Dignity in the Pediatric Population: A Systematic Review.

1. Participants will be able to describe the intricacies of dignity-centered care in pediatrics and develop strategies to maintain and enhance dignity in the pediatric population. 2. Participants will be able to explain gaps in measurement or assessment tools specific to dignity-centered care in pediatrics and propose strategies to address existing gaps. In this systematic review, we synthesize existing literature to describe how dignity is conceptualized, defined, measured, and assessed in the field of pediatrics. Central themes emerged surrounding communication, autonomy, privacy, and respect, with current scholarship focused on dignity therapy and end of life care. We highlight further opportunities for standardized approaches to advance the science and practice of dignity-centered care. Children are a uniquely vulnerable patient population with restricted abilities for self-advocacy in the context of limited autonomy and evolving developmental stages. While greater literature focuses on dignity in adult populations, the meaning, purpose, and actualization of dignity in the field of pediatrics remains under-explored. We aimed to review existing literature to characterize and report how dignity is conceptualized, defined, measured, and assessed in pediatrics. Following PRISMA guidelines, we conducted a systematic review of the literature searching seven databases from inception until April 2023. Eligible articles were published in English, involved children aged 0-18 years, and prioritized dignity as a central theme with a focus on defining, measuring, or evaluating dignity. The searches yielded a total of 5,482 citations across databases; 44 articles met inclusion criteria, with less than half comprising original research (20/44, 45.5%). Articles spanned broad topics across healthcare (39/44, 88.6%), education (6/44, 13.6%), legal (4/44, 9.1%), and ethics (19/44, 43.2%) domains. Most articles (38/44, 86.4%) included some description of the meaning of dignity in pediatrics, with emergence of salient themes around communication, autonomy, privacy, and respect. Less than half (19/44, 43.2%) of articles included a measurement or assessment of dignity, of which approximately one-third focused on dignity therapy (7/19, 36.8%). A sizable minority of studies centered on palliative/hospice (15/44, 34.1%) and end of life (17/44, 38.6%) concepts. This systematic review of the literature spotlights a relative lack of scholarship on dignity in pediatrics, including lack of consensus on a definition for dignity and actionable opportunities to improve standardized outcome metrics and assessment tools to advance dignity-centered care for children and adolescents. Partnership with pediatrics stakeholders should inform future work to co-design and test novel pediatric-specific interventions to strengthen dignity-centered care for children and families. Existential / Humanities / Spirituality / Religion / Managing Suffering and Distress [ABSTRACT FROM AUTHOR]