Oncology Nurses Can Help Older Patients Maintain Dignity

Oncology Nurses Can Help Older Patients Maintain Dignity

Certain patient characteristics are associated with an increased risk for a perceived loss of dignity in patients with cancer, highlighting the importance of oncology nurses and other providers to “enable dignity in patients with cancer and aid in the development of methods that promote their dignity,” according to recent research.

“Dignity is an intrinsic human feature and is related to personal values, freedom, responsibility, and capability,” the authors wrote in the study, which was published in the journal, Asian Nursing Research. “It arises from interpersonal interactions, in which social constructionism plays a role.”

The researchers analyzed data from 267 patients with cancer who filled out the Patient Dignity Inventory Mandarin version, which measures sources of dignity-related distress at the end of life; the Demoralization Scale Mandarin Version, which measures existential distress in patients with cancer; and the Patient Health Questtionnaire-9, which is used to screen, diagnose, monitor, and measure depression.

Findings showed that age, demoralization, and depression all tended to have an impact on dignity. Specifically, patients aged 65 years or older had “significant dignity-related issues.” This is in line with prior research which showed that older patients may be more likely to perceive themselves as having little or nothing to contribute to society and are unvalued if they have serious health issues.

“It is therefore crucial to maintain the dignity of elderly patients with cancer in healthcare settings, be it through the healthcare professionals paying attention to their language, attitude, and behaviors, or the environment and facilities,” the authors suggested. “The key is to ensure that the elderly patients with cancer feel valued and recognized and see their life as meaningful.”

The researchers also emphasized that a cancer diagnosis often brings feelings of anxiety and uncertainty, making it crucial that oncology clinicians have honest discussions with their patients about their disease, prognosis, and treatment options.

“Accordingly, we recommend that healthcare professionals share the disease progression and treatment process with the patients in detail and also encourage them to express their views about the future. This will help reduce their uncertainty and psychological distress and boost their hopes for the future,” they wrote.

However, they also noted that screening for and diagnosing demoralization or depression can be difficult for healthcare providers, though the Patient Dignity Inventory can help.

“We recommend that healthcare professionals pay more attention toward patients with cancer with a [Patient Dignity Inventory] aggregate score of 35 or more, as they may have developed psychological distress due to dignity-related issues (such as demoralization or depression); implementing additional psychological assessments or counseling for such patients will allow healthcare professionals to better understand their psychological state and offer appropriate treatment and care.”

Finally, the authors wrote that some patients perceive cancer as fatal or hopeless, which “can threaten patient dignity,” and that it is important for treating clinicians not to share such beliefs.

“Therefore, the dignity of patients with cancer should receive greater educational attention and social recognition in the healthcare sector. Healthcare professionals have to advocate for a dignified healthcare environment. This applies to their language, attitude, and behaviors, as well as medical and care facilities.”

Reference

Li Y, Feng Y, Ma S, Wang H. Dignity and Related Factors in Patients with Cancer: A Cross-Sectional Study. Asian Research Nursing. doi.org/10.1016/j.anr.2022.12.001