Dignity Among Older Persons in Long-Term Care Institutions in Taiwan and Related Factors: A Cross-Sectional Study

With a gradually aging global population, more and more older persons are receiving care in long-term care institutions during the final stages of their lives. A variety of factors, including the process of aging, dependence on assistance, and psychological problems, are known to undermine the self-perceived sense of dignity of older persons living in long-term care institutions.

The purpose of this study was to examine the factors that influence dignity and the incidence of low self-perceived dignity among older persons living in long-term care institutions.

This cross-sectional descriptive study was conducted from April to December 2022 on a sample of 188 older persons living in seven long-term care institutions in southern Taiwan. A structured questionnaire, including a demographic characteristics datasheet, Barthel Index, Patient Dignity Inventory-Mandarin version, and Patient Health Questionnaire-9, was used to collect data. The independent samples t test, one-way analysis of variance (ANOVA), and Pearson's correlation coefficient were used to examine the correlation between demographic variables and dignity, while binary logistic regression was used to analyze the probability of low dignity.

Dignity was found to relate significantly with marital status ( t = 2.49, p = .014), number of children ( r = -.19, p = .008), educational level ( t = -2.42, p = .016), chronic condition ( r = .25, p = .001), ability to perform activities of daily living ( r = -.36, p < .001), dependency level ( F = 9.85, p < .001), mobility level ( t = 2.84, p = .005), indwelling catheter status ( t = -3.29, p = .001), and depression level ( r = .47, p < .001). The results of binary logistic regression analysis showed factors including having fewer children ( OR = 0.652, p < .001) or no children ( OR = 0.101, p = .007), a higher education level ( OR = 3.441, p = .001), or lower activities of daily living ( OR = 0.976, p = .001) as well as suffering from depression ( OR = 6.025, p = .047) or being unable to walk ( OR = 0.448, p = .045) to be significantly associated with self-perceived low dignity.

The findings indicate that older persons living in long-term care institutions with fewer or no children, a higher level of education, and/or lower activities of daily living, as well as those unable to walk and/or suffering from depression, face a relatively greater risk of suffering from low dignity. In light of this, professional caregivers working in long-term care institutions should place greater emphasis on providing dignified care to older persons.