Understanding the role of home-based palliative care in supporting patient dignity: a scoping review

Home-based palliative care (HBPC) plays a crucial role in preserving the dignity of patients with terminal illness and their families. However, the factors influencing this experience from the perspective of patients, family caregivers, and healthcare professionals remain insufficiently explored. This study aimed to map and analyze the role of HBPC on patient dignity, considering the perspectives of patients, family caregivers, and healthcare professionals. A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology and reporting according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA)-ScR guidelines. Six databases (PubMed, Scopus, Web of Science, Cochrane Library, CINAHL, and PsycArticles) were searched up to December 2024, yielding a total of 5,259 records. Studies that focused on patient dignity in HBPC were eligible. Reports, protocols, editorials, and gray literature were excluded. A narrative synthesis was used to identify and categorize the key themes related to dignity in HBPC. Five qualitative studies met the eligibility criteria. The key factors supporting patient dignity included autonomy, emotional support, effective symptom management, and supportive care environments. Challenges involved caregiver burden, inadequate training, organizational barriers, and lack of infrastructure in home care services. HBPC has the potential to preserve patient dignity when practices such as empathetic communication, respect for autonomy, and pain control are prioritized. Nevertheless, limitations such as underrepresentation of culturally diverse contexts and the exclusion of gray literature constrain the strength of the evidence base. Future research should incorporate culturally diverse perspectives, assess quality using tools such as CASP, and expand the scope to include gray literature and regional databases.