Patients’ experience of privacy and
dignity. Part 2: an empirical study
Abstract
In May–June 2006, a self-report questionnaire was completed by 40 in-
patients to assess their experience of privacy and dignity in hospital.
The questionnaire comprised closed and open questions, where
the latter, among other things, required the patient’s own narrative.
Results indicate that patients view privacy/dignity as crucial. Although
the staff and inadequate ward layouts compromise and conspire
against patients’ privacy and dignity, patients appear to sympathize
with how hospitals are run, even if the caring environment fails to
provide full privacy. Women have greater concerns, and both genders
indicated how their privacy and dignity could be met. Recognizing
problems relating to meeting patients’ privacy and dignity, the article
challenges clinical staff and hospital designers to address the issue,
especially as central government initiatives and law demand serious
attention to ensuring patients’ privacy and dignity. Research is
indicated to ascertain hospital designs, preferred care strategies and
education to address the problem.
Key words: Dignity n Healthcare provision n Patient experience
Privacy n Ward layout
T
his is the second article in a series of two on the
subject of patients’ experience of privacy and dignity
in hospital. The first article (Whitehead and Wheeler,
2008) reviewed the literature relating to patients’
privacy and dignity and set the scene for the current article,
which reports a research study carried out to ascertain what
a sample of patients on a cardiothoracic ward thought about
privacy and dignity. In particular the study attempted to
identify patients’ experience of how they thought their privacy
and dignity needs were met, and how they felt the caring
environment could enhance patients’ privacy and dignity
during their stay in hospital.
Whitehead and Wheeler (2008) concluded that interest
in the topic of privacy and dignity goes back to psychiatric
patients in the 1960s, although the 1990s saw a shift to all
hospitals. Key findings revealed that current United Kingdom
(UK) government policies advocate the need for researchers
and healthcare professionals to focus on the issues of patients’
Juliet Whitehead is Professional Development Sister, University Hospital
Birmingham NHS Foundation Trust; and Dr Herman Wheeler is
Lecturer in Health Sciences, School of Medicine, Dentistry and Health
Sciences, University of Birmingham, England
Accepted for publication: March 2008
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Juliet Whitehead, Herman Wheeler
privacy and dignity. In particular there needs to be a focus on
how healthcare practice militates against patients’ privacy and
dignity, and how these needs can best be met.
Background to the study
There is evidence that patients’ privacy and dignity arouse
universal interest and debate; moreover, more research on the
subject is indicated. Various UK government policy initiatives
(and the Human Rights Act 1998) have called for healthcare
professionals to respect patients’ privacy and dignity; government
policies also seem in favour of single rooms. But do patients feel
their professional carers are rising to the challenge?
Aim of the study
The aim of the study was to ascertain the views of a
convenience sample of 40 coronary by-pass graft patients,
within a mixed gender ward, on their experience of privacy
and dignity in hospital. Would their conceptualization of
privacy and dignity be supported by the reality of caring?
n
Objectives of the study
The study had two main objectives:
1. To identify what patients understood by the notion of
privacy and dignity
2. To explore patients’ thoughts on whether they felt their
privacy and dignity were met within a mixed gender ward,
any problems they felt stood in the way of their privacy
and dignity and how these needs could be met.
Study design, including sample
In May–June 2006, a self-report questionnaire, comprising
two open and 16 closed questions, was given to a convenience
sample of 40 elective coronary artery bypass graft patients (9
women and 31 men) from a cardiothoracic ward. Self-report
questionnaires were chosen over alternatives, such as interviews
and focus groups, for convenience of the respondents and the
researchers. Also with one of the researchers being a nursing
sister working on the ward concerned, it was considered
that the use of questionnaires was less likely to introduce the
risk of work-observer bias (Clifford, 1997). Moreover, the
questionnaire approach guaranteed respondents’ anonymity,
and probably contributed to more honest, objective answers.
Underlying the rationale for using a mixture of open and
closed questions was the belief that the respondents would
more readily respond to a combination of closed and open
questions, the latter requiring construction of the patient’s
own narrative. Moreover, the open questions presented a
more exploratory qualitative slant, providing opportunity
British Journal of Nursing, 2008, Vol 17, No 7

for free expression, rather than just selecting from a list of
predetermined alternatives. Porter (2000) believes that open
questions are more likely than closed ones to explore ideas in
depth. According to Playle (2000), a single method approach
shows the researcher only one side of the topic, whereas a
design comprising both open and closed questions gives a
more accurate picture. Orb et al (2001) make the point that
a combination of both closed and open questions works best,
as together both are more likely to adequately cover all the
responses that respondents wish to give.
The questionnaire
The questionnaire gathered biographical data, such as age,
gender, number of hospital admissions and length of stay.
Closed questions attempted to ascertain the degree of
importance respondents attached to privacy and dignity;
their view of the ward’s ability to respect their privacy and
dignity; whether they were informed prior to admission that
they would be nursed on a mixed gender ward and how they
felt about this; and whether they had raised concerns about
the mixed gender ward with the staff. The closed questions
also required respondents to declare whether they felt their
privacy and dignity were compromised, the degree of respect
accorded to them by nursing staff, and whether they felt
curtains positioned between beds provided adequate privacy.
One of the closed questions required respondents to state
whether they at any time overheard staff conversations giving
personal information about other patients and who was giving
the information. The final question ascertained whether
respondents needed to talk to a doctor or nurse about sensitive
issues and where such conversations took place. Each closed
question additionally asked respondents to comment on their
answers. The two open-ended questions required respondents
to supply their own narrative on their understanding of privacy
and dignity, including stating what each meant to them.
Piloting: The questionnaire was piloted on three patients
from the population from which the sample was drawn,
although these patients were excluded from the main study
to avoid the risk of contaminating data.The sample was asked
to critique the questionnaire on: (a) clarity and intelligibility
to them; (b) whether they thought the questionnaire was
user-friendly; (c) appeal of the length of the questionnaire;
(d) their views on the content and whether in the light of
the study’s aims and objectives, they felt there were major
omissions, or necessary additions and deletions they would
have made. A senior nursing colleague from the Trust who has
a nurse consultant brief, including research responsibilities,
and the Trust’s statistician were invited to offer a critique of
the questionnaire, particularly the suitability of the scales for
the proposes intended. Responses were used to evaluate the
suitability and credibility of the questionnaire, which was
modified to produce the final version used in this study.
Ethics
Ethical approval for the study was secured from the Local
Research Ethics Committee. An ethical concern that arose
was the that one of the researchers involved in the research
was also a member of the nursing staff where the study would
take place. How this may affect the research was a question the
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PATIENT WELFARE
researchers felt necessary to address, from the point of view of
objectivity in both obtaining the data and making sense of it.
However, the authors concluded that these two issues would
be addressed by appropriate sensitivity in the data gathering;
moreover, additional expert help with data analysis would be
sort if considered necessary to help enhance objectivity.
Another concern was whether the patients would feel
inhibited in terms of the answers they gave, from the point
of view of producing socially desirable answers, rather than
expressing what they truly felt. Although the researchers did
not feel they could exert any really measurable control to
test patients’ tendency towards expressing socially desirable
responses, they nevertheless chose the day before discharge
to ask participants to complete the questionnaire.
The authors looked for any evidence of tension and anxiety
in patient’s willingness to participate. At the pilot study
stage one patient declined to take part after he had seen the
questionnaire, expressing the view that he was not comfortable
with the open nature of the questions and would have preferred
more closed ‘yes’ and ‘no’ questions. No other patients declined
nor expressed any anxiety about participating.
Contact numbers for the researchers as well as for Trust’s
research and development officer were provided to the
participants, who were advised to raise any concerns they had
about the study, at any time. Participants were also reassured
that anonymity would be kept at all times.
Data analysis
Quantitative analysis
Quantitative data were coded and analysed using Microsoft
Excel. As most of the variables in the analysis were ordinal
and dichotomous, Fisher’s exact test was used to ascertain
significant associations between two dichotomous variables.
Kendall’s tau-b was used to test for significant associations
between one ordinal variable and one dichotomous variable,
and between two ordinal variables. Spearman’s correlation
was used to identify significant associations between the
discrete variable, age, and ordinal variables.
Qualitative analysis
For the qualitative data obtained, a combination of
Leininger’s (1998) theoretical model and Burnard’s (1991)
recommendations for analysis of qualitative data was used.
Both theoretical approaches have foundations in grounded
theory (Glaser and Strauss, 1967; Strauss, 1986) and the
literature on content and qualitative data analysis (Fox, 1982;
Field and Morse, 1985; Couchman and Dawson, 1990).
Validation of the researchers’ interpretation of the data
was undertaken by colleagues experienced at qualitative data
analysis. There was complete agreement that the findings
accurately reflected respondents’ open-ended responses.
Results of the study
Forty questionnaires were distributed and all were returned
(response rate of 100%). Thirty-one (77%) respondents were
male and 9 (23%) were female.
Figure 1 gives the age distribution for the respondents. A
two-sample t-test was performed to establish if age differed
significantly for groups. There were no significant differences
459
 Figure 1. Age distribution. one respondent did not state a preference. Kendall’s tau-b
test was carried out to establish if there were any differences
10
Standard deviation = 10.18 between days in hospital and gender. All respondents had
Mean = 65.3 been in hospital for a variation of days and results show no
8 n = 40 significant difference between male and female respondents
for days in hospital (P=0.848). These findings indicate that
6
Frequency

respondents place as much emphasis on their privacy and

dignity no matter how long their stay.
4

Difference between male and female in their

2
value of privacy and dignity
Privacy
0
Kendall’s tau-b was performed to establish significant
9

9
–3

–4

–4

–5

–5

–6

–6

–7

–7

–8

–8
associations between genders in terms of how they perceive
35

40

45

50

55

60

65

70

75

80

85
privacy. Statistical differences were found between male and
Age (years) female in relation to the importance of privacy. Symmetric
Figure 2. ‘First time in hospital’ by gender.
measures show a positive relationship of P=0.037, indicating
a significant difference between male and female respondents.
35 Female respondents thought of privacy as ‘very important’
compared with ‘important’ by the males. Thus, female patients
30
Yes valued their privacy more highly than the men. Nevertheless,
25 No men also clearly valued their privacy (Figure 4; Tables 1 and 2).
Count of gender

Not stated
20
15
10
5
0 In relation to respondents being asked to rate their ward’s
Female Male
First time in hospital
because age was normally distributed.The 40 respondents were
between 35 and 85 years, with a mean age of 65.3 years.
With respect to whether respondents had previous admissions,
of the 9 female respondents, 8 had previous admissions and
one did not. Eighteen male respondents had been in-patients
previously, and 12 for the first time. One male respondent did
not state whether this was his first admission (Figure 2).
Figure 3 shows the number of in-patient days for all
respondents: 1–7 days = 33% (13); 8–14 days = 34% (14); 15–
21 days = 15% (6); 22–28 days = 5% (2); > 28 days = 10% (4);
Dignity
Figure 5 shows the importance respondents attach to dignity.
There were no statistically significant difference between
genders (P=0.39); male and female respondents both saw
dignity as either ‘important’ or ‘very important’ (Table 3).
ability to respect their privacy and dignity, 27.5% (11) rated
the ward ‘excellent’, 47.5% (19) ‘very good’, 15% (6) ‘good’,
and 10% (4) ‘fair’.
With respect to whether respondents had been informed,
prior to admission, that they would be nursed in a mixed
gender ward, 72.5% (29) reported not to have been informed,
whereas 22.5% (9) admitted to have been, and 5% (2) did
not report either way. Despite of this, with respect to how
respondents felt about being nursed on a mixed gender ward,
27.5% (11) were either ‘very unhappy’ or ‘unhappy’, 52.5%
(21) ‘neither happy nor unhappy’, 17.5% (7) ‘very happy’ or
‘happy’ and 2.5% (1) did not give a response. Table 4 contains
the cross tabulation for sensitive issues by gender.

Not stated = 1 (3%) Qualitative results

1–7 days = 13 (33%)
Respondents’ feelings and perceptions about privacy and
>28 days = 4 (10%)
dignity were further explored by the open-ended questions.
22–28 days = 2 (5%)
Respondents placed very high value and importance on
their privacy and dignity and were keen that both should be
respected. Moreover, in some cases they indicated how they felt
such respect should be accorded.

Concept and definition of privacy

15–21 days = 6 (15%) The following themes indicate how the patients defined and
conceptualized privacy:
Privacy of information, e.g. having one’s conversation not
being overheard
8–14 days = 14 (34%) Privacy of person and body, e.g. not being viewed during
one’s private moments (e.g. performing toilet functions)
Figure 3. Number of days in hospital since present admission. Exerting personal control, e.g. matters relating to one’s care

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 PATIENT WELFARE

Table 1. Cross tabulation for gender Table 2. Symmetric measures showing significant values
and privacy importance (n=40) Asymp. Approx. Approx. Exact
Value Std. error a T b Sig. Sig.
Count Privacy
1.00 2.00 3.00 Total
Ordinal by ordinal 0.347 0.071 3.254 0.001 0.037
Gender Female 9 9 Kendall’s tau-b
Male 19 11 1 31 Number of valid cases 40
Total 28 11 1 40 a Not assuming the null hypotyesis; b Using the asymptotic standard error assuming the null hypothesis

1.00 = Very important; 2.00 = Important; 3.00 = Slightly

important
Acknowledgement of the need for peace of mind at a
stressful time.
Able to be alone at one’s choosing Comments supporting the dignity themes include:
Gain respect from professionals
‘That you are treated with due respect and
Having one’s hospital records and files removed from
consideration.’ (P3)
visitors’ attention/space
Having one’s own/personal space ‘Being treated like a human being and not an
Everyone should value privacy as essential or important, object.’ (P5)
especially in mixed wards
‘To be treated with sympathy and compassion on
The value of single as opposed to mixed sex wards/bays
a very traumatic occasion.’ (P6)
Freedom and privacy to worship
Right to perform intimate activity of daily living, e.g. using ‘A feeling of being in control of own private
the toilet in private and alone, only having staff present if functions.’ (P26)
essential.
‘To be treated with respect whether you are old,
Comments supporting the privacy themes include:
senile and illiterate or a foreign national.’ (P40)
‘When being treated in private places to be out
‘Peace of mind at a stressful time.’ (P15)
of sight of other people.’ (P8)
‘Privacy to me is to be allowed to do as I would
at home but also be assisted by hospital staff as 35
Very important
and when required.’ (P10) 30 Slightly important
Count of gender

‘Having your own space – feeling you can be in 25 Important

that space, not being pushed around.’ (P24) 20
‘Ability to wash and do personal things without 15
being observed.’ (P26) 10

Concept and definition of dignity 5

In response to being asked to say what the notion of dignity 0
meant to them, respondents’ comments support the formation Female Male
Privacy importance
of the following themes:
Absence of embarrassment, e.g. shown up in front of others Figure 4. Importance of privacy by gender.
Having ones privacy and dignity respected
Being treated humanely, like a human being and not as an 35
object
30
Being treated with respect as well as respecting others Very important
Count of gender

Being treated with sympathy, consideration and compassion 25 Important

To be treated as an individual
When all staff introduce themselves and say who they are 20
before treating you 15
Being able to maintain ones privacy, e.g. treated in private,
out of public gaze 10
A feeling of being in control, e.g. over decisions and private 5
bodily functions
When staff explain your treatment and changes and what 0
Female Male
is going to happen
Dignity importance
Being listened to and get heard
Desire to have own personal space and independence Figure 5. Importance of dignity by gender.

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 Discussion
Table 3. Cross tabulation for gender The research indicates that patients have strong views on
and dignity importance (n=40) privacy and dignity, how they are being compromised in
the clinical environment, and what can be done to remedy
Dignity the problem. The results suggest that while patients’ views
Count 1.00 2.00 Total
about privacy and dignity vary somehow, both are of great
importance to them. In defining privacy and dignity the
Gender Female 6 3 9
patients’ views showed some overlap in the way they defined
Male 25 6 31
both concepts, suggesting some support for the view that
Total 31 9 40 privacy and dignity are interlinking concepts (Woogara,
2005). The present study supports Burden’s (1998) views that
1.00 = Very important; 2.00 = Important
the definition of privacy is fraught with problems.
Respondents demonstrated understanding of what privacy
meant to them. A prominent view is that both male and female
Table 4. Cross tabulation for sensitive patients value their privacy, in terms of information privacy,
issue by gender privacy of body, exerting control over ones care, gaining
respect, having the right to be alone and having one’s own
personal space respected.With regard to privacy of information,
Sensitive issue need
Count No Yes Total patients expressed anxiety about their visitors reading their files.
Healthcare professionals need to be sensitive about patients’
Gender Female 8 1 9 anxieties and take steps to safeguard their documents from
Male 20 11 31 visitors. Medical staff also need to demonstrate empathy,
Total 28 12 40 addressing themselves to the question: ‘how would I feel lying
in bed looking at my visitors reading my nursing notes?’ In the
ward where this research was carried out, it was observed that
Privacy and dignity compromised on the front of each patient’s folder is a ‘NO ENTRY’ sign that
Participants were asked dichotomous questions, and within these requires permission from patients before their notes are read. In
they were free to choose their preferred alternative answers. reality, however, some of the respondents stated that they would
Additionally, they were required to give brief explanations find it difficult to stop family members reading their nursing
for their chosen answers. Analysis of the responses suggests notes. This care policy perhaps needs re-evaluating.
that patients have concerns about the inability of the ward’s Patients expressed anxiety that verbal exchanges (e.g. during
layout to permit confidential exchange of information. Some bedside handovers) could be overheard and felt that this
patients stated that their business was discussed in the presence intruded on their rights to privacy and respect. Greaves (1999)
of others. Some respondents felt that the screens/curtains were argues that nursing care handover should be managed just as
often inadequate to guarantee physical and auditory privacy confidentially as diagnosis as this is private to each patient.
and furthermore indicated that bathrooms did not always Privacy of information and the maintenance of dignity are
provide total privacy nor allowed dignity to be upheld: major issues given that both the Data Protection Act 1998 and
the Human Rights Act 1998 (Article 8) recognize patients’
‘Personal health issues discussed in front of rights to have their privacy respected. These justified patient
visitors and patients.’ (P7) concerns have serious implications for clinical practice standards
and therefore healthcare staff need to exercise sensitivity.
‘That the physical environment over which, as
Respondents also felt that in some cases screens and curtains
a patient, I have virtually no control is properly
provided visual but not auditory privacy, a point borne out
managed so as not to increase my anxiety. The
by the work of Barlas et al (2001), who found that solid walls
proximity of other patients means privacy is
were far more effective than curtains in providing auditory
almost non-existent.’ (P13)
and visual privacy. One may pose the question: to what extent
‘Design of bath area with basin next to an open are healthcare workers aware of such anxiety in patients and
door.’ (P15) the fact that curtains do not by themselves secure patients the
privacy they are entitled to? The view that curtains between
‘Because the wards are not that large you hear all
and around beds do not by themselves provide patients the
that is said, there is only a curtain between.’ (P17)
privacy they need is shared by Scott (1997), who argues that
‘These were not direct conversations with me but curtains alone are not the answer. Scott goes on to argue there
overhead from nursing staff.’ (P18) needs to be widespread education to ensure that healthcare
professionals achieve the requirements of the Charter Standards
‘Regarding close proximity of other patients is
relating to privacy and dignity. If respondents’ concerns are
there a potential for cross-infection with patients
borne out by a widespread reality, then healthcare staff leave
so close?’ (P27)
themselves open to litigation for breach of confidentiality
‘Medical opinion expressed in hearing of other and privacy. In terms of nurses, their professional code of
patient.’ (P40) conduct stipulates the need to respect patients’ privacy, consent

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and confidentiality (Nursing and Midwifery Council, 2004).
Healthcare professionals should realize that even though
disclosure of confidential information may be an unwitting act
on their part, they may still be liable for breach of confidence,
and for failure to respect patients’ right to confidentiality.
Of particular interest is that although the respondents were
fairly positive about their ward’s ability to respect their privacy
and dignity, their theoretical conceptualization of patient
privacy and dignity reveals their deep-seated fear that their
sick-role disposition leaves them vulnerable. Chochinov et al
(2002a; b) support this finding that healthcare professionals
need to be sensitive to the need for patient dignity,
demonstrating levels of skills that reflect how they would like
to be treated even in the end-of-life situation.
At a theoretical and conceptual level of definition, some
of the positive ways the respondents characterized patient
privacy and dignity (and the preconditions for their reality
within the ward) were not always borne out by some of
the activities within their ward. This made the researchers
postulate that in the non-threatening and ‘safe’ theoretical
zone, the patients were actually being critical of some of the
ward’s shortcomings in its ability to maintain their privacy
and dignity. If the researchers’ analysis of the results is accurate,
and reflects what the patients in the study actually feel, even if
not what they overtly expressed, then the conclusion may be
drawn that at a psychological level some of the patients saw
their privacy and dignity being compromised in hospital.
Previous research about patients in rehabilitation care
settings relate how nurses perceive the challenges faced in
ensuring patients’ dignity (Stabell and Naden, 2006). Similar
challenges also arose in earlier studies by Gallagher and
Seedhouse (2002) and Jacelon (2003) regarding patients’
needs and the strategies they used to affirm their dignity. The
most important findings of these studies is the view expressed
by patients that in the presence of adequate staffing the
conditions that foster privacy and dignity were more likely to
be in place. Research findings related to inadequate provision
for patients’ privacy and dignity are worrying as it is now
many years since the publication of the Essence of Care (DH,
2001), Privacy and Dignity for Hospital Patients (DH, 1997a)
and The Patients Charter: Privacy and Dignity and the Provision
of Single-Sex Hospital Accommodation (DH, 1997b). Although
a previous study (Woogara, 2005) of patients’ privacy in the
NHS adopted a different methodology to the present research
and had taken place in different clinical settings, both studies
have identified that there are some cases where healthcare
staff and ward designs are compromising patients’ privacy
and dignity. All healthcare professionals need to address the
problem even if at present it is not obviously bad.
The present research is the only one the authors are aware of
that has shown patients also define privacy and dignity in terms
of their right to creating conditions for them to worship. With
respect to patients’ definition of privacy and dignity the present
study suggests that it is difficult to establish straightforward,
single and narrow definitions of patient privacy and dignity.
Both privacy and dignity share some common and overlapping
characteristics and are therefore closely intertwined.
The literature relating to patients’ privacy and dignity suggest
that these issues are sparking debate in many circles, as well as
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PATIENT WELFARE
promoting government initiatives. Foss (2006) points out that
the Government has decided to impose a new duty on nurses,
that of the ‘dignity nurse’, and criticized the move on the basis
that all nurses have a responsibility to promote patient privacy
and dignity. Moreover, having a ‘dignity’ nurse insults all nurses,
all of whom should possess capacity and readiness to promote
privacy and dignity in all aspects of care. Creating another tier
of healthcare professionals under the title of ‘dignity nurses’
would be a waste of resources, argues Foss (2006).
The study demonstrates that admission to hospital leaves
patients feeling vulnerable and open to medical scrutiny, which
may cause a loss of privacy and dignity, a finding supported
by Doyal (1997), McParland et al (2000) and Leino-Kilipi et
al (2001). It is hoped that the findings of the present study
will help healthcare professionals develop clear, sensitive
understanding of how privacy and dignity are viewed by
patients, how they may be compromised, or how they may be
promoted in the clinical environment. Healthcare staff who fail
to promote patients’ privacy and dignity are contributing to
an unnecessarily high level of patient stress and anxiety, which
may force patients to make complaints against Trusts that they
may not have otherwise done. Clearly, if patients are distressed
over the level of privacy provided to them, this will adversely
affect their recovery. Moreover, this would impact negatively
on their perception of their Trust. It must be encouraging to
healthcare staff to realise that respect for privacy and dignity
brings improvements in care standards (Woogara, 2001).
Patients’ experience of privacy and dignity
on a mixed sex ward
Despite the recommendation by the DH (1997a; b; 2005)
for separation of male and female patients and for single sex
occupancy bays, the findings from this study revealed that
52.5% of the respondents were neither happy nor unhappy
being nursed on a mixed sex ward:
‘I could see by the quantity of patients there was
no alternative to the situation.’ (P32)
‘I thought it was general policy to have mixed sex
wards, but in my ward the best efforts had been
made to achieve separation.’ (P40)
Given that the mixed sex ward was not viewed as particularly
problematic by 52.5% of the sample leads one to conclude
that perhaps modern planners and designers of hospitals ought
to stress to government the need to commission hospital
designs that would suit the differing views and needs of the
patients who would occupy them. Hospitals made up purely
of single rooms may not be the answer since some patients
may prefer to be with others in bays, and value togetherness.
Patients should have a choice between single rooms and bays.
If modern hospital designs cater for a substantial number of
single rooms then this would be ideal not only to afford better
privacy, but would be more effective at controlling infection
and promoting sleep.
Recommendations for future research
The authors hope that the current findings will not only
be read by healthcare professionals but will stimulate debate.
463
 There is a need for more research on what hospital ward
designs patients would prefer, since there are bound to be
patients who would abhor the thought of being nursed in a
mixed bay of strangers, regardless of gender, especially when
they are very ill, perhaps dying or suffering from illnesses that
remove their ability to wash, dress and maintain other facets
of their privacy and dignity. From the researchers’ clinical
experience there are patients who often express the need to be
with others for various reasons, not least for companionship,
to kill boredom and promote recovery. Before any full scale
move to single room designs, further research is indicated. As
Britain’s healthcare population becomes more multiethnic and
multicultural, this will impact on patients’ perceptions of their
privacy and dignity needs. Research is required to find the
most ideal formulae for hospital designs capable of delivering
privacy and dignity under a multicultural scale.
Finally, given that the authors acknowledge that the present
research is on a small scale, and has focused only on a small
sample of coronary artery bypass patients, thus limiting
generalizability, then perhaps future researchers may wish
to replicate this study with larger samples of the same client
group, as well as other client groups.
Conclusion
This study has highlighted the importance of privacy and
dignity from the patient’s perspective. While it would be
unusual for a study of this size to reveal ground-breaking
findings, the views and opinions expressed by the participants
are worth considering if healthcare professionals are to improve
standards of care by promoting privacy and dignity within all
spheres of clinical practice.
There is no doubt that the notion of privacy and dignity
are interrelated, and as such there is no straightforward and
simplistic definition of either concept. Whatever gender,
patients value their privacy and dignity highly, and wish that
healthcare professionals will do their best to promote both.
They are aware that in some cases their rights to personal
privacy and dignity are sometimes compromised, sometimes
with the patient’s best interest in mind, and they have some
sympathy for this. Nevertheless, patients feel strongly that
KEY POINTS
n This article indicates that more research and critical thinking needs to be put
into strategic hospital planning, design and building.
n United Kingdom Government policies, research and law call for a shift from
mixed bays to single rooms to achieve patients’ privacy.
n Self-report questionnaires comprising closed and open questions (with
scope for the patient’s own narrative), can successfully explore patients’
conceptualization of privacy and dignity.
n Patients value their privacy highly, females more than males, and both have
definite views how clinical staff can best meet their privacy and dignity needs.
n This article contributes to existing research-generated knowledge about patients’
privacy and dignity and adds to the debate by reviewing the literature.
464
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stringent sensitivity to guarantee them privacy and dignity to
which they are entitled. This does not imply purely single
room designs, but other considerations such as patients’
individual and sociocultural characterization of privacy and
dignity. Staff development of nurses and other healthcare
professionals must also concentrate on the most effective ways
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British Journal of Nursing, 2008, Vol 17, No 7