Dignity in interactions from the viewpoint of staff in long-term care facilities: A qualitative study

To explore the elements of dignity in interaction and the residents' individual dignity from the viewpoint of staff in long-term care facilities.

In-depth interviews were conducted twice with each participant using a hermeneutic phenomenological approach to understand staff experiences and clarify how they understood the meaning of dignity and dignified care. After theme generation, a panel of seven experts reviewed the themes. The previously established framework of the conceptual matrix derived from the residents' perspective was used to verify the applicability of the result.

A total of 18 in-depth interviews were conducted with nine staff who worked at long-term care facilities. Mean age of participants was 36.8 years (SD = 5.9; range: 25-43); six were female (66.7%). A total of 944 codes were extracted from the interviews, and four themes were generated: "dignity in relation to family members, friends, society, and other residents"; "dignified direct care"; "dignified care by nursing care facilities and the nursing care system"; and "(residents') dignity developed over the life course."

Dignity in interaction and the residents' individual dignity are perceived to be important to care staff. Comparing the elements of dignity extracted from interviews of care staff and those of residents, dignified care is defined by staff with more specific behaviors, responsibilities, and relationships. In long-term care, "dignity developed over the life course" is a subjective and unique dignity that is not easily influenced by others or the environment and is the background of dignity in interaction.