Promoting Patient Dignity in Healthcare
Humans have an intrinsic need for dignity as a basic element of well-being. Yet, the concept of dignity can be somewhat nebulous and its defining features can vary across societies, cultures, and individuals.
In the context of healthcare, dignity often is defined as a multifaceted approach to patient interactions that involves the elements of respect, autonomy, empowerment, safety, communication, privacy, acceptance, acknowledgment, fairness, and more.(1)
The very nature of healthcare, however, can generate feelings that starkly contrast with the pillars of dignity. During chiropractic encounters, patients might feel exposed, vulnerable, judged, anxious, and frightened. Further, in the busy chiropractic practice, the principles that promote dignity — such as compassion, empathy, and attentiveness — can suffer because of time limitations and greater focus on goals and improvements that are more easily defined and measured.
Despite these barriers, treating patients with dignity is an essential element of patient-centered care, engagement, and satisfaction. Even small gestures or modest changes can have a meaningful effect on a person’s sense of dignity. This article discusses eight areas in which chiropractors can promote patient dignity and reinforce patient-centered care as part of everyday practice.
Promote a culture of dignity in your organization by showing patients and colleagues respect, compassion, empathy, and kindness. Recognize and respect each person’s individuality, and encourage other chiropractors and staff members in your practice to do the same. Consider how your organization can raise awareness about improving patient dignity through training, patient feedback, periodic reminders, and other methods.
Remember common courtesies in your daily interactions with patients, such as greeting patients, introducing yourself (if appropriate), asking how the patient is feeling, and making direct eye contact during discussions.
During initial encounters, ask patients how they would prefer that you address them. Some patients might prefer their first names or nicknames, while others want to use titles and surnames. Making an assumption about how to address a patient might lead to feelings of disrespect, especially in relation to cultural or generational differences.
Additionally, take stock of your attitude and demeanor when interacting with patients to ensure that personal or external factors (e.g., tiredness, stress, and staff or technology interruptions) don’t influence how patients perceive your feelings about them.
Privacy and Confidentiality
Respect patients’ privacy and confidentiality by taking steps to (a) ensure privacy during office visits (e.g., not discussing patients’ personal information in open areas and lowering your voice when communicating personal information), and (b) safeguard patients’ protected health information. Actual or perceived lapses in privacy and confidentiality can trigger feelings of disregard and diminish patients’ trust.
Decency and Modesty
Patients have varying definitions of decency and modesty, so it’s prudent to gauge these feelings and respond appropriately. Some general strategies for respecting patients’ modesty include:
- Knocking on exam room doors and asking permission before entering
- Using curtains in exam rooms to block the view from hallways and to provide a greater sense of privacy
- Offering drapes or gowns that fasten to help patients feel less exposed
- Securing patients’ gowns or providing them with an additional cover if you’re planning to transfer them to another room
Additionally, ask for consent before physically examining or treating patients. Explain to patients what you’re doing as you’re doing it, and encourage them to speak up if they are uncomfortable or in pain. Acknowledging their feelings and providing support might help alleviate feelings of vulnerability.
Autonomy is a fundamental aspect of dignity, and includes dimensions such as having choice, giving choice, making decisions, being able to make decisions, competence, rights, needs, and independence.(2) Autonomy also is an underlying principle of informed consent, a legal and ethical process that recognizes individuals’ rights to make decisions about their healthcare.
When providing patients with treatment options and recommendations, be vigilant about engaging patients in discussions about the risks and benefits of care and respecting patients’ rights related to choice and decision-making, including their right to refuse care.
Without a doubt, communication is central to how patients perceive they are treated during chiropractic encounters. Both verbal and nonverbal communication must be considered when developing strategies to promote patient dignity.
Effective verbal communication can help reinforce dignity by supporting a culture of safety, creating a successful chiropractor–patient partnership, and engaging patients in shared responsibility for their care.
When conversing with patients, be cognizant about not interrupting or rushing them. Doing so can imply lack of respect for the individual or general disinterest in what the patient is trying to communicate. Limiting external interruptions also can help minimize frustrations and make patients feel like they are a priority.
Speak clearly and use words that patients will understand, but avoid using a tone that might be perceived as demeaning, patronizing, or dismissive. Also, be mindful about avoiding language that implies stereotypes based on age, culture, gender, sexual orientation, and so on. Even if these statements are well intentioned or unintentional, they might be perceived as offensive or derisive. Carefully consider your wording and whether it is appropriate for the individual and the situation.
Considering that the majority of daily communication is nonverbal, it is no surprise that this aspect of communication has a significant impact on human interactions. Positive nonverbal communication is a powerful tool for connecting with patients in a constructive way and reinforcing mutual understanding and respect.
Developing situational awareness of your nonverbal communication — such as facial expressions, gestures, and body language — can help you recognize its potential to either alienate or engage patients and develop strategies for reassuring patients in nonverbal ways.
Cultural competence is a distinguishing feature of patient-centered care and a vital component of communicating well with patients and promoting dignity. Providing culturally competent care requires developing an awareness of how patients’ cultural beliefs and values can affect their perception of chiropractic interactions and understanding of chiropractic information. Further, it’s important to consider how cultural influences might contribute to how patients define the various aspects of dignity, such as respect, self-worth, pride, modesty, and autonomy.
Empathy, Understanding, and Compassion
Although the day-to-day activities and tasks that occur in chiropractic practices, clinics, and hospitals often are routine for people who work in these settings, they might be overwhelming for patients. Additionally, chiropractic encounters don’t occur in a vacuum, and the emotions they evoke can intermingle with patients’ other personal and professional stressors.
During patient interactions, give pause to consider how patients are responding to diagnoses, treatment recommendations, and outcomes. Acknowledging patients’ emotions and responding with empathy, understanding, and compassion can greatly influence patients’ overall experience and help them feel respected and comforted.
This document does not constitute legal or medical advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions.