Exploring the Sense of Dignity Among Informal Caregivers of Individuals With Dementia in a Psychiatric Hospital: A Qualitative Study

<h2>Abstract</h2><h3>Objective</h3> Informal caregivers of hospitalized persons with dementia in psychiatric hospitals can be considered a vulnerable population. Alongside psychological burden, potential violations of their sense of dignity (SoD) may arise, even though the inviolability of human dignity is enshrined in German Basic Law. This research aims to explore the individual SoD of informal caregivers by specifically defining how and by whom their sense of dignity is enhanced or violated. <h3>Design</h3> The collected data were analyzed using qualitative content analysis. <h3>Setting</h3> Informal caregivers were recruited for a qualitative study on their SoD in a German psychiatric hospital. <h3>Participants</h3> About 20 individual, semi-structured interviews with informal caregivers were conducted. <h3>Results</h3> When describing the SoD of informal caregivers, there were the following four relevant sources: 1) the informal caregiver whose dignity is being affected, 2) the person with dementia, 3) the caregiver's social environment and 4) supporting facilities, both while in hospital and in the community. Each source included SoD-contributing factors that can either reinforce or violate the SoD. In total, 21 contributing factors were extracted and evaluated (11 reinforcing and 10 violating a caregiver's sense of dignity). <h3>Conclusions</h3> The caregivers themselves and primarily the relationship between the caregiver and the person with dementia appear to have the most significant impact on their sense of dignity. Nevertheless, healthcare institutions play a crucial role which can either reinforce or violate the caregivers' sense of dignity. Therefore, psychiatric hospitals need to train the staff accordingly to support and preserve dignity in psychiatric hospitals.