The missing metric: Why dignity must be measured in chronic illness and long-term care

Dignity is widely recognised as a fundamental principle of person-centred healthcare, yet it remains rarely measured as a patient-reported outcome in routine clinical practice. This opinion article argues that dignity should be systematically assessed in chronic illness and long-term care, where prolonged interactions with healthcare systems can profoundly influence patients' autonomy, identity, and quality of life. Drawing on theoretical and empirical evidence, the article highlights the relevance of dignity beyond palliative care and discusses its potential role as both a Patient-Reported Outcome (PRO) and a nursing-sensitive outcome. Integrating dignity into healthcare evaluation frameworks could strengthen person-centred care, support Value-Based Healthcare, and promote accountability for outcomes that matter most to patients. Recognising and measuring dignity is presented as a necessary step toward ensuring that healthcare systems preserve not only clinical effectiveness but also the human experience of ageing and chronic illness.