Understanding the dignity experience of South African patients in primary palliative care.

Background:  To meet the goals of primary palliative care for patients with advanced disease and to provide holistic patient-centred compassionate care that respects the experience of patients, dignity in its entirety needs to be understood from the patients' perspective. There are no studies to understand the predominant factors that impact the dignity experience of South African patients with advanced disease.

Methods:  This was a descriptive qualitative study where a semi-structured interview guide was used to understand the dignity experience of adult patients with advanced disease (Stage IV cancer, AIDS, people living with human immunodeficiency virus [HIV]), receiving home care from two hospices in the North of Durban, KwaZulu-Natal. Purposive sampling was used to identify 14 patients from culturally, linguistically and socioeconomically diverse populations representative of South Africa. In-depth interviews allowed for an exploration of participants' lived experiences. Interviews were audiotaped and transcribed verbatim. Data were analysed using thematic analysis.

Results:  Four major themes and numerous sub-themes defined the total dignity experience. The themes were: (1) Physical Concerns; (2) Psychological Concerns and coping mechanisms; (3) Social Concerns; and (4) Spiritual Concerns and coping mechanisms. Sub-themes are described in the main article.

Conclusion:  With awareness of the factors that affect the total dignity experience, healthcare providers can be considerate of and offer optimal dignity-conserving compassionate care to respect and improve the quality of life of South African patients living with advanced disease.Contribution: This study extensively explored new knowledge on the total dignity experience of South African patients with advanced disease.