Development of a Dignity Experience Scale in Mental Healthcare. Co-creating Empirical Measures with Service Users and Healthcare Professionals

Dignity is enshrined in statute, healthcare professional (HCP) ethics and policy, yet worldwide, mental healthcare violates service user dignity. Dignity lacks empirical definition as an operational concept. The aim of this study is to operationalize dignity in mental healthcare service user experience, to inform service design and delivery. This thesis addresses concepts of dignity within a theoretical framework of service experience and proposes a new paradigm for understanding dignity which emphasizes the dynamic co-production of dignity experiences. It proposes a consensus model for the mechanisms of dignity co-production and the first Dignity Experience Scale found in mental healthcare, co-created with service users (SUs) and HCPs. The study uses a sequential mixed methods approach to knowledge co-creation which privileges SU perspectives, comprising: 1. a literature meta-synthesis to specify an initial scale; 2. 17 experiential narratives to develop the scale and a Delphi panel of 11 HCPs to refine it; 3. quantitative research with 160 SUs and HCPs to test the scale; 4. Exploratory Factor Analysis (EFA) to identify latent factors. Study findings show the importance of dignity co-production in rights-based, person-centred, recovery-oriented mental healthcare across 3 domains: Relationships, Environment and Confidentiality. EFA proposes an internally consistent 25-item, 5-factor scale. The primary factor, Empowering Empathy, emphasizes collaborative therapeutic relationships in which SUs are met with understanding and empowered with information and choice for recovery beyond symptom reduction. Other factors emphasize Respect for Equal Humanity, No Informal Coercion and creating Safe Space for Difference within relationships; and developing Comfortable, Confidential Environments.

Grantor dc:publisher.institution

University of Bradford

Author dc:creator

• Brooks, Claire A.

Advisors dc:contributor.advisor

• Hou, Jiachen
• Breen, Liz
• Maruyama, Takao

• Mental healthcare
• Dignity Experience Scale
• Co-creation
• Service user naratives
• Delphi panel
• Healthcare professionals
• Empathy
• Therapeutic relationships

Statement dc:rights

• <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><img alt="Creative Commons License" style="border-width:0" src="http://i.creativecommons.org/l/by-nc-nd/3.0/88x31.png" /></a><br />The University of Bradford theses are licenced under a <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/">Creative Commons Licence</a>.

Language dc:language.iso

en

Repository record dc:identifier.uri

https://bradscholars.brad.ac.uk/handle/10454/20668

OAI identifier oai:identifier

oai:bradscholars.brad.ac.uk:10454/20668