Threats to patient dignity in clinical care settings: A qualitative comparison of Indonesian nurses and patients

• Published in: Journal of clinical nursing 2020-03, Vol.29 (5-6), p.899-908
• Main Authors: Asmaningrum, Nurfika, Kurniawati, Dini, Tsai, Yun‐Fang
• Format: Article
• Language: English
• Subjects: Adult; Attitude of Health Personnel; Clinical medicine; Content analysis; dignity; disrespectful; Empathy; Female; Humans; Indonesia; Inpatients - psychology; Male; Middle Aged; nurse; Nurse-Patient Relations; Nurses; Nursing; Nursing care; patient; Patient-centered care; Patient-Centered Care - standards; Patients; qualitative descriptive; Qualitative Research; Respect; threat; undignified care; violation; Young Adult
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.15144

Aims and objectives To explore and compare nurses’ and patients’ viewpoints of disrespectful behaviours that threaten patient dignity during hospitalised care. Background Patient's dignity is an important ethical consideration for nursing care practice. In clinical settings, nurse–patient interactions can generate behaviour considered disrespectful and undignified, often due to a disruptive hospital atmosphere and emotional frustrations of nurses and patients. How behaviours and attitudes threaten patient dignity in Indonesian clinical care settings has not been well studied. Design Qualitative descriptive study. Methods This multi‐site study purposively recruited nurses and inpatients from six public hospitals in four districts in Eastern Java, Indonesia. Individual, face‐to‐face semi‐structured interviews were conducted with 35 inpatients and 40 registered nurses from medical and surgical wards. Data from verbatim transcriptions of digital audio recordings were analysed with inductive content analysis. The COREQ checklist for qualitative research was used for reporting this study. Results Five categories emerged which described disrespectful behaviours that threaten patient dignity. Three categories were important for both nurses and patients: negligence, impoliteness and dismissal. Descriptions of the behaviours were comparable for both groups. The forth category, inattentiveness, was highlighted by nurses, while the fifth category, discrimination, was highlighted by patients. Conclusions Examining behaviours considered to be disrespectful in an Indonesian healthcare setting expand on perspectives towards dignity in care. The comparable viewpoints of nurses and patients provide knowledge of how undignified behaviours could be reduced in cross‐cultural healthcare settings. Behaviours perceived as undignified primarily by nurses or patients might result from differences in social roles and responsibilities. Relevance to clinical practice Understanding nurses’ and patients’ perspectives of undignified care is an important step in reducing behaviours that violate patient dignity in clinical practice. Nurses’ commitment to patient‐centred care should include being responsive, compassionate, communicative and attentive, which could ameliorate instances of undignified behaviours.