Relational autonomy in pediatric healthcare: A scoping review
Bibliographic record
Abstract
BackgroundThe concept of relational autonomy has gained popularity for accentuating the social embeddedness of autonomy. In pediatrics, relational autonomy provides a framework for conceptualizing the complexities of healthcare processes, such as shared decision-making and children's transitions to adult care systems. However, a lack of clarity exists regarding how to define and operationalize relational autonomy in pediatric healthcare. To our knowledge, no reviews of literature have been conducted to better understand this concept in pediatrics and guide further research.Research AimThe purpose of this scoping review was to describe literature focusing on relational approaches to autonomy in the context of pediatric healthcare.Research designA scoping review methodology proposed by Arksey and O'Malley and the Joanna Briggs Institute guided this review. Seven databases were searched for literature published between 2004 and 2024. Out of 2895 potentially relevant publications, a total of 28 articles were included for review.Ethical ConsiderationsThis study was conducted and reported in accordance with recognized scientific scoping review guidelines.FindingsVarious terms were used to describe relational approaches to autonomy in pediatrics. These terms shared a common goal of promoting a more holistic view of children and their decision-making processes in pediatric care. Most articles relied on adult perspectives (e.g., caregivers and healthcare providers) to shed light on shared decision-making processes. The perspectives of children and nurses were underrepresented in the literature, especially in the context of the Global South.ConclusionAdditional research is needed to capture the lived experiences of a wider range of individuals with developing and exercising autonomy using diverse research methods. As the perspectives of nurses and children remain excluded from literature, new knowledge on their experiences with autonomy can inform the delivery of care that is ethically and morally sound.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.003 | 0.012 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".