Dignity enhanced through faith & family support in palliative care: a qualitative study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088685 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-684X (Electronic) Linking ISSN: 1472684X NLM ISO Abbreviation: BMC Palliat Care Subsets: MEDLINE

Original Publication: London : BioMed Central, [2002-

Qualitative Research* ; Palliative Care*/psychology ; Palliative Care*/methods ; Palliative Care*/standards; Humans ; Male ; Female ; Middle Aged ; Aged ; Lebanon ; Adult ; Family/psychology ; Social Support ; Aged, 80 and over ; Respect ; Personhood ; Interviews as Topic/methods ; Family Support

Background: Dignity is integral to palliative care. Illness can diminish it, causing hopelessness and the wish to hasten death. Yet, dignity is a complex multidimensional phenomenon, influenced by values and context. Understanding its varying interpretations can inform practice and policy. The aim of the study is to explore the understanding of dignity in adult patients with palliative care needs from a Lebanese perspective and how it is preserved during illness and while receiving health services.
Design: Qualitative interview study underpinned with a social constructionist lens. Fourteen patients recruited from home-based hospice and outpatient clinics in Lebanon. Data analysed using reflexive thematic analysis.
Results: Four themes were developed across all the interviews: (a) Dignity anchored through faith in God and religious practices; (b) Family support in maintaining physical, psychological wellbeing, and social connectedness; (c) Physical fitness, mental acuity, and healthy appearance through which patients may escape the stigma of disease, (d) accessible, equitable, and compassionate healthcare.
Discussion: Dignity is elusive and difficult to define but faith and religious beliefs play a significant contribution in this study. For the participants, illness is seen as a natural part of life that does not necessarily diminish dignity, but it is the illness related changes that potentially affect dignity. Findings show the importance of family and children in preserving dignity during illness and how their active presence provide a sense of pride and identity. Participants aspired to restore physical, social, and mental well-being to reclaim their dignity and normalize their lives. Challenges related to physical appearance, memory loss, vitality, and social stigma associated with illness diminished dignity. Accessible, equitable and compassionate healthcare services are also crucial in preserving dignity. Participants valued clear communication, respect, and empathy from healthcare providers and identified affordability of care essential for maintaining dignity.
Conclusion: Faith in God, and strong family ties are dominant elements to maintaining dignity in the Lebanese context. Relational connectedness with family, children or God is also a need in maintaining dignity in other communal countries with variations in emphasis. The study indicates that religious and cultural context shapes the needs and perceptions of dignity during illness. These findings are likely to be transferable to many Middle Eastern countries but also countries with strong religious and family ties globally.
(© 2024. The Author(s).)

Age Ageing. 2013 Jul;42(4):455-61. (PMID: 23443510)
BMC Med Ethics. 2020 Jun 30;21(1):50. (PMID: 32605569)
J Med Ethics Hist Med. 2018 Apr 18;11:4. (PMID: 30258554)
Bull World Health Organ. 2001;79(4):373-4. (PMID: 11357217)
Nurs Ethics. 2020 Feb;27(1):104-115. (PMID: 31104584)
J Palliat Med. 2014 Jun;17(6):688-95. (PMID: 24735024)
J Clin Oncol. 2005 Aug 20;23(24):5520-5. (PMID: 16110012)
J Pain Symptom Manage. 2019 Apr;57(4):835-845. (PMID: 30611709)
Curr Opin Support Palliat Care. 2012 Jun;6(2):269-74. (PMID: 22469668)
Eur J Oncol Nurs. 2012 Sep;16(4):353-67. (PMID: 21917517)
J Pain Symptom Manage. 2013 Jun;45(6):1094-106. (PMID: 23017628)
BMC Palliat Care. 2019 Jan 24;18(1):10. (PMID: 30678669)
Qual Health Res. 2009 Nov;19(11):1536-47. (PMID: 19797155)
Age Ageing. 2007 Mar;36(2):197-202. (PMID: 17208924)
JAMA. 2002 May 1;287(17):2253-60. (PMID: 11980525)
J Clin Nurs. 2015 Jul;24(13-14):1743-72. (PMID: 25706903)
Gerontol Geriatr Med. 2018 Jul 17;4:2333721418778195. (PMID: 30035200)
Int J Equity Health. 2012 May 09;11:23. (PMID: 22571591)
Nurse Res. 2014 Mar;21(4):32-7. (PMID: 24673351)
Nurs Ethics. 2018 Jan 1;:969733018759832. (PMID: 29558850)
Palliat Med. 2003 Apr;17(3):263-9. (PMID: 12725480)
Int J Nurs Stud. 2009 Jan;46(1):23-36. (PMID: 18790477)
J Adv Nurs. 2006 Jun;54(6):700-9. (PMID: 16796662)
Palliat Care Soc Pract. 2023 May 29;17:26323524231176829. (PMID: 37266393)
BMC Int Health Hum Rights. 2009 Feb 24;9:3. (PMID: 19239684)
Scand J Caring Sci. 2018 Mar;32(1):8-23. (PMID: 28509335)
BMC Palliat Care. 2020 Apr 22;19(1):55. (PMID: 32321487)
Death Stud. 2013 Nov-Dec;37(10):953-70. (PMID: 24517523)
Eur J Ageing. 2010 Dec;7(4):313-316. (PMID: 21212820)
Am J Hosp Palliat Care. 2020 May;37(5):385-398. (PMID: 31581779)
Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937)
Nurs Ethics. 2017 Feb;24(1):20-32. (PMID: 26391693)
Nurs Ethics. 2019 May;26(3):738-752. (PMID: 28835156)
J Palliat Med. 2006 Jun;9(3):666-72. (PMID: 16752972)
Soc Sci Med. 2002 Feb;54(3):433-43. (PMID: 11824919)
Bull Hist Med. 2014 Spring;88(1):48-74. (PMID: 24769802)
BMJ. 2007 Jul 28;335(7612):184-7. (PMID: 17656543)
Semin Oncol Nurs. 2018 Aug;34(3):274-283. (PMID: 30122429)
Accid Emerg Nurs. 2005 Oct;13(4):251-7. (PMID: 16298291)
BMC Palliat Care. 2023 Nov 30;22(1):192. (PMID: 38037061)
Palliat Support Care. 2022 Apr;20(2):296-297. (PMID: 33952377)
Lancet Glob Health. 2019 Jul;7(7):e883-e892. (PMID: 31129125)
Adm Policy Ment Health. 2015 Sep;42(5):533-44. (PMID: 24193818)
Palliat Med. 2020 Dec;34(10):1385-1392. (PMID: 32912088)
J Clin Nurs. 2017 Dec;26(23-24):4300-4312. (PMID: 28178386)
Nurs Ethics. 2012 Sep;19(5):619-28. (PMID: 22323394)
BMC Palliat Care. 2021 Jul 16;20(1):112. (PMID: 34271909)
PLoS One. 2016 Mar 24;11(3):e0151435. (PMID: 27010323)
Lancet. 2002 Dec 21-28;360(9350):2026-30. (PMID: 12504398)
Nurs Ethics. 2017 Jun;24(4):408-418. (PMID: 26419439)
Palliat Med. 2021 Jan;35(1):97-108. (PMID: 32945248)
J Pain Symptom Manage. 2008 Dec;36(6):559-71. (PMID: 18579340)
Health Psychol Open. 2014 Sep 25;1(1):2055102914552281. (PMID: 28070343)
Health Care Women Int. 2020 Sep;41(9):1036-1058. (PMID: 33084519)
Psychooncology. 2021 Aug;30(8):1220-1231. (PMID: 33893677)
Narrat Inq Bioeth. 2015;5(1A):5A-14A. (PMID: 25772731)

Keywords: Dignity; Faith; Family; Middle East; Palliative care; Qualitative research

Date Created: 20240607 Date Completed: 20240607 Latest Revision: 20240610

20240610

PMC11157805

10.1186/s12904-024-01478-4

38849809