Exploring nursing students’ perspectives on preserving dignity in care: A mixed methods Q-methodology study

Mullen, Rosemary F.

Abstract

Background
A complex and contested concept, dignity is recognised as a significant factor in a person’s experience of care. Variations in the provision of dignity in care are reported in the literature and in the media. Despite growing interest in the potential of nursing education to enhance dignity in nursing care, relatively little is known about what dignity means to nursing students.

Purpose
The purpose of the study was to explore perspectives on preserving dignity in care among nursing students and addressed the following research questions:
1. What meaning do nursing students attach to the term ‘dignity in care’?
2. What are nursing students’ perspectives on the personal and environmental influences on the preservation of dignity in care?
3. What are nursing students’ perspectives on the nurse’s role in preserving dignity in care?

Methods
The study adopted a two-strand mixed methods Q-methodology approach situated within a theoretical framework of pragmatism. Nursing students were recruited from a three-year undergraduate preregistration adult nursing programme in Scotland. A total of 31 nursing students participated in Strand 1 which employed photo-elicitation and Nominal Group Technique (NGT). Qualitative and quantitative content analysis were used to provide insight into perspectives on the meaning of dignity in care and influences on its preservation. A total of 21 nursing students participated in Strand 2 which used Q-methodology to reveal perspectives on the important aspects of the role of the nurse in preserving dignity in care.

Results
The concept of dignity was recognisable and meaningful for the participants. Participants’ understanding of dignity in care and influences on it seem to be rooted in the nature of the nurse-patient relationship and interaction. Four distinct perspectives were identified: Enabler, Caregiver, Companion and Defender. Enabling the role of the person in their own care was the most important aspect of the role of the nurse in preserving dignity in care for the Enabler while for the Caregiver it was the delivery of ‘good’ care. The Companion perspective attached the greatest importance to being with the person, while the Defender identified being courageous in the face of threats to dignity as most important.

Conclusion
This study provides insight into the under-researched area of nursing students’ perspectives on dignity in care. Some consensus among participants was identified in relation to their perspectives on the meaning of dignity in care and the importance of the role of the nurse in preserving it. Four distinct perspectives were also identified, and these illuminated a perception among the participants that the ‘good’ nurse should be able to overcome context. A perception also existed among the participants that strategies to preserve dignity in care are ‘just basic care’ that does not require specific education or training. This contrasts strongly with the participants’ limited reference to the physical environment of care as an important factor in the nurse’s role in preserving dignity in care.

Citation

Mullen, R. F. Exploring nursing students’ perspectives on preserving dignity in care: A mixed methods Q-methodology study. (Thesis). Edinburgh Napier University. Retrieved from http://researchrepository.napier.ac.uk/Output/2086422

• Thesis Type: Thesis
• Deposit Date: Aug 27, 2019
• Publicly Available Date: Aug 29, 2019
• Keywords: dignity; nursing care; nursing students; dignity in care; nurse-patient relationship
• Public URL: http://researchrepository.napier.ac.uk/Output/2086422
• Award Date: Jul 3, 2019