The DOI matches its Crossref record; 43 of the 45 references it cites were found in a registry or an index.
Dignity in the terminally ill: a developing empirical model
Abstract
Despite use of the term dignity in arguments for and against a patient's self-governance in matters pertaining to death, there is little empirical research on how this term has been used by patients who are nearing death. The objective of this study was to determine how dying patients understand and define the term dignity, in order to develop a model of dignity in the terminally ill. A semi-structured interview was designed to explore how patients cope with their advanced cancer and to detail their perceptions of dignity. Interviews were audiotaped and transcribed verbatim. A consecutive sample of 50 consenting patients with advanced terminal cancer were recruited over a 15-month period of time from an urban extended care hospital housing a specialized unit for palliative care. This unit provides both inpatient services. and coordinates end-of-life care community based programming. Data were analysed using latent content analysis and constant comparison techniques. Four members of the research team independently coded the transcribed data, to develop conceptually meaningful categories of responses. Operational definitions were written for major categories, themes and sub-themes. Three major categories emerged from the qualitative analysis, including illness-related concerns; dignity conserving repertoire; and social dignity inventory. These broad categories and their carefully defined themes and sub-themes form the foundation for an emerging model of dignity amongst the dying. The concept of dignity and the dignity model offer a way of understanding how patients face advancing terminal illness. This will serve to promote dignity and the quality of life of patients nearing death.
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“Dignity therapy is based on a theoretical model of dignity in the terminally ill [3] and its purpose is to reduce dignity-related distress while enhancing hope and meaning [4].”
From Feasibility, acceptability and potential effectiveness of dignity therapy for family carers of people with motor neurone disease (2014) · cites this paper as [3]
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BackgroundInfluentialA dignified last phase of life for patients with a migration background: A qualitative study
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“[3] developed an empirical Dignity Model based on a cohort of adult patients with advanced cancer which provided a perspective to understand the meaning of dignity for terminally ill patients and guidance for dignity-conserving care.”
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“These categories include illness related issues, dignity conserving repertoire, and social dignity inventory.(26) This model suggests that the inter-relatedness of these themes is as illustrated schematically in Figure 1.”
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“Much of the research on dignified dying to date has been accomplished by Chochinov and colleagues.(14) Their early work focused on development of an empirical model of dignity in the terminally ill via interviews of 50 patients with advanced terminal cancer.”
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Relationship between illness-related worries and social dignity in patients with heart failure
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“Chochinov and colleagues performed a qualitative study focusing on how dying cancer patients understand and define dignity, and developed an empirical model of dignity to understand how patients face an advancing terminal illness.(17) From the themes and subthemes of this model, a list of 22 items concerning symptoms…”
Death and dignity: dogma disputed
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Qualitative and Mixed‐Methods Research
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“It was based on a model which identifies three main domains relevant to patient experience of dignity: illness-related concerns, social dignity inventory and dignity conserving repertoire (Chochinov et al. 2002).”
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“Individual factors, such as personal characteristics, attributes, and worldview, together with personal approaches of living in the moment, maintaining normalcy, and seeking spiritual comfort, have been identified as mediators and strategies for preserving dignity while living with serious illness (Chochinov et al., 2…”
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“found that the presence of an available and helpful community of friends and family enhanced patients’ dignity [28].”
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“…’ s et al. Dignity Model that recognizes the “ Social Dignity Inventory ” as an essential area contributing to defining social concerns that influence a patient ’ s dignity (Chochinov, 2002, 2006; Chochinov et al., 2002, 2008; Thompson and Chochinov, 2008; Östlund et al., 2012; Best, 2019).”
Limitación del esfuerzo terapéutico en cuidados intensivos pediátricos
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“While dignity is typically understood as meaning “the state or quality of being worthy of honor or respect” (20), the model based on qualitative input from terminally ill patients illustrates that there are multiple dimensions of end-of-life experience that can support or undermine patients’ sense of dignity (21).”
BackgroundSelf-citationSchoppee, T. M., Scarton, L. J., Bluck, S., Yao, Y., Keenan, G. M., Handzo, G. F., Chochinov, H. M., Fitchett, G. A., Emanuel, L. L., & Wilkie, D. J. (2021) · Palliative & Supportive Care · doi:10.1017/s1478951521000614 · Cited by 10
“…textbook that describes the background, therapeutic process, and evidence regarding DT (Chochinov, 2012), and there are more than two dozen journal articles with varying information about DT therapist training (Chochinov et al., 2002; Chochinov, 2012; Fitchett et al., 2015; Martinez et al., 2017).”
BackgroundSelf-citationDignity-Conserving Care in Medicine
Grassi, L. G., Chochinov, H. M., Moretto, G., & Nanni, M. G. (2018) · Integrating psychiatry and primary care · doi:10.1007/978-3-319-74736-1_6 · Cited by 10
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Borhani, F., Abbaszadeh, A., & Mehdipour‐Rabori, R. (2015) · Journal of Advances in Medicine and Medical Research · doi:10.9734/bjmmr/2015/18886 · Cited by 12
“Chochinov, whose opinions on patient dignity have been accepted, defines dignity based on illness-related concerns, dignity conserving repertoire, and the Social Dignity Inventory [4].”
BackgroundInfluentialLee, G. L., Ow, R., Ramaswamy, A., & Goh, C. R. (2012) · Progress in Palliative Care · doi:10.1179/1743291x12y.0000000041 · Cited by 10
Blanchard, M. R., Serfaty, M. A., Duckett, S., & Flatley, M. (2008) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2083 · Cited by 10
“More recently, essential concepts such as ‘dignity’ in care, and the experience of ‘self-transcendence’ for older people with an accumulation of physical illnesses have been developed (Block, 2001; Chochinov et al., 2002).”
BackgroundTwo decades of palliative care.
Chan, K. (2002) · PubMed · Cited by 10
Universitat Internacional de Catalunya
Barba, E. L. (2017) · Dialnet (Universidad de la Rioja) · Cited by 10
Rodríguez‐Prat, A., Monforte‐Royo, C., & Balaguer, A. (2018) · Frontiers in Pharmacology · doi:10.3389/fphar.2018.00294 · Cited by 10
“However, it is worth remembering that a common experience reported in studies of advanced patients who request AS (Lavery et al., 2001; Chochinov et al., 2002; Pearlman et al., 2005) is a “loss of the self,” the sense that one’s own essence or identity is disintegrating (“I’m no longer the person I…”
BackgroundWürde in der Begleitung schwer kranker und sterbender Patienten
Mehnert, A., Schröder, A. S., Puhlmann, K., Müllerleile, U., & Koch, U. (2006) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-006-0069-6 · Cited by 10
“Darauf aufbauend wurde ein Rahmenmodell geschaffen, das dazu beitragen soll, das Erleben von Würde bei terminal Erkrankten besser zu verstehen und interventive Ansätze zu erarbeiten, die die Würde des Patienten bewahren helfen [17, 18, 27, 28].”
BackgroundInfluentialDeSanto‐Madeya, S., Tjia, J., Fitch, C. E., & Wachholtz, A. (2020) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/1049909120971569 · Cited by 9
“Legacy making interventions are an opportunity for patients to reflect upon and communicate their memories, wisdom, and life values, and can succeed the patient in death by leaving family members with a lasting memory of the person.(4) Legacy making has been shown to increase patient’s sense of dignity, purpose, meani…”
BackgroundLaranjeira, C., & Dourado, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192417029 · Cited by 9
“[21], sustaining a sense of dignity is important for all people in need of care, and upholding these people’s dignity becomes a critical issue for healthcare professionals [22].”
BackgroundDignity and Dignity Therapy in End-of-Life Care
Lim, Y. (2023) · The Journal of Hospice and Palliative Care · doi:10.14475/jhpc.2023.26.3.145 · Cited by 9
“Each category encompasses various themes and sub-themes (Table 1) [3].”
BackgroundDignity in Iranian cancer patients: a qualitative approach
Azadi, M., Azarbayejani, M., & Tabatabie, S. K. R. Z. (2020) · Mental Health Religion & Culture · doi:10.1080/13674676.2020.1712592 · Cited by 9
“The initial coding scheme and interview questions were developed from Chochinov ’ s (2002) study.”
InfluentialČeh, H. K., Lunder, U., Bulli, F., Caswell, G., van Delden, J. J. M., Kars, M. C., Korfage, I. J., Miccinesi, G., Rietjens, J. A. C., Seymour, J. E., et al. (2022) · European Journal of Cancer Care · doi:10.1111/ecc.13719 · Cited by 9
“Hope is widely considered to be essential to well-being and quality of life and even to life itself (Chochinov et al., 2002; Eliott & Olver, 2009).”
BackgroundFuseini, A., Redley, B., Rawson, H. A., Ley, L., & Kerr, D. C. (2023) · Journal of Clinical Nursing · doi:10.1111/jocn.16598 · Cited by 9
Attachment and the End of Life Experience
Hales, S. (2015) · Springer eBooks · doi:10.1007/978-3-319-23300-0_7 · Cited by 10
What’s Dignity Got To Do With It? Patient Experience of the Dignity Care Intervention
Johnston, B. M., Papadopoulou, C., Östlund, U., Hunter, K., Andrew, J. E., & Buchanan, D. (2017) · SAGE Open Nursing · doi:10.1177/2377960817699839 · Cited by 9
“Three of the four themes aligned closely to Chochinov’s model of dignity (Chochinov et al., 2002).”
BackgroundMethodDignity Matters: Advance Care Planning for People Experiencing Homelessness
Bartels, D. M., Ulvestad, N., Ratner, E. R., Wall, M. M., Uutala, M. M., & Song, J. Y. (2008) · The Journal of Clinical Ethics · doi:10.1086/jce200819303 · Cited by 9
The Culture of Research in Palliative Care: You Probably Think This Song Is About You
Chochinov, H. M. (2009) · Journal of Palliative Medicine · doi:10.1089/jpm.2009.9662 · Cited by 9
Self-citationLost in Translation: Dignity Dialogues at the End of Life
Hawryluck, L. (2004) · Journal of Palliative Care · doi:10.1177/082585970402000306 · Cited by 9
“Dignity is commonly invoked in such discussions (1-3), which ultimately explore issues of quality of life, personal goals, values, and beliefs.”
BackgroundChochinov, H. M. (2003) · Palliative & Supportive Care · doi:10.1017/s1478951503030451 · Cited by 9
“Appearance, or perhaps more accurately the perception of how one is seen, emerged as an important correlate of preserved dignity ~Chochinov et al., 2002a!.”
BackgroundMethodSelf-citationLin, J., Guo, Q., Zhou, X. R., Li, H., & Cai, S. (2024) · Palliative & Supportive Care · doi:10.1017/s1478951523001839 · Cited by 9
“To understand and maintain patient dignity, Chochinov et al. (2002) developed an empirical dignity model through interviewing 50 terminal adults on their understanding of dignity.”
A COMUNICAÇÃO NA PROMOÇÃO DA DIGNIDADE EM CUIDADOS PALIATIVOS: DESAFIOS PARA A ENFERMAGEM
Monho, B. M. F., Ferreira, I. M. P., Ribeiro, M. F. B., Alves, T. S. C., & Mauricio, M. D. A. L. L. D. (2020) · Revista Baiana de Enfermagem · doi:10.18471/rbe.v35.34788 · Cited by 8
Metadata
- Authors
- Chochinov, H. M., Hack, T., McClement, S., Kristjanson, L., & Harlos, M.
- Affiliations
- CancerCare Manitoba (CA)
- University of Manitoba (CA)
- Edith Cowan University (AU)
- St. Boniface Hospital (CA)
- Corresponding author
- Chochinov, Harvey Max
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2002-02
- Volume
- 54
- Issue
- 3
- Pages
- 433-443
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2015893364
- Cited by
- 733
- References
- 45
- Citations by year
- 2026: 34 · 2025: 37 · 2024: 31 · 2023: 30 · 2022: 34 · 2021: 38 · 2020: 34 · 2019: 25 · 2018: 28 · 2017: 40 · 2016: 35 · 2015: 30 · 2014: 30 · 2013: 39 · 2012: 30
- FWCI
- 19.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Online (Edith Cowan University) (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Funders
- University of Manitoba
- Topics
- Health Sciences › Nursing › Issues, ethics and legal aspects › Patient Dignity and Privacy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- human dignity, dying patients, advanced cancer, end-of-life care, palliative care, patient perspectives, coping with terminal illness, social dignity, quality of life
- MeSH terms
- Activities of Daily Living, Adaptation, Psychological, Anecdotes as Topic, Attitude to Death, Family Relations, Humans, Interviews as Topic, Manitoba, Neoplasms, Professional-Patient Relations, Quality of Life, Right to Die, Skilled Nursing Facilities, Terminal Care, Cost of Illness, Terminally Ill
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