Exploring children’s dignity: A qualitative approach
More details
Hide details
Nursing PhD Candidate, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
PhD, Associated Professor, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
PhD, Professor, Behavioral Sciences Research Center, Nursing Faculty of Baqiyatallah University of Medical Sciences, Iran
Shiraz University of Medical Sciences, Iran
Online publication date: 2018-08-08
Publication date: 2019-04-22
Electron J Gen Med 2019;16(2):em129
Background and Objective:
Children’s rights to good health care are enshrined in various publications and policy documents. The maintenance of human dignity is recognized as a core value in foundational to human rights. Although it has been studied extensively from adult patients perspective, there are few studies of dignity in relation to school age children, generally or in relation to health care. This paper explores school age childeren,s and parents perceptions of children’s, dignity.

Materials and Methods:
A conventional qualitative content analysis method was used to explore the meaning of hospitalized childrens’ dignity. Hospitalized children and parents in general medical and surgical pediatric units were eligible to participate. Data were obtained through unstructured interviews. Purposive sampling was used and school age children and parent were recruited until data saturation was reached (n =20, 12 children and 8 parent).

Hospitalized children and parents in general medical and surgical pediatric units were eligible to participate. Data were obtained through unstructured interviews. Purposive sampling was used and school age children and parent were recruited until data saturation was reached (n =20, 12 children and 8 parent). Ethical approval for the study was granted by the Ethics Committee of Shiraz University of Medical Sciences. Participants were provided with information about the purpose, reasons for recording interviews, voluntary participation, and confidentiality of data and interviewees. Dignity was reflected in three themes (1) Respect for the child (2) protection of personal privacy (3) family center communication.

Hospitalized childrens and parents stated that healthcare services should Respect for the child and protect their personal privacy. Also, they should communicating with the child and their parents to provide dignity. School age is a discrete developmental stage, with specific healthcare needs which must be addressed effectively by healthcare providers.

Mann J. Dignity and health: the UDHR’s revolutionary first article. Health Hum. Rights 1998;3:30–8. https://doi.org/10.2307/406529... PMid:10343291.
Jacobson N. Dignity and health: a review. Soc. Sci. Med. 2007;64:292–302. https://doi.org/10.1016/j.socs... PMid:17034918.
Feldman D. Human dignity as a legal value: part 1. Public Law 1999;(Winter):682–702.
Manookian A, Cheraghi MA and Nasrabadi AN. Factors influencing patients’ dignity: a qualitative study. Nurs Ethics 2014;21(3):323–334. https://doi.org/10.1177/096973... PMid:24077096.
Royal College of Nursing (2008) Defending Dignity: Opportunities and Challenges for Nursing. RCN, London.
Borhani F, Abbaszadeh A and Moosavi S. Status of human dignity of adult patients admitted to hospitals of Tehran. J Med Ethics Hist Med. 2014;7:20.
Griffin-Heslin VL. An analysis of the concept dignity. Accid Emerg Nurs. 2005;13(4):251–257. https://doi.org/10.1016/j.aaen... PMid:16298291.
Wilkinson JM, Leuven K. Fundamentals of nursing: theory, concepts and applications (vol. 1). Philadelphia, PA: F. A. Davis Company. 2006:912–913.
Eccles JS. The Development of Children Ages 6 to 14. The Future of Children When School is Out. 1999;9(2).
Ball JW, Bindler RM, Cowen KJ. Principles of Pediatric Nursing: Caring for Children. Boston: Pearson. 2015.
Reed P, et al. Promoting the dignity of the child in hospital. Nursing Ethics. 2003;10(1):67-76. https://doi.org/10.1191/096973... PMid:12572762.
Barnes CM, Bandak AG, Beardslee CI. Content Analysis of 186 Descriptive Case Studies of Hospitalised Children. Maternal–Child Nursing Journal. 1990;19(2):281–96. PMid:2136580.
Duzkaya DS, Uysal G, Akay H. Nursing perception of the children hospitalized in a university hospital. Procedia-Social and Behavioral Sciences. 2014;152:362–367. https://doi.org/10.1016/j.sbsp....
Council of Europe. European Convention on the Exercise of Children’s Rights. Strasbourg 25. I. European Treaty Series/160, Strasbourg. 1996.
Council of Europe. Convention for the Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine. Oviedo 4. IV. European Treaty, Strasbourg. 1997.
United Nations. Convention on the Rights of the Child. Available from: www.unicef.org/crc/ (Last accessed: January 28 2009.Wiley, 1998. 1989:553–618.
Department of Health. National Service Framework for Children, Young People and Maternity Services. Core standards. DH, London. 2004.
Eccles JS, Wigfield A, Schiefele U. Motivation to succeed. In Handbook of child psychology, 5th edition: Vol. 3, Social, emotional, and personality development. W. Damon and N. Eisenberg, eds. New York: Wiley, 1998:1017–95.
Harter S. The development of self-representation. In Handbook of child psychology, 5th edition: Vol. 3, Social, emotional, and personality development. W. Damon and N. Eisenberg, eds. New York:.
Rylance G. Privacy, dignity and confidentiality: interview study with structured questionnaire. BMJ. 1999;318:301. https://doi.org/10.1136/bmj.31... PMid:9924057 PMCid:PMC27713.
The Concept of Hospitalization of Children from the View Point of Parents and Children Kokab Bsiri-Moghaddam, Mahdi Basiri-Moghaddam, Leila Sadeghmoghaddam; Fazlollah Ahmadi. Iran J Pediatr Jun 2011;21(2):201-208. PMid:23056788 PMCid:PMC3446164.
Lambert V, Coad J, Hicks P, et al. Young children’s perspectives of ideal physical design features for hospital-built environments. Journal of Child Health Care. 2014;18(1):57–71. https://doi.org/10.1177/136749... PMid:23423998.
Milton CL. The ethics of human dignity: a nursing theoretical perspective. Nursing Science Quarterly. 2008;21(3):207-10. https://doi.org/10.1177/089431... PMid:18544780.
Lerwick JL. Psychosocial implications of pediatric surgical hospitalization. In Seminars in Pediatric Surgery. 2013;22(3):129–33. https://doi.org/10.1053/j.semp... PMid:23870205.
Calnan M, Tadd W. Dignity and older Europeans: methodology. Qual. Ageing Policy Pract. Res. 2005;6:10–16. https://doi.org/10.1108/147177....
Sensen O. Human dignity in historical perspective: the contemporary and traditional paradigms. Eur J Polit Theor 2011;10(1):71–91. https://doi.org/10.1177/147488....
Baillie L. Patient dignity in an acute hospital setting: A case study. Int J Nurs Stud. 2009;46(1):23-37. https://doi.org/10.1016/j.ijnu... PMid:18790477.
Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107–15. https://doi.org/10.1111/j.1365... PMid:18352969.
Patton MQ. Qualitative Research & Evaluation Methods. Thousand Oaks, London, New Delhi: Sage Publications. 2002:348–54.
Hetherington EM, Parke RD. Child Psychology: a Contemporary Viewpoint (3rd edn). New York: McGraw Hill. 1986.
Elo S, Kääriäinen M, Kanste O, et al. Qualitative content analysis: a focus on trustworthiness. Sage Open 2014; https://doi.org/10.1177/215824....
Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open 2016;2:8–14. https://doi.org/10.1016/j.npls....
Lincoln YS, Guba EG. Naturalistic inquiry. Newbury Park, CA: Sage, 1985.
Ferri P, Muzzalupo J, Di Lorenzo R. Patients’ perception of dignity in an Italian general hospital: a cross-sectional analysis. BMC Health Serv Res 2015;15(1):41. https://doi.org/10.1186/s12913... PMid:25627836 PMCid:PMC4312597.
Alderson P. Children’s Consent to Surgery. Open University Press, Buckingham. 1993.
Coyne I. Consultation with children in hospital: children, parents’ and nurses’ perspectives. J Clin Nurs. 2006;15(1):61–71. https://doi.org/10.1111/j.1365... PMid:16390525.
Canadian Paediatric Society. Treatment decisions regarding infants, children and adolescents. Paediatr Child Health. 2004;9(2):99-114. https://doi.org/10.1093/pch/9.....
Parsapoor A. Parsapoor MB, Larijani B. Informed consent, contents, conditions and practical methods. Iran J Diab Lipid Disord. 2005;5(Supp:1):1-15. [in Persian].
Cahill P, Papageorgiou A. Video analysis of communication in paediatric consultations in primary care. Br J Gen Pract. 2007a;57:866-71. https://doi.org/10.3399/096016....
Findlay S, Pinzon J, Goldberg E, et al. Issues of care for hospitalized youth. Paediatr Child Health. 2008;13(1):61–4. https://doi.org/10.1093/pch/13....
Dawood M, Gallini A. Using discovery interviews to understand the patient experience. Nurs Manag. 2010;17(1):26-31. https://doi.org/10.7748/nm2010... PMid:20432643.
Matiti MR, Trorey GM. Patients’ expectations of the maintenance of their dignity. J Clin Nurs 2008;17(20):2709-17. https://doi.org/10.1111/j.1365... PMid:18808639.
Heijkenskjold KB, Ekstedt M, Lindwall L. The patient’s dignity from the nurse’s perspective. Nurs Ethics 2010;17(3):313-24. https://doi.org/10.1177/096973... PMid:20444773.
Walsh K, Kowanko I. Nurses’ and patients’ perceptions of dignity. Int J Nurs Pract. 2002;8(3):143–51. https://doi.org/10.1046/j.1440... PMid:12000633.
Barksdale DJ. Provider factors affecting adherence: cultural competency and sensitivity. Ethn Dis. 2009 Autumn; 19(4 Suppl 5):S5-3-7. PMID: 20077597.
Pearson OBA, Hall P. Culture and Language. http://www.eduction.com/refere... Published July 19, 2013. Accessed September 28, 2013.
Wechter S. School-age children’s perceptions of stress in the hospital: A draw and tell story (Conference Paper • April 2013).
Lin Y-P, Tsai Y-F. Maintaining patients’ dignity during clinical care: a qualitative interview study. Journal of Advanced Nursing. 2010;67(2):340–8. https://doi.org/10.1111/j.1365....
Scott P, Vlimki M, Leino-Kilpi H, et al. Autonomy, privacy and informed consent 1: concepts and definitions. Br J Nurs. 2003;12(1):43–7. https://doi.org/10.12968/bjon.... PMid:12574725.
Jamalimoghadam N, Yektatalab SH, Momennasab M, et al. Hospitalized adolescents’ perception of dignity: A qualitative study. Nursing Ethics. 2017;14(1). https://doi.org/10.1177/096973....
Woolhead G, Tadd W, Boix-Ferrer JA, Krajcik S, Schmid-Pfahler B, Spjuth B, Stratton D, Dieppe P. “Tu” or “Vous?” A European qualitative study of dignity and communication with older people in health and social care settings. Patient Educ Couns. 2006;61(3):363-71. https://doi.org/10.1016/j.pec.... PMid:15970421.
Smith L, Coleman V, Bradshaw M. Family centred care: concept, theory and practice. Basingstoke: Palgrave Macmillan, 2002.
Denney KM. Psychological distress and nursing for latino parents in neonatal intensive care: The contributing effects on parenting efficacy. A Dissertation for the degree of Doctor of Philosophy in Education. University of California. 2003.
Schor EL. American Academy of Pediatrics Task Force on the Family. Family pediatrics: report of the Task Force on the Family. Pediatrics. 2003;111:1541-71. PMid:12777595.
King A, Hoppe RB. “Best practice” for patient-centered communication: a narrative review. J Grad Med Educ. 2013;5:385-93. https://doi.org/10.4300/JGME-D... PMid:24404300 PMCid:PMC3771166.
Lundqvist A, Nilstun T. Human dignity in paediatrics: the effects of health care. Nursing Ethics. 2007;14(2):216-28. https://doi.org/10.1177/096973... PMid:17425150.
Simons J, Franck L, Robertson E. Parents involvement in children’s pain care: views of parents and nurses. Journal of Advanced Nursing. 2001;36:591–599. https://doi.org/10.1046/j.1365... PMid:11703554.
Hallström I, Runeson I, Elander G. An observation study of the level at which parents participate in decisions during their child’s hospitalization. Nursing Ethics. 2002;9(2):202–14. https://doi.org/10.1191/096973... PMid:11944209.
Journals System - logo
Scroll to top