Content area
Full Text
Acknowledgment. This work was funded by a grant from the Gordon and Betty Moore Foundation.
Conflicts of Interest. The authors report no conflicts of interest.
Abstract. Despite wide recognition of the importance of treating patients with respect and dignity, little is known about what constitutes treatment in this regard. The intensive care unit (ICU) is a unique setting that can pose specific threats to treatment with respect and dignity owing to the critical state of patients, stress and anxiety amongst patients and their family members, and the highly technical nature of the environment. In attempt to understand various stakeholders' perspectives of treatment with respect and dignity, patients and family members were interviewed, a wide range of health care professionals participated in focus groups, and third party observers took field notes of interactions in the ICU. This paper compares and contrasts the data that were generated using these different methods. Triangulating the data in this way contributes to a more complete and nuanced understanding of treatment with respect and dignity in the ICU.
Key Words. Bioethics, Critical Care, Dignity, Family, Health Care, Patient Experience, Professional, Respect, Qualitative Research, Triangulation.
The importance of treating patients with respect is broadly recognized. For example, respectful treatment is considered an essential component of high-quality, patient-centered health care. In its landmark report, "Crossing the Quality Chasm," the Institute of Medicine (2001) defines patient-centered care as "providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions." The Picker Institute (2013) describes patient-centered care as a multidimensional concept with "Respect for patient values, preferences, and expressed needs" as one of these dimensions. The Institute for Patient-and Family-Centered Care (2011) highlights the importance of "dignity and respect." The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a nationally administered survey that provides publicly reported performance data on patients' experiences of care, which are used by the Centers for Medicare & Medicaid Services for hospital quality reimbursement, also includes items asking patients whether they were treated with courtesy and respect by their doctors and nurses while in the hospital (Crofton, Darby, Farquhar, & Clancy, 2005; Goldstein, Farquhar, Crofton, Darby, & Garfinkel, 2005; HCAHPS, 2014).
However, despite broad recognition...