Dignity in Medicine: Definition, Assessment and Therapy.

IF 5.5 2区 医学 Q1 PSYCHIATRY Current Psychiatry Reports Pub Date : 2024-06-01 Epub Date: 2024-05-29 DOI:10.1007/s11920-024-01506-3
Luigi Grassi, Maria Giulia Nanni, Michelle Riba, Federica Folesani
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Abstract

Purpose of review: Over the last 20 years, dignity and dignity-conserving care have become the center of investigation, in many areas of medicine, including palliative care, oncology, neurology, geriatrics, and psychiatry. We summarized peer-reviewed literature and examined the definition, conceptualization of dignity, potential problems, and suggested interventions.

Recent findings: We performed a review utilizing several databases, including the most relevant studies in full journal articles, investigating the problems of dignity in medicine. It emerged that dignity is a multifactorial construct and that dignity-preserving care should be at the center of the health organization. Dignity should be also regularly assessed through the tools currently available in clinical practice. Among dignity intervention, besides dignity models of care, dignity intervention, such as dignity therapy (DT), life review and reminiscence therapy, have a role in maintaining both the extrinsic (preserved when health care professionals treat the patient with respect, meeting physical and emotional needs, honors the patient's wishes, and makes attempts to maintain privacy and confidentiality) and intrinsic dignity (preserved when the patient has appropriate self-esteem, is able to exercise autonomy and has a sense of hope and meaning). Unified trends across diverse medical contexts highlight the need for a holistic, patient-centered approach in healthcare settings. Challenges compromising dignity are pervasive, underscoring the importance of interventions and systematic efforts to address these issues. Future research and interventions should prioritize the multifaceted nature of dignity, striving to create healthcare environments that foster compassion, respect, and dignity across all medical settings.

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医学的尊严:医学中的尊严:定义、评估和治疗
综述的目的:在过去 20 年中,尊严和维护尊严的护理已成为许多医学领域的研究中心,包括姑息治疗、肿瘤学、神经病学、老年医学和精神病学。我们总结了同行评议的文献,研究了尊严的定义、概念化、潜在问题以及建议的干预措施:我们利用多个数据库进行了综述,包括期刊论文全文中最相关的研究,调查了医学中的尊严问题。研究表明,尊严是一个多因素的概念,维护尊严的护理应成为医疗机构的中心工作。尊严也应通过临床实践中现有的工具定期进行评估。在尊严干预措施中,除了尊严护理模式外,尊严疗法(DT)、生命回顾和回忆疗法等尊严干预措施在维护外在尊严(医护人员尊重患者,满足患者的生理和情感需求,尊重患者的意愿,并努力维护患者的隐私和保密性,从而维护患者的尊严)和内在尊严(患者拥有适当的自尊,能够行使自主权,并拥有希望和意义感,从而维护患者的尊严)方面都发挥着作用。不同医疗环境下的统一趋势凸显了在医疗环境中采取以患者为中心的整体方法的必要性。有损尊严的挑战是普遍存在的,这凸显了干预和系统性努力解决这些问题的重要性。未来的研究和干预措施应优先考虑尊严的多面性,努力创造在所有医疗环境中培养同情心、尊重和尊严的医疗环境。
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来源期刊
CiteScore
11.30
自引率
3.00%
发文量
68
审稿时长
6-12 weeks
期刊介绍: This journal aims to review the most important, recently published research in psychiatry. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by psychiatric disorders. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as anxiety, medicopsychiatric disorders, and schizophrenia and other related psychotic disorders. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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