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Background Front-line NHS staff undertake small research projects to answer questions about local patients and services, but these projects often face considerable challenges. This paper reports on one such project. Aims and methods of study The study used structured interviews in order to find out about the knowledge of nutrition among Bangladeshis using an NHS Walk-in Centre. Development of the study Time constraints posed considerable difficulties in progressing and completing the study; flaws in the methodology emerged; and underpinning assumptions about health promotion and ethnic minority health beliefs were open to challenge. Learning from the study Despite this, some findings were valuable and have considerable potential as a stimulus to critical thinking among practitioners about their own attitudes, as well as raising issues that future research would find it useful to address

Aims and Objectives: This paper reports the findings from interviews conducted as part of a wider study on interventions to support dignified care in older people in acute hospital care. The data in this paper present the interview data. Background: Dignity is a complex concept. Despite a plethora of recommendations on how to achieve dignified care it remains unclear how to attain this in practice and what the priorities of patients and staff are in relation to dignity. Design: A purposive sample of older patients and staff took part in semi-structured interviews and gave their insight on the meaning of dignity and examples of what sustains and breaches a patient’s dignity in acute hospital care. Method: Thirteen patients and thirty eight healthcare professionals in a single metropolitan hospital in the UK interviewed. Interviews were transcribed verbatim and underwent a thematic analysis. Results: The meaning of dignity was broadly agreed on by patients and staff. Three broad themes were identified; the meaning of dignity, staffing level and its impact on dignity, and organisational culture and dignity. Registered staff of all healthcare discipline and student nurses report very little training on dignity or care of the older person. Conclusion: There remains inconsistencies in the application of dignified care. Staff behaviour, a lack of training and the organisational processes continue to result in breaches to dignity of older people. Clinical nurses have a major role in ensuring dignified care for older people in hospital. Relevance to clinical practice: There needs to be systematic dignity related training with regular refreshers. This education coupled with measures to change the cultural attitudes in an organisation towards older peoples’ care should result in long term improvements in the level of dignified care. Hospital managers have an important rol

Background: Dignity is a concept that applies to all patients. Older patients can be particularly vulnerable to experiencing a loss of dignity in hospital. Previous tools developed to measure dignity have been aimed at palliative and end of life care. No tools for measuring dignity in acute hospital care have been reported. Objectives: To develop tools for measuring patient dignity in acute hospitals. Setting: A large UK acute hospital. We purposively selected 17 wards where at least 50% of patients are 65 or over. Methods: Three methods of capturing data related to dignity were developed: an electronic patient dignity survey (possible score range 6-24); a format for non-participant observations; and individual face-to-face semi-structured patient and staff interviews (reported elsewhere). Results: 5693 surveys were completed. Mean score increased from 22.00 pre-intervention to 23.03 after intervention (p<0.001). Staff-patient interactions (581) were recorded. Overall 41% of interactions (239) were positive, 39% (228) were neutral and 20% (114) were nega-tive. The positive interactions ranged from 17% to 59% between wards. Quality of interaction was highest for allied health professionals (76% positive), lowest for domestic staff (22% pos-itive) and pharmacists (29% positive), and intermediate for doctors, nurses, Health Care As-sistants and student nurses (40% to 48% positive). A positive interaction was more likely with increased length of interaction from 25% (brief) to 63% (longer interactions) (F[2, 557]=28.67, p<.001). Conclusions: We have developed a simple format for a dignity survey and observations. Overall, most patients reported electronically that they received dignified care in hospital. However, observations identified a high percentage of interactions categorised as neu-tral/basic care, which, while not actively diminishing dignity, will not enhance dignity. There

Aims and Objectives: This paper reports the findings from interviews conducted as part of a wider study on interventions to support dignified care in older people in acute hospital care. The data in this paper present the interview data. Background: Dignity is a complex concept. Despite a plethora of recommendations on how to achieve dignified care it remains unclear how to attain this in practice and what the priorities of patients and staff are in relation to dignity. Design: A purposive sample of older patients and staff took part in semi-structured interviews and gave their insight on the meaning of dignity and examples of what sustains and breaches a patient’s dignity in acute hospital care. Method: Thirteen patients and thirty eight healthcare professionals in a single metropolitan hospital in the UK interviewed. Interviews were transcribed verbatim and underwent a thematic analysis. Results: The meaning of dignity was broadly agreed on by patients and staff. Three broad themes were identified; the meaning of dignity, staffing level and its impact on dignity, and organisational culture and dignity. Registered staff of all healthcare discipline and student nurses report very little training on dignity or care of the older person. Conclusion: There remains inconsistencies in the application of dignified care. Staff behaviour, a lack of training and the organisational processes continue to result in breaches to dignity of older people. Clinical nurses have a major role in ensuring dignified care for older people in hospital. Relevance to clinical practice: There needs to be systematic dignity related training with regular refreshers. This education coupled with measures to change the cultural attitudes in an organisation towards older peoples’ care should result in long term improvements in the level of dignified care. Hospital managers have an important rol

Background Front-line NHS staff undertake small research projects to answer questions about local patients and services, but these projects often face considerable challenges. This paper reports on one such project. Aims and methods of study The study used structured interviews in order to find out about the knowledge of nutrition among Bangladeshis using an NHS Walk-in Centre. Development of the study Time constraints posed considerable difficulties in progressing and completing the study; flaws in the methodology emerged; and underpinning assumptions about health promotion and ethnic minority health beliefs were open to challenge. Learning from the study Despite this, some findings were valuable and have considerable potential as a stimulus to critical thinking among practitioners about their own attitudes, as well as raising issues that future research would find it useful to address