Exploring Nurses' Perceptions of Dignity During End-of-life Care

Exploring Nurses' Perceptions of Dignity During End-of-life Care

Author: 
Barbara Crump
Program of study: 
Ph.D./NUR
Abstract: 
The purpose of this qualitative grounded theory study was to understand nurses’ perceptions of care that supports patients’ dignity during hospitalization at the end of life, and to propose a theoretical foundation consistent with these perceptions as a guide to practice. The research involved analyzing perceptions about processes that can explain how nurses perceive care that supports patients’ dignity at the end of life during hospitalization. The aim of the research in this study included a focus on the general problem that patients’ dignity is not always respected by healthcare providers according to the review of the literature and the acknowledgment of the lack of theories related to nurses’ perceptions of care that supports dignity during end-of-life care. A grounded theory design offered a systematic approach to developing a theoretical model from data that takes into consideration the complexities of nurses’ perceptions of care that supports dignity during hospitalization at end of life. Semistructured interviews were conducted with 11 experienced registered oncology female nurses from the northeastern region of the United States. The research involved analysis of the perceptions of nurses caring for cancer patients admitted to the hospital during end of life. The development of a beginning model for dignity care stemmed from the emergence of three major categories, which were communication, support, and facilitation. The identified subcategories were education, workshops, course curriculum, inservices, being an advocate, listening, being present, physical needs, emotional support, compassion, honoring wishes, respect, and being treated as human. The emergence and development of a dignity model may offer a process that can serve as a valuable reference in providing care that supports the dignity of patients during hospitalization at end of life.
Dedication: 
This dissertation is dedicated to my husband, Spencer; my parents, Cleveland and Annie Johnson; my children; and my grandchildren, all of whom provided loving support and never complained, even when my work on this dissertation interfered with our family time. I am forever grateful for their love, encouragement, and inspiration, especially during the times I almost gave up. I also want to thank Dr. Victor Chang, who has inspired me throughout my doctoral journey. This dissertation is also dedicated to all the nurses who graciously shared their experiences, insight, and commitment to this study.
Acknowledgements: 
First, I would like to acknowledge Almighty God the highest, who gave me the strength, courage, and knowledge to pursue this doctoral journey through its completion. Many people contributed to my development as a scholar–practitioner and leader throughout this dissertation initiative. I would like to thank my chairperson, Dr. Cydney Mullen, for her support, guidance, and encouragement throughout this amazing academic accomplishment. In addition, I would like to thank my committee members, Dr. Lorna Kendrick and Dr. Kathryn Macdavitt. I would also like to thank Dr. Marilyn Miller, who came in at the last hour to fill in as my second committee member. Most important, I would like to thank each one of them for their support and mentorship. In addition, I would be remiss not to thank Alberto Sarmiento for his support and consideration. I am profoundly touched and thankful for all of the support and encouragement.