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Reconnecting nursing and patient dignity : an integrative review Roy, Jennifer Ann


Preserving dignity is an essential part of nursing. However, there are mounting concerns that nurses are not fulfilling this important responsibility. A gap exists between nursing discourse and practice. The aim of this paper was to examine strategies that have been proposed, or implemented, to translate a conceptual understanding of patient dignity into a central role in daily acute care nursing practice. A greater understanding of strategies offers insight to how nurses can reconnect with upholding patient dignity and provides a starting point for further research. An integrative review was carried out using Whittemore and Knafl’s (2005) updated methodology, which includes 5 stages: problem identification, literature search, data evaluation, data analysis, and presentation. The literature search included the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, and Academic Search Complete databases. The keywords for the search were: dignity, nursing, nursing interventions, patients, nurse-patient relations, and staff development. Twelve highly relevant publications were identified. These articles consisted of program development initiatives, expert opinion pieces, practice-based journal articles, and a high-profile campaign. Five strategies emerged from the analysis: Training; Reflection and discussion; Imagining the patient perspective; Leadership; and Planning for action. The strategies focused on the individual nurse and nursing relationships. Structural influences had only a limited focus. Although the nurse participants described a greater understanding, a deeper awareness, better skills, and a desire to create change, the impact of the strategies was not evaluated in practice. Further research needs to assess the impact of the strategies in daily nursing practice, their influence on nursing culture, and the patient experience. A long-term view toward the sustainability of any changes once nurses return to their workplaces must also be taken. In addition, strategies must focus on the system and how nurses can be supported to uphold dignity within the challenges of acute care.

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