The Health Care Providers’ Perspectives on End-of-Life Patients’ Sense of Dignity. A Comparison Among Four Different Professionals’ Categories

  • Andrea BoveroEmail author
  • Chiara Tosi
  • Rossana Botto
  • Alessandra Cito
  • Valentina Malerba
  • Valentina Molfetta
  • Valentina Ieraci
  • Riccardo Torta


The studies on terminally ill patients’ dignity as perceived by health care providers (HCPs) in palliative care are growing. The comparison of different HCPs’ perspectives in particular is necessary to explore how HCPs perceive patients’ dignity in order to promote reflection on this core issue. This study aimed to investigate the perspectives on end-of-life patients’ sense of dignity among four different categories of professionals: nurse assistants, nurses, psychologists, and physicians. A sample of 306 HCPs completed the Patient Dignity Inventory-Italian Version (PDI-IT) adapted for them and an ad hoc semi-structured written interview. Their responses were then analyzed using frequencies of the answers to the PDI-IT, a multivariate analysis of variance, Pearson’s correlation index, t tests, and content analysis. All HCPs scored the relevance to the dignity-related physical aspects highly, followed by the psychological distress. Nurse assistants and nurses provided higher scores on the psychological and existential and spiritual PDI subscales than the other HCP groups. The social sphere was evaluated as the least salient for the patients’ sense of dignity. Physicians who attended a course on dignity considered the psychological and existential dignity dimensions more. Differences in role and expertise could lead to different HCPs’ perspectives on dignity, while the multidisciplinary work could favor their aligning. Therefore, it is essential to encourage HCPs’ communicative exchange and reflective awareness through training, i.e., courses, seminars, and focus groups. These developments could promote increasingly adequate patient-centered care.


Dignity Health care providers End-of-life patients Cancer Palliative care 



The authors thank the research staff for their precious contribution and the colleagues of the “Città della Salute e della Scienza” Hospital’s departments that participated in the study: Dermatology, Oncology, Internal Medicine, Hematology, Geriatrics, General Medicine, Urology, and Psycho-Oncology Unit.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional ethics committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© American Association for Cancer Education 2019

Authors and Affiliations

  1. 1.Clinical Psychology and Psycho-Oncology Unit, Department of NeuroscienceUniversity of Turin, “Città della Salute e della Scienza” HospitalTurinItaly

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