Dignity violation of patients with schizophrenia: a grounded theory

Considering that dignity is a fundamental entitlement of each patient, respecting the dignity of patients is essential. Unfortunately, in many cases, especially among people with schizophrenia, dignity is not fully respected, which can challenge their coping strategies, and affect the results. Nonetheless, there is limited knowledge regarding this matter in Middle Eastern Nations. Investigating the process of dignity violation in patients with schizophrenia. The present study data were collected through field notes, semi-structured, face-to-face interviews with 16 patients with schizophrenia (4 patients had partial insight, and 12 patients had complete insight), 4 family caregivers, 2 nurses, 3 psychologists, and 1 service worker with maximum variation. The data were analyzed through the consistent comparison methodology of Grounded Theory, and coded using MAXQDA-10 software. Data analysis showed that the main concern of the patients was “Being ignored by others”. The contextual factors contributing to “Being ignored by others” were “Being ignored by family”, “Silent treatment organization”, and “Sociocultural barriers”. The patients used the main strategy of “Attempting to violate mutual dignity” to deal with their main concern. This strategy led to some consequences that have been examined in a main category of “Death wish”. Overall, the efforts that the patients used to protest the threat to their dignity were not effective, and further exposed them to threats to their dignity. The category of “Death wish” has two subcategories: “Patient’s internal dissatisfaction”, and “Dependency”. The results of the present study showed that maintaining the dignity of patients with schizophrenia is a downward cycle due to the negative mentality of those around them. Violation of the basic rights of patients by their families, social exclusion, and failure to act according to instructions are common in psychiatric wards. However, the results of this study showed that patients strive to maintain, and regain their dignity even in the most difficult circumstances. Psychiatric nurses can empower patients with the essential abilities to counteract dignity violation, and modify the sense of disability as an obstacle to dignity violation resistance.