Journal of Qualitative Research in Health Sciences

Journal of Qualitative Research in Health Sciences

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Peer Review Process

Editorial Policy

Indexing and Abstracting

Related Links

Journal Metrics

FAQ

News

Guide for Authors

Galley Proof

Dignity of Iranian Women with Breast Cancer: A Qualitative Study

Document Type : Original Article

Authors

1 Community-Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Public Health Nursing, Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

3 Australia Director, Rosemary Bryant AO Research Centre, University of South Australia and Adjunct Professor at Flinders University, Australia

4 Department of Operating Room, School of Paramedical Sciences, Birjand University of Medical Sciences, Birjand, Iran

5 Department of Operating Room, School of Paramedical, Social determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran

10.34172/jqr.2023.14

Abstract

Background: Respecting the human dignity of patients is one of the most important ethical requirements of the medical and nursing profession. Respect for dignity in all patients, especially in patients with breast cancer, is important because of the profound and lasting effects of this disease on patients. This study aimed to understand the perspective of patients with breast cancer on the concept of patient dignity from June 2020 to December 2020 in Iran Mehr Hospital (Radiotherapy and Oncology Center) in Birjand. 
Methods: This study was conducted using a qualitative approach. The data were collected through semi-structured individual interviews and analyzed using qualitative content analysis. The data were saturated after interviewing 16 patients with breast cancer who were selected using purposive sampling from June 2020 to December 2020. The main interview question was, “What does ‘dignity’ mean to you based on your experiences during your time with cancer?” The data elicited from the interviews were analyzed using content analysis via MAXQDA 2012 software.
Results: Analysis of the patients’ statements and experiences of maintaining dignity revealed three main themes. The first main theme was respect for human values, which included the subthemes of personal privacy, avoiding curiosity, confidentiality of information, and use of same-sex caregivers. The second main theme was psychological support, which included the subthemes of spousal and family empathy and support, understanding the patient’s concerns and preoccupations, resentment of pity, and disclosing cancer diagnosis. The third main theme was socioeconomic support, which included the subthemes of spousal and family financial support, financial aid by support organizations, and community awareness.
Conclusion: Receiving care by respecting dignity is the right of every patient. Since patients with cancer are more vulnerable, it can be argued that maintaining the dignity of these patients is more important than other patients due to the nature of the disease 
and the long-term involvement of patients with the disease.

Highlights

Farkhondeh Sharif (Google Scholar) (PubMed)

Zohreh Khoshnood (Google Scholar) (PubMed)

Marion Eckert (Google Scholar) (PubMed)

Marzieh Helal Birjandi (Google Scholar) (PubMed)

Samaneh Bagherian (Google Scholar) (PubMed)

Keywords

References

  1. References

    1. Probst H, Rosbottom K, Crank H, Stanton A, Reed H. The patient experience of radiotherapy for breast cancer: a qualitative investigation as part of the SuPPORT 4 All study. Radiography (Lond). 2021;27(2):352-9. doi: 1016/j.radi.2020.09.011.
    2. Refaei M, Khakbazan Z, Dehghan Nayeri N. Regular cervical cancer screening for Iranian women: facilitators and barriers. J Qual Res Health Sci. 2020;9(2):155-65. doi: 22062/jqr.2020.91461.
    3. Bahrami Baresari Z, Abbaszadeh A, Heydarirad G. Demographic and clinical factors affecting the cancer-related fatigue. Razi J Med Sci. 2020;26(11):34-42. [Persian].
    4. Shahhoseini S, Borhani F, Atashzadeh Shoorideh F, Kavousi A, Bagheri H, Almasi-Hashiani A. Different sources of dignity-related distress in women receiving chemotherapy for breast cancer. Asian Pac J Cancer Prev. 2017;18(11):2953-8. doi: 22034/apjcp.2017.18.11.2953.
    5. Saberi MK, Paknahad S, Jowkar A. Health literacy of patients with breast cancer: a qualitative study. J Qual Res Health Sci. 2019;8(2):131-42. [Persian].
    6. Neyestani H, Vafaee-Najar A, Ebrahimipour H, Shams M, Esmaeili H, Nikparast N, et al. Mammography in rural areas of Iran: a qualitative study for designing a social marketing intervention. J Qual Res Health Sci. 2020;2(2):173-83.
    7. Abadi Bavil D, Dolatian M. A survey on social support for breast cancer in Iran: a review study. Clin Exc. 2018;7(4):48-56. [Persian].
    8. Omidi Z, Koosha M, Nazeri N, Khosravi N, Zolfaghari S, Haghighat S. Status of breast cancer screening strategies and indicators in Iran: a scoping review. J Res Med Sci. 2022;27:21. doi: 4103/jrms.jrms_1390_20.
    9. Nafissi N, Khayamzadeh M, Zeinali Z, Pazooki D, Hosseini M, Akbari ME. Epidemiology and histopathology of breast cancer in Iran versus other Middle Eastern countries. Middle East J Cancer. 2018;9(3):243-51. doi: 30476/mejc.2018.42130.
    10. Shahhoseini S, Borhani F, Atashzadeh-Shoorideh F, Kavousi A. Assessment of human dignity in women with breast cancer undergoing chemotherapy. Med Ethics J. 2017;11(39):7-17. [Persian].
    11. Darby SC, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med. 2013;368(11):987-98. doi: 1056/NEJMoa1209825.
    12. Kim J, Han JY, Shaw B, McTavish F, Gustafson D. The roles of social support and coping strategies in predicting breast cancer patients’ emotional well-being: testing mediation and moderation models. J Health Psychol. 2010;15(4):543-52. doi: 1177/1359105309355338.
    13. Leal I, Engebretson J, Cohen L, Rodriguez A, Wangyal T, Lopez G, et al. Experiences of paradox: a qualitative analysis of living with cancer using a framework approach. Psychooncology. 2015;24(2):138-46. doi: 1002/pon.3578.
    14. Manookian A, Zakinejad M, Nikbakht Nasrabadi A, Shamshiri AR, Hojjat S. The effect of dignity therapy on sense of dignity in cancer patients. Iran J Nurs Res. 2020;15(2):76-83. [Persian].
    15. Fuseini AG, Ley L, Rawson H, Redley B, Kerr D. A systematic review of patient-reported dignity and dignified care during acute hospital admission. J Adv Nurs. 2022;78(11):3540-58. doi: 1111/jan.15370.
    16. Bagherian S, Sharif F, Zarshenas L, Torabizadeh C, Abbaszadeh A, Izadpanahi P. Cancer patients’ perspectives on dignity in care. Nurs Ethics. 2020;27(1):127-40. doi: 1177/0969733019845126.
    17. Kadivar M, Mardani-Hamooleh M, Kouhnavard M. Concept analysis of human dignity in patient care: Rodgers’ evolutionary approach. J Med Ethics Hist Med. 2018;11:4.
    18. Moradoghli F, Darvishpoor Kakhki A, Esmaeili R. The association between frailty and dignity in community-dwelling older people. BMC Geriatr. 2022;22(1):344. doi: 1186/s12877-022-03056-w.
    19. Tehranineshat B, Rakhshan M, Torabizadeh C, Fararouei M. Patient dignity in Iranian clinical care settings as perceived by physicians, caregivers, and patients. J Multidiscip Healthc. 2020;13:923-33. doi: 2147/jmdh.s258962.
    20. Manookian A, Cheraghi MA, Nikbakht Nasrabadi A. Factors influencing patients’ dignity: a qualitative study. Nurs Ethics. 2014;21(3):323-34. doi: 1177/0969733013498526.
    21. Bagherian S, Sharif F, Torabizadeh C, Zarshenas L, Abbaszadeh A. Development and psychometrics of a dignity assessment questionnaire for Iranian cancer patients: a mixed exploratory study. Middle East J Cancer. 2022;13(1):159-71. doi: 30476/mejc.2021.85999.1318.
    22. Borhani F, Abbaszadeh A, Moosavi S. Status of human dignity of adult patients admitted to hospitals of Tehran. J Med Ethics Hist Med. 2014;7:20.
    23. Glendinning C, Clarke S, Hare P, Kotchetkova I, Maddison J, Newbronner L. Outcomes-Focused Services for Older People. London: Social Care Institute for Excellence; 2006.
    24. Cheraghi MA, Manookian A, Nikbakht Nasrabadi A. Human dignity in religion-embedded cross-cultural nursing. Nurs Ethics. 2014;21(8):916-28. doi: 1177/0969733014521095.
    25. Henderson A, Van Eps MA, Pearson K, James C, Henderson P, Osborne Y. Maintainance of patients’ dignity during hospitalization: comparison of staff-patient observations and patient feedback through interviews. Int J Nurs Pract. 2009;15(4):227-30. doi: 1111/j.1440-172X.2009.01764.x.
    26. Lopez-Class M, Perret-Gentil M, Kreling B, Caicedo L, Mandelblatt J, Graves KD. Quality of life among immigrant Latina breast cancer survivors: realities of culture and enhancing cancer care. J Cancer Educ. 2011;26(4):724-33. doi: 1007/s13187-011-0249-4.
    27. Atashzadeh-Shoorideh F, Pazargadi M, Zagheri Tafreshi M. The concept of nursing care quality from the perspective of stakeholders: a phenomenological study. J Qual Res Health Sci. 2012;1(3):214-28. [Persian].
    28. Mohammadi M, Larijani B, Emami Razavi SH, Fotouhi A, Ghaderi A, Madani SJ, et al. Do patients know that physicians should be confidential? study on patients’ awareness of privacy and confidentiality. J Med Ethics Hist Med. 2018;11:1.
    29. Mohammadi F, Oshvandi K, Khodaveisi M, Fatemeh C, Hasan Tehrani T, Khalili A, et al. Caregivers’ perception of teenagers’ dignity in end of life stages: a phenomenological study. Nurs Ethics. 2023;30(1):121-32. doi: 1177/09697330221085776.
    30. Hosseini FA, Momennasab M, Yektatalab S, Zareiyan A. Patients’ perception of dignity in Iranian general hospital settings. Nurs Ethics. 2019;26(6):1777-90. doi: 1177/0969733018772078.
    31. Azadi M, Azarbayejani M, Rasoul Zadeh Tabatabie SK. Dignity in Iranian cancer patients: a qualitative approach. Ment Health Relig Cult. 2020;23(7):519-31. doi: 1080/13674676.2020.1712592.
    32. Cheraghi MA, Manookian A, Nikbakht Nasrabadi A. Patients’ lived experiences regarding maintaining dignity. J Med Ethics Hist Med. 2015;8:6.
    33. Mohammadi F, Rakhshan M, Molazem Z, Zareh N, Gillespie M. Caregivers’ perception of dignity in teenagers with autism spectrum disorder. Nurs Ethics. 2019;26(7-8):2035-46. doi: 1177/0969733018796679.
    34. Liu YJ, Li XY, Wang YJ, Li XH. Dignity in nursing: a bibliometric and visual analysis of scientific publications. Scand J Caring Sci. 2023;37(2):384-96. doi: 1111/scs.13118.
    35. Tehranineshat B, Torabizadeh C. Dignity of nursing students in clinical learning environments. Nurs Ethics. 2022;29(3):742-57. doi: 1177/09697330211041735.
    36. Ounalli H, Mamo D, Testoni I, Belvederi Murri M, Caruso R, Grassi L. Improving dignity of care in community-dwelling elderly patients with cognitive decline and their caregivers. The role of dignity therapy. Behav Sci (Basel). 2020;10(12):178. doi: 3390/bs10120178.
    37. Kisvetrová H, Tomanová J, Hanáčková R, Greaves PJ, Steven A. Dignity and predictors of its change among inpatients in long-term care. Clin Nurs Res. 2022;31(2):274-83. doi: 1177/10547738211036969.
    38. Mehdipour-Rabori R, Abbaszadeh A, Borhani F. Human dignity of patients with cardiovascular disease admitted to hospitals of Kerman, Iran, in 2015. J Med Ethics Hist Med. 2016;9:8.
    39. Amininasab SS, Azimi Lolaty H, Moosazadeh M, Shafipour V. The relationship between human dignity and medication adherence in patients with heart failure. J Med Ethics Hist Med. 2017;10:5.
    40. Liu Y, Wang R, Qiao S, Liu F, Wang L, Su Y. How dignity-related distress interacts with quality of life in young adult patients with cancer during the active treatment stage: a network analysis. Psychooncology. 2022;31(9):1564-71. doi: 1002/pon.5998.
    41. Wang L, Guo Q, Zuo J, Wang Y, Feng L, Zhou X, et al. Exploring the characteristics of dignity loss in patients with cancer in North China. J Clin Oncol. 2022;40(16 Suppl):e24132. doi: 1200/JCO.2022.40.16_suppl.e24132.
    42. Xiao J, Chow KM, Tang S, Chan CW. Development and feasibility of culturally sensitive family-oriented dignity therapy for Chinese patients with lung cancer undergoing chemotherapy. Asia Pac J Oncol Nurs. 2022;9(9):100078. doi: 1016/j.apjon.2022.100078.
    43. Matiti MR, Trorey GM. Patients’ expectations of the maintenance of their dignity. J Clin Nurs. 2008;17(20):2709-17. doi: 1111/j.1365-2702.2008.02365.x.
    44. Khoshnood Z, Mehdipour-Rabori R, Nazari Robati F, Helal Birjandi M, Bagherian S. Patients’ experiences of living with coronavirus disease 2019: a qualitative study. Evid Based Care. 2021;11(1):44-50. doi: 22038/ebcj.2021.57471.2499.
    45. Rakhshan M, Joolaee S, Mousazadeh N, Hakimi H, Bagherian S. Causes of futile care from the perspective of intensive care unit nurses (I.C.U): qualitative content analysis. BMC Nurs. 2022;21(1):225. doi: 1186/s12912-022-01004-y.
    46. Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health. 2015;42(5):533-44. doi: 1007/s10488-013-0528-y.
    47. Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52(4):1893-907. doi: 1007/s11135-017-0574-8.
    48. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12. doi: 1016/j.nedt.2003.10.001.
    49. Barati O, Khamarni M, Sadeghi A, Siavashi E. Skills, Capabilities, and Requirements of Hospital Managers: A Qualitative Study. J Qual Res Health Sci. 2020;5(1):17-28. [Persian].
    50. Abtan AA, Rahnama M, Noori Sanchooli H, Naderifar M. Burn patients’ experiences of hospitalization: a content analysis study. J Qual Res Health Sci. 2022;11(2):92-8. doi: 22062/jqr.2021.193741.0.
    51. Guba EG, Lincoln YS. Competing paradigms in qualitative research. In: Denzin NK, Lincoln YS, Eds. Handbook of Qualitative Research. Thousand Oaks: Sage Publications, Inc.; 1994. p. 105-117.
    52. Ebrahimi H, Torabizadeh C, Mohammadi E, Valizadeh S. Patients’ perception of dignity in Iranian healthcare settings: a qualitative content analysis. J Med Ethics. 2012;38(12):723-8. doi: 1136/medethics-2011-100396.
    53. Matiti M, Cotrel-Gibbons E, Teasdale K. Promoting patient dignity in healthcare settings. Nurs Stand. 2007;21(45):46-52. doi: 7748/ns2007.07.21.45.46.c4584.
    54. Khoshnood Z, Iranmanesh S, Rayyani M, Dehghan M. Getting out or remaining in the cage of inauthentic self: the meaning of existential challenges in patients’ with cancer. Indian J Palliat Care. 2018;24(2):131-8. doi: 4103/ijpc.ijpc_179_17.
    55. Khanjari S, Langius-Eklöf A, Oskouie F, Sundberg K. Family caregivers of women with breast cancer in Iran report high psychological impact six months after diagnosis. Eur J Oncol Nurs. 2014;18(6):630-5. doi: 1016/j.ejon.2014.06.002.
    56. Sajadian A, Montazeri A. Exploring the experiences of Iranian women with breast cancer: a qualitative study. Iran J Epidemiol. 2011;7(2):8-16. [Persian].
    57. Ripamonti CI, Buonaccorso L, Maruelli A, Bandieri E, Pessi MA, Boldini S, et al. Patient dignity inventory (PDI) questionnaire: the validation study in Italian patients with solid and hematological cancers on active oncological treatments. Tumori. 2012;98(4):491-500. doi: 1177/030089161209800415.
    58. Jassim GA, Whitford DL. Understanding the experiences and quality of life issues of Bahraini women with breast cancer. Soc Sci Med. 2014;107:189-95. doi: 1016/j.socscimed.2014.01.031.
    59. Fazel A, Tirgari B, Mokhber N, Koushyar M, Esmaily H. The effect of mastectomy on mood and quality of life in breast cancer patients. J Shahid Sadoughi Univ Med Sci. 2008;16(3):28-36. [Persian].
    60. Wong-Kim E, Sun A, Merighi JR, Chow EA. Understanding quality-of-life issues in Chinese women with breast cancer: a qualitative investigation. Cancer Control. 2005;12 Suppl 2:6-12. doi: 1177/1073274805012004s02.
    61. Harandy TF, Ghofranipour F, Montazeri A, Anoosheh M, Mohammadi E, Ahmadi F, et al. Health-related quality of life in Iranian breast cancer survivors: a qualitative study. Appl Res Qual Life. 2010;5(2):121-32. doi: 1007/s11482-010-9097-3.
    62. Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine. Lancet. 2004;363(9405):312-9. doi: 1016/s0140-6736(03)15392-5.
    63. Taei Z, Radfar M, Mogadam Tabriz F, Sheikhei N. The effect of dimension of social support on hope and loneliness in patients with breast cancer. J Urmia Nurs Midwifery Fac. 2015;13(6):473-80. [Persian].
Journal of Qualitative Research in Health Sciences
Volume 12, Issue 2
August 2023
Pages 91-99
Files
History
  • Receive Date: 13 July 2022
  • Revise Date: 18 September 2022
  • Accept Date: 15 October 2022
Share
How to cite
Statistics