Opinions of palliative care patients and nurses regarding dignified care

This study was conducted to investigate the views of the palliative care patients and the nurses working in this field about dignified care and to evaluate Turkish validity and reliability of the Patient Dignity Inventory. This descriptive and methodological study comprise of two phases. The first stage is validity and reliability study of "Patient Dignity Inventory" developed in Canada by Chochinov et al. within the Turkish society with a sample consisted of 127 advanced cancer patients who were hospitalized in the clinics of two university hospitals in Ankara. Demographic form, Palliative Performance Scale, Patient Dignity Inventory and Hospital Anxiety and Depression Scale were used to collect data in the study. Patient Dignity Inventory was reapplied to 32 patients at least one week after the first application. In the second stage, opinions of 10 palliative care patients and 10 nurses working with those patients were investigated relating to dignified care via one-to-one semi-structured interview technique. The study was conducted between February-July 2018. Patient Dignity Inventory was presented to expert opinion after the language validity was provided and, approved by experts. The Cronbach alpha value was calculated as 0.94 for the first application and 0.90 for the second application. The total score of the inventory was 46.85±18.49 (min: 25- max: 125) for the first application and 40.78 ± 13.96 (min: 25-max: 70) for the second application. Explanatory factor analysis and confirmatory factor analysis were performed to examine construct validity of the scale. The Kaiser-Meyer-Olkin sampling adequacy criterion value was found as 0.89 and factor analysis adequacy criterion The Bartlett's Test of Sphericity was found as p <0.000. Five factors were obtained as result of construct validity analysis of the Turkish version of Patient Dignity Inventory, differing from the original scale in terms of item distribution. It was found that 5 factors obtained by analysis explained 68.7 of total variances. Analysis of the interview data performed with the patients resulted in three themes as respectability, caring practices and usefulness. Three major themes were detected through data of interviews held with nurses such as maintaining respectability; barriers and facilitators and benefits. As a result, it was determined that the Patient Dignity Inventory is a valid and reliable scale for Turkish society. Dignified care is specified through interviews held with patients and nurses as a process that protects patient's dignity and provides holistic care for the patient resulting in positive effects by establishing healthy communication between healthcare team and patient, and making the patient feel valuable and safe, and therefore enhances job satisfaction of a nurse. Developing institutional policies to build up and maintain a dignified care culture including raising awareness of the issue, assigning staff according to their qualifications and making arrangements to prevent burnout is recommended.