OBJECTIVES: Dignity of patients with early-stage dementia (PwESD) is a core value of person-centered care. To evaluate the effectiveness of the intervention programs targeted at this population, a reliable tool that would measure dignity in PwESD is needed. Based on a qualitative analysis of how PwESD perceive and experience dignity, this study aims to determine the adequacy of the Czech version of the Patient Dignity Inventory (PDI-CZ) for this patient population. METHOD: The sample from two outpatient clinics in Czechia included home-dwelling individuals aged 60 years or older with mild dementia. In the first interview (T1), there were 21 respondents; 10 of whom participated in the second interview (T2) that was conducted after 12 months. The qualitative material was analyzed using a deductive approach based on the PDI-CZ domains. RESULTS: Thematic analysis shows that the PwESD thematized all domains of the PDI-CZ in their interviews and their views of dignity were stable over time. Some experiences were not considered in the PDI-CZ (such as lowered support of the society, lowered ability to advocate for oneself, or feeling of not suitable living conditions). CONCLUSION: When developing a revised version of the tool, items that reflect missing views of dignity should be included.
- MeSH
- demence * psychologie MeSH
- důstojnost lidského života * MeSH
- kvalitativní výzkum MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- samostatný způsob života * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- uznání * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: A psychosocial problem faced by people with early-stage dementia (PwESD) is the perception of threats to personal dignity. Insights into its dynamics are important for understanding how it changes as dementia advances and to develop suitable interventions. However, longitudinal studies on this change in PwESD are lacking. AIMS: To determine how perceptions of dignity and selected clinical and social factors change over 1 year in home-dwelling PwESD and the predictors associated with changes in perceptions of dignity over 1 year. RESEARCH DESIGN AND METHODS: A longitudinal study was conducted. The sample included 258 home-dwelling Czech PwESD. Data were collected using the Patient Dignity Inventory (PDI-CZ), Mini-Mental State Examination, Bristol Activities of Daily Living Scale, Geriatric Depression Scale and items related to social involvement. Questionnaires were completed by the PwESD at baseline and after 1 year. ETHICAL CONSIDERATIONS: The study was approved by the ethics committee and informed consent was provided by the participants. RESULTS: People with Early-Stage Dementia rated the threat to dignity as mild and the ratings did not change significantly after 1 year. Cognitive function, self-sufficiency, vision, and hearing worsened, and more PwESD lived with others rather than with a partner after 1 year. Worsened depression was the only predictor of change in perceived personal dignity after 1 year, both overall and in each of the PDI-CZ domains. Predictors of self-sufficiency and pain affected only some PDI-CZ domains. CONCLUSIONS: Perceptions of threat to dignity were mild in PwESD after 1 year, although worsened clinical factors represented a potential threat to dignity. Our findings lead us to hypothesise that perceived threats to personal dignity are not directly influenced by health condition, but rather by the social context.
- MeSH
- demence * psychologie MeSH
- důstojnost lidského života * MeSH
- lidé MeSH
- longitudinální studie MeSH
- průzkumy a dotazníky MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- uznání MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Koncept lidské důstojnosti je spojen s autonomií a kvalitou života, která je důležitá i při pobytu seniora v institucionálním prostředí. Zahrnuje sebeúctu a chování, které prokazuje sebeúctu a respekt k ostatním. Posouzení důstojnosti z pohledu seniorů lze provést pomocí Jacelonové škály přisuzované důstojnosti (JADS). Cílem našeho výzkumu bylo zjistit vliv vybraných sociodemografických a klinických charakteristik na hodnocení přisuzované důstojnosti v jednotlivých doménách JADS u hospitalizovaných seniorů (N = 150). Byl použit soubor českých verzí dotazníků zaměřených na důstojnost (JADS), postoje ke stárnutí (AAQ), depresi (GDS), úroveň soběstačnosti (BI) a kognici (MMSE). Pro analýzu dat byla použita popisná statistika, korelační koeficienty (Pearson, Spearman) a jednofaktorová analýza rozptylu (ANOVA). Výsledky ukázaly, že v doméně 1 (Hodnocení sebe sama) vnímali senioři svoji důstojnost lépe, pokud měli pozitivnější postoje ke stárnutí a byli méně depresivní. V doméně 2 (Hodnocení vnímané od ostatních) ovlivňovaly lepší vnímání důstojnosti seniorů pouze pozitivnější postoje ke stárnutí. Domény 3 a 4 zkoumané faktory neovlivňovaly. Výsledky naznačují důležitost podpory pozitivních postojů ke stárnutí u seniorů.
The concept of human dignity is linked to autonomy and quality of life, which is important even when the elderly are in an institutional setting. It includes self-esteem and behaviour that demonstrates self-respect and respect for others. Assessment of dignity from the perspective of the elderly can be done using the Jacelon Attributed Dignity Scale (JADS). The aim of our research was to determine the influence of selected sociodemographic and clinical characteristics on the assessment of attributed dignity in each domain of the JADS in hospitalized elderly (N = 150). A set of questionnaires focused on dignity (JADS), attitudes towards aging (AAQ), depression (GDS), level of self-sufficiency (BI) and cognition (MMSE), all of them in Czech versions, were used. Descriptive statistics, correlation coefficients (Pearson, Spearman) and one-factor analysis of variance (ANOVA) were used for data analysis. The results showed that in Domain 1 (Self-Evaluation), the older people perceived their dignity better if they had more positive attitudes toward aging and were less depressed. In Domain 2 (Evaluation perceived from others), only more positive attitudes toward aging influenced better perceptions of dignity in the older people. Domains 3 and 4 were not influenced by the factors examined. The results suggest the importance of promoting positive attitudes toward aging among the elderly.
- Klíčová slova
- babybox,
- MeSH
- důstojnost lidského života MeSH
- infanticida prevence a kontrola psychologie MeSH
- kojenec MeSH
- lidé MeSH
- nechtěné dítě * zákonodárství a právo MeSH
- novorozenec MeSH
- ochrana práv dítěte * etika klasifikace zákonodárství a právo MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- přehledy MeSH
Background: Given the ageing of the population, it is important to examine the perception of dignity and the factors that may influence it among older adults.Aim: To determine how the perception of dignity and the factors that influence it differ in hospitalized older adult men and women.Methods: A quantitative cross-sectional study was used with a battery of the following questionnaires in their Czech versions: Patient Dignity Questionnaire (PDI-CZ), Geriatric Depression Scale, Attitudes to Ageing Questionnaire, Barthel's Index and Mini-Mental State Examination.Results and discussion: 294 hospitalized older adults participated in the study. In the overall assessment of dignity, men and women did not differ. Differences were confirmed in two PDI-CZ items which were more often perceived as a problem by men, namely: Feeling that I do not have control over my life (p = 0.019) and Feeling that I am not being treated with respect and understanding by others (p = 0.048). It was also shown that the men with higher depression (ß = 2.337, p < 0.0001), a more negative attitude to ageing (ß = -0.481, p = 0.002) and those who did not live alone (ß = 8.379, p = 0.008) had a worse perception of dignity. In women, a lower perception of dignity was associated only with higher depression (ß = 1.99, p < 0.0001) and lower age (ß = -0.311, p = 0.012).Conclusion: The results showed that the only common factor influencing the perception of dignity in both men and women was the level of depression.
1. elektronické vydání 1 online zdroj (400 stran)
Další z řady publikací České lékařské komory editorů prof. Radka Ptáčka doc. Petra Bartůňka, které se v rámci edice dalšího vzdělávání věnují nejen etickým problémům medicíny. Publikace jsou volně spjaty s konferencemi ČLK na identická témata - v prosinci 2021 to byla konference jedenáctá.
