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Table 3 PDI items considered to influence sense of dignity at the end of life by people with one or more advance directives from the Right to die-NL and people with a wish to live statement

From: Analysis of the construct of dignity and content validity of the patient dignity inventory

  Range of distribution
Mean (SD)
People with an advance directive from the Right to die-NL
n = 1947%*
People with a wish to live statement
n = 590%*
Physical aspects    
Not being able to independently manage bodily functions 3.7 (1.3) 73 41
Not being able to carry out tasks of daily living 3.4 (1.3) 58 28
Not being able to continue with usual routines 3.1 (1.2) 45 27
Experiencing distressing symptoms 3.1 (1.1) 37 31
Not being able to carry out important roles 2.7 (1.2) 29 19
Changes in physical appearance 2.2 (1.1) 12 18
Psychological aspects    
Not being able to think clearly 3.8 (1.2) 73 53
Not being able to mentally fight 3.6 (1.2) 61 38
Feeling depressed or anxious 3.3 (1.2) 51 42
Not being able to accept things the way they are 3.2 (1.3) 45 36
Social aspects    
Feeling a burden to others 3.8 (1.3) 74 50
Not being treated with respect or understanding 3.4 (1.3) 52 57
Feeling your privacy has been reduced 3.2 (1.2) 49 38
Not feeling supported by your community 3.2 (1.3) 43 48
Existential aspects    
Feeling you do not have control over your life 3.6 (1.3) 67 38
No longer feeling like who you were 3.5 (1.3) 59 45
Feeling life no longer has meaning or purpose 3.3 (1.4) 58 33
Not feeling worthwhile or valued 3.2 (1.3) 43 44
Not having a meaningful spiritual life 2.9 (1.4) 33 41
Uncertainty regarding illness 2.9 (1.2) 31 33
Not feeling you made a meaning or lasting contribution 2.6 (1.2) 23 21
  1. * Percentage that agree or strongly agree (scored a 4 or 5 on a 5-point scale) that the aspect influence the sense of dignity during the last phase of life
  2. ∞21 items are included because the item "Thinking how life might end" of the original PDI prototype was excluded from the current study as a result of a pilot study