Background
Research in the end-of-life context has explored the sense of dignity experienced by patients with advanced disease, examining the factors associated with it. Whereas certain perspectives regard dignity as an intrinsic quality, independent of external factors, in the clinical setting it is generally equated with the person’s sense of autonomy and control, and it appears to be related to patients’ quality of life. This study aims to explore the relationship between perceived dignity, autonomy and sense of control in patients at the end of life.

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Patient Perspectives of Dignity, Autonomy and Control at the End of Life: Systematic Review and Meta-Ethnography.

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Objectives Patients with advanced disease sometimes express a wish to hasten death (WTHD) In 2012, we published a systematic review and meta-ethnography of qualitative studies examining the experience and meaning of this phenomenon Since then, new studies eligible for inclusion have been reported, including in Europe, a region not previously featured, and specifically in countries with different legal frameworks for euthanasia and assisted suicide The aim of the present study was to update our previous review by including new research and to conduct a new analysis of available data on this topic Setting Eligible studies originated from Australia, Canada, China, Germany, The Netherlands, Switzerland, Thailand and USA Participants Studies of patients with life-threatening conditions that had expressed the WTHD Design The search strategy combined subject terms with free-text searching of PubMed MEDLINE, Web of Science, CINAHL and PsycInfo The qualitative synthesis followed the methodology described by Noblit and Hare, using the ‘adding to and revising the original’ model for updating a meta-ethnography, proposed by France et al  Quality assessment was done using the Critical Appraisal Skills Programme checklist Results 14 studies involving 255 participants with life-threatening illnesses were identified Five themes emerged from the analysis: suffering (overarching theme), reasons for and meanings and functions of the WTHD and the experience of a timeline towards dying and death In the context of advanced disease, the WTHD emerges as a reaction to physical, psychological, social and existential suffering, all of which impacts on the patient’s sense of self, of dignity and meaning in life Conclusions The WTHD can hold different meanings for each individual—serving functions other than to communicate a genuine wish to die Understanding the reasons for, and meanings and functions of, the WTHD is crucial for drawing up and implementing care plans to meet the needs of individual patients

https://bmjopen.bmj.com/content/bmjopen/7/9/e016659.full.pdf

Understanding patients' experiences of the wish to hasten death: an updated and expanded systematic review and meta-ethnography.

Background:A core concept behind patient-centred approaches is the need to treat people with, and preserve, dignity in care settings. People receiving palliative care are one group who may have particularly sensitive needs in terms of their condition, symptoms and life expectancy. Dignity is more likely to be violated in hospital settings. Given the high percentage of people with palliative care needs who are admitted to hospital during their last year of life, the provision of dignity enhancing and preserving care in that setting is of vital importance.Aim:To examine international evidence relating to dignity and person-centred care for people with palliative care needs in the acute hospital setting.Design:A systematic literature review was conducted, incorporating data extraction, analysis and quality appraisal of included papers.Data sources:MEDLINE, CINAHL, PsycINFO, ASSIA, EMBASE, Cochrane Database and Web of Science. Inclusion dates: 1 January 2000–1 April 2014. Eligibility criteria: Adult palliativ...

Dignity and patient-centred care for people with palliative care needs in the acute hospital setting: A systematic review

Relationships among nursing student palliative care knowledge, experience, self-awareness, and performance: An end-of-life simulation study.

Commentary on the article by Park et al. (2022) “A present from the forest: Focus group interviews on cancer survivors’ forest experiences”

A self-administered immersive virtual reality tool for assessing cognitive impairment in patients with cancer.

http://apjon.org/article/S2347562522001809/pdf

Does forest healing be a promising complementary and alternative medicine (CAM) intervention for cancer survivors?

http://www.cell.com/article/S2405844023007752/pdf

Comparison of risk assessments for venous thromboembolism during the puerperium

e24132 Background: Patients with cancer experience different degrees of loss of dignity. Exploring the characteristics of dignity loss for patients with cancer is rare in China, but it is of great significance for patients and their families in the whole anti-cancer trajectory. Methods: Inpatients and outpatients with cancer from the Fourth Hospital of Hebei Medical University were enrolled in this study. The Patient Dignity Inventory(PDI) and EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) was used for measuring patients’ dignity loss and quality of life. Spearman’s correlation analysis was conducted to analyze the correlation factors of dignity loss, and the correlation among dignity loss, quality of life and its dimensions. Results: A total of 403 patients with cancers were included in this study. In terms of loss of dignity, 20 patients (4.96%) didn’t report loss of dignity, 295 patients (73.20%) had mild loss of dignity, 78 (19.35%) had moderate and 10(2.48%) had severe loss of dignity. The three most prevalent PDI problems of patients were “experiencing physically distressing symptoms”(146, 36.23%), “Feeling that I am a burden to others” (126，31.27%) and “worrying about future” (114, 28.29%) . Companionship(r = 0.167, P = 0.001), PS(r = 0.392, P < 0.001), diagnosis to investigation time (r = 0.107, P = 0.031), stage of disease (r = 0.279, P < 0.001), stage of treatment (r = 0.333, P < 0.001), surgery and recurrence (r = 0.158, P = 0.001), anxiety (r = 0.612, P < 0.001), depression (r = 0.603, P < 0.001), psychological distress (r = 0.453, P < 0.001), symptom burden (r = 0.421, P < 0.001) and impact on life (r = 0.450, P < 0.001) were positive correlated with loss of dignity. Age (r = -0.134, P = 0.007), occupation (r = -0.124, P = 0.013) were negative correlated with loss of dignity. Loss of dignity and quality of life are significant correlated with each other. Dignity existential distress showed moderate negative correlation with emotional function (r = -0.513, P < 0.001). Dignity symptom distress showed moderate negative correlation with emotional function (r = -0.675, P < 0.001) and social function (r = -0.515，P < 0.001). Dignity symptom distress showed moderate positive correlation with fatigue symptoms (r = 0.541, P < 0.001). Conclusions: Most cancer patients’ dignity were impaired slightly or moderately in North China. Dignity of cancer patients showed significant association with quality of life. Anxiety and depression were more consistent with dignity than other factors. Improving the quality of life and dignity of patients is vital.

Qiaohong Guo

Papers

Commentary on the article by Park et al. (2022) “A present from the forest: Focus group interviews on cancer survivors’ forest experiences”

A self-administered immersive virtual reality tool for assessing cognitive impairment in patients with cancer.

Does forest healing be a promising complementary and alternative medicine (CAM) intervention for cancer survivors?

Comparison of risk assessments for venous thromboembolism during the puerperium

Exploring the characteristics of dignity loss in patients with cancer in North China.