Training healthcare professionals to dignity-in-care: A scoping review

Despite the wealth of evidence-based practices attesting to the influence of patient dignity on the care relationship, gaps persist in healthcare professionals' abilities to bolster it. Promoting dignity-in-care poses a challenge due to the abstract nature of the concept and its lack of unequivocal definition.

To delineate the scope of training opportunities, identify gaps in dignity-in-care training, excluding the broader concept of dignity beyond healthcare assistance, and propose strategies to address these deficiencies.

Systematic scoping review to determine the range and type of training opportunities for healthcare professionals.

We followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-ScR guidelines. By February 10th 2023, we searched five databases (MEDLINE, Scopus, Embase, Cinahl, PsycINFO) for materials published from 2002 in English and Italian. In addition to the search strategy, we augmented our exploration by scrutinizing the references cited in the included papers. Our scope encompassed studies on healthcare professionals as the target population, specifically physicians, nurses, social workers, psychologists, occupational therapists, chaplains or spiritual care assistants, and students engaged in health-related disciplines.

Two authors independently assessed the abstracts of the retrieved articles. They discussed discrepancies with a third researcher, an expert in qualitative methodology.

Eleven articles were included in the analysis after the initial screening. Most of the studies were conducted in Europe, indicating an increasing interest in training on dignity and suggesting a potential role of international nursing organizations in driving attention to dignity-in-care education. The training appeared to downplay cultural differences. However, these approaches were not without criticism, as they raised concerns about overlooking the complexities and nuances associated with dignity within cultural contexts. Our analysis suggested that incorporating dignity into the curriculum and continuing education for healthcare professionals is paramount. Finally, limited opportunities emerged for medical students, postgraduate residents, and physicians to enhance dignity within care relationships.

Future training programs should prioritize "culturalizing" the concept to ensure a comprehensive approach to dignity-in-care. Moreover, the focus on nursing students and limited representation from other healthcare disciplines emphasizes the need for a broader interdisciplinary approach to integrating dignity-in-care education.