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“It’s Like Opening a Can of Worms”: Evaluating a Dignity Care Intervention for People with Life Limiting Illness in the Community Setting

McIlfatrick, Sonja (2016) “It’s Like Opening a Can of Worms”: Evaluating a Dignity Care Intervention for People with Life Limiting Illness in the Community Setting. Palliative Medicine, 30 (6). NP273-NP273. [Journal article]

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URL: http://pmj.sagepub.com/content/30/6.toc

DOI: 10.1177/0269216316646056


Background: Evidence indicates that people nearing endof life fear loss of dignity and a central tenet of palliativecare is to help people die with dignity. The Dignity CareIntervention (DCI), based on the Chochinov theoreticalmodel of dignity care, comprises four components: educationmanual; patient dignity inventory, reflective questionsand care actions.Aim: To evaluate the usability and acceptability of a DignityCare Intervention (DCI) delivered by communitynurses for people with advanced and life limitingconditions.Method: Mixed methods research design, with threephases.Phase 1: Semi-structured, face-to-face interviews withpatient/carer dyads (n=18),Phase 2: four focus groups with (n=24) and an onlinesurvey with community nurses (n=27),Phase 3: analysis of completed DCI tools (n=27). Datawere analysed using thematic analysis of verbatim transcriptsand descriptive statistical analysis.Results: The DCI was acceptable to the communitynurses. It contributed to the overall assessment of palliativecare patients; identified areas that might not otherwisehave been identified; supported communication andassisted the nurses to provide holistic end of life care. Concernshowever were expressed that the tool ‘opened a canof worms’ initiating difficult conversations for which thenurses felt unprepared. The patients however found thatthe tool helped them to identify and consider future needsand were happy to discuss death and dying.Conclusion: The DCI helped nurses to delivered individualisedholistic care. Whilst all the nurses wished to continueto use the DCI, there were barriers identified such asthe time taken to complete; the identification of suitablepatients and the need for more training to enable them toinitiate difficult conversations on dignity conserving careand end of life care.

Item Type:Journal article
Keywords:dignity; community nurse; assessment
Faculties and Schools:Faculty of Life and Health Sciences > School of Nursing
Faculty of Life and Health Sciences
Research Institutes and Groups:Institute of Nursing and Health Research
Institute of Nursing and Health Research > Managing Chronic Illness Research Centre
ID Code:34950
Deposited By: Professor Sonja McIlfatrick
Deposited On:04 Jul 2016 13:49
Last Modified:26 May 2017 13:31

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