Treating patients with dignity, but what about hands-on care?

Although the UK has well-established local and national policies that champion the need to provide dignified care, breaches in dignity are still a problem with the NHS -- and the study by Brunel University London has uncovered a potential gap between what patients expect and the focus of care professionals.

When asked what dignified care meant to them, health care professionals referred to 'what dignity is', often as a conceptual idea, yet few made reference to 'how dignity is provided' -- including hands-on tasks such as washing, dressing and feeding.

Specific, hands on care tasks are often the focus of reports of dignity breaches and particularly older patients have previously emphasised the importance of such tasks being provided in a dignified manner.

A total of 33 health and social care professionals took part in one of eight focus groups. They described dignity as the backbone of nursing and as being present in the extra "little things" done for patients. Dignified care was about having respect for others, ensuring that patients felt safe and secure and were treated as individuals. The themes were consistent across participants' age, rank and role.

As with national and local guidelines, the study's participants focused on an ideal of how care should be delivered and not how it was actually done, suggesting a gap in the rhetoric of dignity between professionals' emphasis of what it means on a more conceptual level, and patients' very clear focus on how it is translated to hands-on-care tasks.

Christina Victor, Professor of Gerontology and Public Health at Brunel University London, said: "It is important that dignity is enacted through a conceptual understanding and part of everyday care, from communication, safety and security to hands-on-care.

"Older patients in hospital can be particularly vulnerable and we need to make sure that we don't overlook their need for food, water, warm clothing and hygiene.

"It was encouraging to find good awareness of the need for respect, politeness and kindness but we must not forget the importance of providing dignified care in every aspect, including vital tasks such as feeding and providing hygiene needs."