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Abstract(s)
Introdução: A preservação da dignidade é identificada como uma prioridade pelas pessoas em vários contextos paliativos. A dignidade humana consiste no valor intrínseco de cada um. As ameaças à dignidade nos cuidados de saúde são comportamentos que não reconhecem esse valor. As pessoas em hemodiálise são altamente vulneráveis, mas há poucos estudos sobre a sua dignidade. Este estudo pretendeu estimar a prevalência de diferentes tipos de ameaças à dignidade de pessoas em hemodiálise em Portugal, e a sua relação com características sociodemográficas. Metodologia ou material e métodos: Estudo quantitativo, descritivo, transversal, utilizando um questionário de autopreenchimento com 26 perguntas, numa amostra de pessoas em hemodiálise em centros extra-hospitalares. Resultados: Obtivemos 156 respostas em seis clínicas. A média de idades foi 64,2 (±14,4) anos e a maioria dos participantes era caucasiana, portuguesa, católica e fazia hemodiálise há mais de um ano. No total 85,9% assinalaram “nunca” ou “raramente” sentir ameaças à sua dignidade. Em todas as perguntas a moda foi responder “nunca”. Os tipos de ameaças à dignidade mais frequentes foram assinalados por entre 12,2% a 24,7% dos participantes, com destaque para “sentir que as suas opiniões e sentimentos foram ignorados” e “sentir que se foi tratado como um grupo e não como um indivíduo”. Detetámos tendências para uma maior frequência nas pessoas mais jovens, mulheres, há mais tempo em diálise, com maior escolaridade e que não vivem numa relação conjugal; e não detetámos nenhuma associação com a pertença a minorias étnicas, nacionalidade ou religião Conclusões: A maioria dos doentes referiu nunca sentir ameaças à sua dignidade, ou senti-las raramente. Os tipos de ameaças mais frequentes são a Desvalorização, o Agrupamento, a Indiferença ou Desconsideração, a Condescendência e a Descortesia. As associações com variáveis sociodemográficas carecem de confirmação em estudos futuros. Uma limitação dos estudos sobre a dignidade é a dificuldade em garantir a participação das populações mais vulneráveis.
Introduction: The preservation of dignity is identified as a priority by people in various palliative settings. Human dignity consists of the intrinsic value of each person. Dignity violations in healthcare are behaviors that don’t respect that value. People undergoing hemodialysis are highly vulnerable, yet there are few studies assessing their sense of dignity. This study’s goal was to estimate the prevalence of different kinds of threats to the dignity of people undergoing hemodialysis in Portugal, as well as to assess their relationships with sociodemographic variables. Materials and methods: Quantitative, descriptive, cross-sectional study, using a self-administered 26-item dignity violations questionnaire, in a sample of people undergoing hemodialysis in non-hospital centers. Results: We collected 156 questionnaires from 6 centers. The mean age of participants was 64.2 (±14.4) years, and most were caucasian, Portuguese, catholic, and were on hemodialysis for over one year. Overall, 85.9% indicated they “never” or “rarely” feel their dignity threatened. The mode in every question was “never”. The most frequent dignity threats were flagged by 12.2% to 24.7% of participants, the most prominent being “having felt their feelings or opinion were ignored”, and “having felt they were treated as a group and not an individual”. We detected tendencies for a higher frequency of dignity threats in younger people, women, longer dialysis vintage, higher education, and absence of a partner; and we found no association with belonging to a racial minority, nationality, or religion. Conclusion: Most patients feel they never or rarely ever feel their dignity threatened. The most frequent types of dignity violations were Dismissal, Grouping, Indifference or Disregard, Condescension and Rudeness. The associations with sociodemographic variables need confirmation by future studies. A major limitation of studies about dignity violations is the exclusion of participants who are most at risk.
Introduction: The preservation of dignity is identified as a priority by people in various palliative settings. Human dignity consists of the intrinsic value of each person. Dignity violations in healthcare are behaviors that don’t respect that value. People undergoing hemodialysis are highly vulnerable, yet there are few studies assessing their sense of dignity. This study’s goal was to estimate the prevalence of different kinds of threats to the dignity of people undergoing hemodialysis in Portugal, as well as to assess their relationships with sociodemographic variables. Materials and methods: Quantitative, descriptive, cross-sectional study, using a self-administered 26-item dignity violations questionnaire, in a sample of people undergoing hemodialysis in non-hospital centers. Results: We collected 156 questionnaires from 6 centers. The mean age of participants was 64.2 (±14.4) years, and most were caucasian, Portuguese, catholic, and were on hemodialysis for over one year. Overall, 85.9% indicated they “never” or “rarely” feel their dignity threatened. The mode in every question was “never”. The most frequent dignity threats were flagged by 12.2% to 24.7% of participants, the most prominent being “having felt their feelings or opinion were ignored”, and “having felt they were treated as a group and not an individual”. We detected tendencies for a higher frequency of dignity threats in younger people, women, longer dialysis vintage, higher education, and absence of a partner; and we found no association with belonging to a racial minority, nationality, or religion. Conclusion: Most patients feel they never or rarely ever feel their dignity threatened. The most frequent types of dignity violations were Dismissal, Grouping, Indifference or Disregard, Condescension and Rudeness. The associations with sociodemographic variables need confirmation by future studies. A major limitation of studies about dignity violations is the exclusion of participants who are most at risk.
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Keywords
Dignidade Cuidados paliativos Doença renal crónica Hemodiálise Dignity Paliative care Chronic kidney disease Hemodialysis