Dimensional Analysis of Dignity

Dignity is a word used frequently throughout nursing literature. It describes fundamental practices in nursing and directs nurses how to care for individuals and communities. Yet, the concept of dignity used by the nursing profession remains unclear through obscure and vague definitions and understandings.

The aim of this concept analysis is to provide a dimensional analysis of dignity as a fundamental value in nursing practice for the purpose of furthering nursing’s understanding of dignity. As part of the analysis, a literature review was completed to explore literature specific to dignity and how it is used and defined, not only by nursing, but also by other disciplines. Articles included in the review were obtained through a search based on dimensional analysis using the keywords dignity, concept analysis, and nursing, and then casting a wider net to explore and evaluate the use and understanding of dignity through other professions. The main results include identification of five themes: use of dignity in laws, codes, and declarations; definitions of dignity; dimensions in dignity; general actions that affect dignity; and confusion in use of the concept of dignity. Overall, literature revealed the emergence of two dimensions understood in dignity: inherent dignity and personal dignity.

The method used for concept analysis is dimensional analysis, which provides structure and explanatory power to communicate research findings. Findings are reported through use of an explanatory matrix in which characteristics and dimensions can be categorized into perspectives, contexts, conditions, processes, and consequences. Perspective is the central component. It explains the relationships in the remaining four dimensions and is used to organize the integration of all other findings within the dimensions of the matrix. Context refers to the situation in which the dimensions are found and provides for boundaries and circumstances. Conditions facilitate, block, or shape actions or interactions of a phenomena. Processes are moved by specific conditions and include intended or unintended actions or interactions. Consequences are outcomes of specific actions and interactions.

The perspective in this concept analysis of dignity reflects that dignity is a whole concept, which includes two inseparable components: inherent dignity and personal dignity. Personal dignity has two intertwined parts -- dignity of self and dignity in relation to others. The context, or where dignity is embedded, is described through the perspective of inherent and personal dignity. Through inherency, dignity is a common quality belonging to all humans and cannot be quantified, created, or destroyed. The context of personal dignity includes characteristics of being an attribute of self, of a social nature, and being dynamic and changeable. Since inherent dignity is inviolable and unchangeable, it is unaffected in the remaining three dimensions of condition, process, and consequence. The conditions, or components that facilitate actions, of personal dignity include, but are not limited to, self-value, self- control, autonomy, adequacy of healthcare, privacy, symmetrical relationships, vulnerability, and compassion. Processes, or the actions and interactions of personal dignity of self include perseverance, independence, discipline, avoidance, and resistance. Processes specific to dignity in relation to others include actions that can move dignity in either a positive or negative direction and include acceptance, advocacy and empowerment, or rudeness, abuse, and exploitation. The consequences of dignity are expressed mostly through personal dignity of self and are described positively as pride, sense of freedom, and successful coping, or negatively as shame, degradation, and humiliation.

Through dimensional analysis, the following definition of dignity is offered: Dignity is a quality unique to all humans, and includes the two inseparable components of inherent dignity and personal dignity. Personal dignity reflects both dignity as related to the person, and the social aspect of dignity through relations to others. Inherent dignity is inviolable and unchangeable. Personal dignity is dynamic, exists with broad conditions, and can be affected by processes that will lead to positive or negative consequences.