Nursing interventions to promote dignified dying in four countries.

PURPOSE/OBJECTIVES To describe nursing interventions to promote dignified dying as identified by nurses in four countries. DESIGN Cross-sectional survey design. SETTING Hospitals and clinics in Ethiopia, India, Kenya, and the United States. SAMPLE A convenience sample of 560 nurses who cared for dying patients in Ethiopia (n = 14), India (n = 229), Kenya (n = 36), and the United States (n = 281). METHODS Nurses who agreed to participate completed the International Classification for Nursing Practice Dignified Dying Survey. Responses to an open-ended survey question about the interventions nurses use to promote dignified dying were analyzed qualitatively. MAIN RESEARCH VARIABLES Nursing interventions. FINDINGS The Dignity-Conserving Care Model provided a framework to analyze nursing interventions used to promote dignified dying. Although some variation was found in the interventions used, nurses from all four countries identified interventions representing each of the three major categories of the model: illness-related concerns, a dignity-conserving repertoire, and a social-dignity inventory. CONCLUSIONS Nurses identified the holistic nature of the dying experience and the multiple interventions needed to promote dignity for dying patients and their family members. Palliative care is an area of practice that crosses healthcare settings, specialties, countries, and cultures. IMPLICATIONS FOR NURSING This study begins to identify specific interventions for future research and applies the Dignity-Conserving Care Model to further understand dignified dying from an international nursing perspective.