their dignity. However, there is little knowledge in this domain within the sociocultural context of Iran. RESEARCH OBJECTIVE: This study aimed to explore the role of the healthcare organization in the dignity of patients with schizophrenia, based on the opinions of patients, healthcare personnel, and family caregivers. RESEARCH DESIGN: This qualitative study was conducted with 26 participants (16 patients, 4 family caregivers, 2 nurses, 3 psychologists, and 1 service worker) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until data saturation was reached. The data were analyzed via Graneheim and Lundman's method. ETHICAL CONSIDERATIONS: The study protocol was approved by the Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099). FINDINGS: Based on data analysis, participants reported the three following challenges as organizational hidden threats to patients' dignity: "Lack of facilities," "premature management," and "ineffective communication." CONCLUSION: The study findings indicated that the healthcare organization does not support the dignity of patients. Management inefficiency and lack of facilities are evident in psychiatric hospitals, and healthcare centers are not monitored based on standard criteria. Limited interactions between healthcare personnel and patients were identified as the main reasons for the neglect of patients with schizophrenia and the violation of their dignity. The results of this study can help healthcare policymakers in designing and implementing effective programs to preserve the dignity of patients with schizophrenia.

Effect of logotherapy counseling program on chronic sorrow, dignity, and meaning in life of palliative care patients: a randomized controlled trial.

PURPOSE: Palliative care patients experience chronic sorrow with loss in dignity and meaning in life. Logotherapy is an effective way to cope with loss. This study aimed to evaluate the effect of logotherapy on chronic sorrow, dignity, and meaning in life of palliative care patients. METHODS: This study was conducted with 58 adults hospitalized due to advanced cancer and assigned to either intervention or control group by simple randomization. Data were collected with descriptive information form, Palliative Performance Scale, Patient Dignity Inventory (PDI), Prolonged Grief Disorder Scale-Patient Form (PGDS-PF), and Meaning in Life Questionnaire (MIL) on admission, at the 4th and 8th weeks. The intervention group received eight sessions of logotherapy. The control group received routine care. RESULTS: The mean scores of PGDS-PF (p = 0.01), PDI (p = 0.01), and searched meaning subdimension of MIL (MIL-SM) (p = 0.11) decreased in the intervention group compared to controls, both at the 4th and 8th week evaluation. The mean score of the present meaning subdimension of MIL (MIL-PM) (p = 0.02) increased at the 4th week evaluation but decreased at a non-statistically significant level at the 8th week. The mean scores of PGDS-PF and PDI increased in the control group while MIL-PM and MIL-SM decreased, both at the 4th and 8th week evaluation. CONCLUSIONS: Logotherapy was found effective in decreasing the sorrow and dignity-related distress of palliative care patients, while increasing finding meaning in life. Logotherapy is recommended to be used by palliative care professionals to empower patients. TRIAL REGISTRATION: Clinicaltrials registration number and date: NCT05129059, 19/01/2021.

Reducing Racial Disparities at End-of-life: Using Narratives to Build Trust and Promote advance Care Planning.

Black Americans are less likely than White Americans to have advance directives, die while receiving hospice services, or have their end-of life wishes honored. The root causes of disparities include imbalance of resources, lack of trust in health care institutions, lack of adequate education regarding end-of-life options, communication differences of health care providers with black vs white patients, variable access to hospice services in different communities, and poorer pain management for Black patients compared to White patients. Because root causes are numerous, comprehensive solutions are required. When advance care planning is in place, people are more likely to choose care focused on priorities and comfort than on seeking aggressive, sometimes futile, interventions in the last weeks of life. One important component of the solution should include listening to narrative stories of Black people as they encounter life-limiting diagnoses. Gathering the stories about life events and how strength was found through adversities can be a tool for growing trusting relationships and engaging in shared decision-making. Health care professionals should invite Black patients with serious illnesses to explore the sources of their strengths and identify their core values to work toward developing directives for the nature and place of their end-of-life and help to mitigate disparities in high quality end-of-life care.

Barriers to maintaining dignity for patients with schizophrenia: A qualitative study.

BACKGROUND: Since dignity is one of the fundamental rights of each patient, maintaining patients' dignity is essential. Unfortunately, in many cases, particularly among patients with schizophrenia (SCZ), dignity is not fully respected. Nonetheless, there is limited knowledge regarding this matter in Middle Eastern Nations. RESEARCH OBJECTIVE: This study aimed to identify the barriers to maintaining dignity for patients with schizophrenia from the perspective of patients with schizophrenia, their family caregivers, and healthcare personnel. RESEARCH DESIGN: This qualitative study was conducted with patients (n = 16), family caregivers (n = 4), and healthcare personnel (n = 6) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until the data reached saturation. Data were analyzed using the Graneheim and Lundman method. ETHICAL CONSIDERATIONS: The Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099). FINDINGS: Analysis of the interviews revealed two main themes and five subthemes as the barriers to maintaining dignity for patients with schizophrenia. The main themes included "Black shadow of stigma" (three subthemes: "Facing the fear and discrimination of others," "Misconceptions in society," and "Social rejection") and "Facing violations" (two subthemes: "Basic human rights violation" and "Negative emotional responses"). CONCLUSION: Patients' dignity with schizophrenia was at a low level due to the negative attitude of society toward these patients. In this respect, the basic human rights violations, social rejection, and misconceptions were abundant in society and care centers. An in-depth comprehension of the threatening factors affecting dignity can assist policymakers in safeguarding their dignity through effective programs.

Healthcare professionals' experiences of eHealth in palliative care for older people: challenges, compromises and the price of dignity.

PURPOSE: To explore whether and how eHealth solutions support the dignity of healthcare professionals and patients in palliative care contexts. METHOD: This qualitative study used phenomenographic analysis involving four focus group interviews, with healthcare professionals who provide palliative care to older people. RESULTS: Analysis revealed four categories of views on working with eHealth in hierarchical order: Safeguarding the patient by documenting-eHealth is a grain of support, Treated as less worthy by authorities-double standards, Distrust in the eHealth solution-when the "solution" presents a danger; and Patient first-personal contact with patients endows more dignity than eHealth. The ability to have up-to-date patient information was considered crucial when caring for vulnerable, dying patients. eHealth solutions were perceived as essential technological support, but also as unreliable, even dangerous, lacking patient information, with critical information potentially missing or overlooked. This caused distrust in eHealth, introduced unease at work, and challenged healthcare professionals' identities, leading to embodied discomfort and feeling of a lack of dignity. CONCLUSION: The healthcare professionals perceived work with eHealth solutions as challenging their sense of dignity, and therefore affecting their ability to provide dignified care for the patients. However, healthcare professionals managed to provide dignified palliative care by focusing on patient first.