Nurses' Actions of Maintaining Patient Dignity: An Integrative Review

BACKGROUND: Dignity is both an objective, intrinsic right and a subjective experience that forms through interaction with other people. Humane care is a precondition for nurses' ethics practice and maintaining patients' dignity. During care, patients' dignity is maintained through nurses' actions. However, acute care settings are particularly challenging environments for maintaining patients' dignity. AIM: The aim of this study was to review previous research to identify nurses' actions that provide humane care and maintain patients' dignity in acute care settings, and to synthesize evidence on how nurses enact dignified humane care. METHODS: This integrative review followed the approach by Whittemore and Knafl and is reported according to the PRISMA guidelines. The databases searched were PubMed, CINAHL, Web of Science, Scopus and PsycInfo. The selected articles were analysed using inductive content analysis. RESULTS: Thirty-one articles were included in the review. Nurses' actions demonstrating humane care and maintaining patients' dignity formed five categories: Respecting the patient as a unique individual, Being present to the patient's expressions and experiences, Giving the patient the opportunity to be involved and in control, Protecting the patient's integrity and physical boundaries and Providing individual and appropriate care considering the patient's vulnerability. CONCLUSIONS: Patients' dignity is maintained through everyday nursing actions. Providing humane care and maintaining patients' dignity requires that nurses are genuinely present with the patient to recognise their unique experience.