Proxy evaluation of dignity expectations and satisfaction of older patients with dementia by family members and nurses.
Eriko Otake, Katsumasa Ota, Chikako Ikegami and 4 others
PMID 34347391WHAT IT FOUND
Family members often agreed with older hospital patients' dignity ratings, while nurses mostly did not unless they had 20 years or more experience.
The tool did not capture satisfaction well.
Key findings
01Family members' proxy ratings agreed with patients' own dignity expectations and satisfaction more often than nurses' proxy ratings did.
02Nurses with 20 years or more clinical experience agreed with patients on more dignity expectation and satisfaction items than nurses overall.
03The satisfaction part of the questionnaire did not measure dignity satisfaction as intended.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The survey patients were older hospital patients without dementia, so the study did not test proxy dignity ratings in patients with dementia. Family members and nurses were chosen because they had a good relationship with the patient, which may make proxy agreement look better than in routine care. Only 186 of 233 returned responses were analysed, and only 52 complete patient-family-nurse triads were available. The response rate was 45.5%, and only 52 of the returned sets were complete. The satisfaction questions did not measure dignity satisfaction as intended. The expectation questions did not correlate with the self-esteem score used as an external check. Nurses' own beliefs about their care may have affected their proxy ratings.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude this questionnaire can reliably assess dignity for patients with dementia. It was tested only with older patients without dementia, family members were selected for good relationships, and the satisfaction items did not measure dignity satisfaction as intended.