Promoting the Dignity of the Child in Hospital

Abstract

This article aims to deconstruct the concept of dignity in a way that is meaningful, in particular to nurses and other health workers who seek to promote the dignity of children in their care. Despite the emphasis in a variety of codes and policies to promote dignity, there is a lack of a clear definition of dignity in the literature. In particular there is little reference to dignity, theoretically or empirically, as it relates to children. Without clarity it is not possible to act in an ethical way on behalf of children whose dignity could otherwise be compromised. The theoretical position taken has evolved from the medico-nursing and philosophical discourse concerning the nature of human dignity and more recent sociological texts that discuss the social construction of the child and childhood. The article is further influenced by additional insights derived from an ethnographic pilot study at a large district general hospital. This study was undertaken in an attempt to appreciate the subjective experience of dignity by children, and to begin to address the empirical gap in the literature and promote discussion. The concept of a macro and a micro dignity is discussed, together with the role of the nurse in articulating the relationship between the two. The importance of control and witnesses in the experience of dignity is discussed and, finally, also the ethical implications when seeking to promote the dignity of children.

Editorial: What do we know about dignity in care?

“…[10][11][12][13][14][15][16][17] These qualitative studies have provided in-depth perspectives from patients and nurses regarding what dignity means and how it is experienced by younger and older patients and care home residents. The factors suggested in other empirical studies that have the potential to promote or diminish patient dignity in care are: staff attitudes and behaviour; the physical care environment; and organizational culture.…”

Mothers’ and health workers’ perceptions of participation in a child-friendly health initiative in rural South Africa

“…Many barriers to implementing child-friendliness were highlighted, mainly resulting from the great burden of HIV and tuberculosis at the clinics, leading to inadequate space for additional activities, and exhausted health staff [8,9]. These high levels of occupational stress have not only been reported in high HIV prevalence countries including South Africa [9] and Uganda [8] but also resource-rich settings including England [38]. The problem of dealing with painful procedures was also identified, with participants suggesting that children themselves can present barriers to engaging with health staff because of their innate fear of PHCs, something highlighted in previous research [10,21,22,24,39,40].…”

Exploring children’s dignity: A qualitative approach

“…Although Researchers have confirmed Erikson's notion that feelings of competence and personal esteem are very importance for a child's well-being (18,19) but studies have shown that children are not treated with respect, courtesy and sensitivity (20). Reed et al (2003) studied dignity of children and points out that they are often less valuable than adults. Lack of privacy in hospital, the loss of control of body functions and the risk of exposure in front of others, all of them were identified as threatening children's dignity (21).…”

“…Hospitalization is a stressful experience for children and their parents and can greatly influence their self-esteem (10). Hospitalization to this age may cause negative changes and endanger the health of children and increase the need for security (11). Several studies have shown that, despite the age and increased mastry, school age children fear and worry about illness, hospitalization and loss of control and self-determination (12).…”