Toward dignity in care: An in-service model

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Abstract
How can the dignity or well being of people in the terminal phase of their lives be fostered? A short-term educational program model was developed to assist a group of personnel (N = 83) in a hospital for the chronically HI to become more responsive to this challenge. Three major considerations basic to the design of the program were: (1) application of the learning model to other sites within the hospital and to similar agencies; (2) on-site saturation technique to involve all members of the staff over a relatively short but intensive period; (3) heterogeneous grouping to bring together professional, parapro-fessional, and service personnel for a common learning experience. Data from personal interviews conducted with a representative sample population of health personnel yielded a contextual understanding that was used as a basis for the program design. Individual and group strategies were used to increase the participants'awareness of the dimensions of pain, loneliness, intrusiveness, and loss in the lives of terminal patients; to encourage participants' reflection of their own attitudes toward this patient population; and to develop preferred norms of patient care that would be more congruent with new emerging insights. Although an evaluation of the program's goal of promoting a greater sense of patient dignity can be attained only by long-term measures, several indicators of success were demonstrated.

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