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Children’s active participation in decision-making processes during hospitalisation: an observational study

Afua Quaye, Angela LU ; Coyne, Imelda ; Söderbäck, Maria and Kristensson Hallström, Inger LU (2019) In Journal of Clinical Nursing 28(23-24). p.4525-4537
Abstract
Aims and objectives

The aim was to explore and describe the child's active participation in daily healthcare practice at children's hospital units in Sweden.
Objectives

(a) Identify everyday situations in medical and nursing care that illustrate children's active participation in decision‐making, (b) identify various ways of active participation, actual and optimal in situations involving decision‐making and (c) explore factors in nursing and medical care that influence children's active participation in decision‐making.
Background

Despite active participation being a fundamental right for children, they are not always involved in decision‐making processes during their health care. There still remains... (More)
Aims and objectives

The aim was to explore and describe the child's active participation in daily healthcare practice at children's hospital units in Sweden.
Objectives

(a) Identify everyday situations in medical and nursing care that illustrate children's active participation in decision‐making, (b) identify various ways of active participation, actual and optimal in situations involving decision‐making and (c) explore factors in nursing and medical care that influence children's active participation in decision‐making.
Background

Despite active participation being a fundamental right for children, they are not always involved in decision‐making processes during their health care. There still remains uncertainty on how to support children to actively participate in decisions concerning their health care.
Design

A qualitative study with overt, nonparticipant observations fulfilling the COREQ checklist criteria.
Methods

Observations of interactions between children aged 2 and 17 years with both acute and chronic conditions, their parents, and healthcare professionals were conducted at three paediatric hospitals in Sweden. The Scale of Degrees of Self Determination was used to grade identified situations. The scale describes five levels of active participation, with level one being the least and level five being the most active level of participation. Normative judgements were also made.
Results

Children's active participation was assessed as being generally at levels four and five. Children demonstrated both verbal and nonverbal ways of communication during decision‐making. Findings indicated that children's, parents' and healthcare professional's actions influenced children's active participation in decision‐making processes involving healthcare.
Conclusions

Healthcare professionals specialised in paediatrics need to embrace both a child perspective and a child's perspective, plan care incorporating key elements of a child‐centred care approach, to ensure children's active participation at a level of their choosing.
Relevance to clinical practice

There is a need for awareness creation to help healthcare professionals facilitate children's active participation in their care and decision‐making.
(Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Nursing
volume
28
issue
23-24
pages
4525 - 4537
publisher
Wiley-Blackwell
external identifiers
  • scopus:85074673633
  • pmid:31430412
ISSN
1365-2702
DOI
10.1111/jocn.15042
project
LUC3 - Lund University Child Centered Care
Knowledge development and translation in implemented CCC
language
English
LU publication?
yes
id
c5572e45-3536-4c7b-abdd-a4c9f771a266
date added to LUP
2019-06-19 11:31:56
date last changed
2022-10-30 22:41:39
@article{c5572e45-3536-4c7b-abdd-a4c9f771a266,
  abstract     = {{Aims and objectives<br/><br/>The aim was to explore and describe the child's active participation in daily healthcare practice at children's hospital units in Sweden.<br/>Objectives<br/><br/>(a) Identify everyday situations in medical and nursing care that illustrate children's active participation in decision‐making, (b) identify various ways of active participation, actual and optimal in situations involving decision‐making and (c) explore factors in nursing and medical care that influence children's active participation in decision‐making.<br/>Background<br/><br/>Despite active participation being a fundamental right for children, they are not always involved in decision‐making processes during their health care. There still remains uncertainty on how to support children to actively participate in decisions concerning their health care.<br/>Design<br/><br/>A qualitative study with overt, nonparticipant observations fulfilling the COREQ checklist criteria.<br/>Methods<br/><br/>Observations of interactions between children aged 2 and 17 years with both acute and chronic conditions, their parents, and healthcare professionals were conducted at three paediatric hospitals in Sweden. The Scale of Degrees of Self Determination was used to grade identified situations. The scale describes five levels of active participation, with level one being the least and level five being the most active level of participation. Normative judgements were also made.<br/>Results<br/><br/>Children's active participation was assessed as being generally at levels four and five. Children demonstrated both verbal and nonverbal ways of communication during decision‐making. Findings indicated that children's, parents' and healthcare professional's actions influenced children's active participation in decision‐making processes involving healthcare.<br/>Conclusions<br/><br/>Healthcare professionals specialised in paediatrics need to embrace both a child perspective and a child's perspective, plan care incorporating key elements of a child‐centred care approach, to ensure children's active participation at a level of their choosing.<br/>Relevance to clinical practice<br/><br/>There is a need for awareness creation to help healthcare professionals facilitate children's active participation in their care and decision‐making.<br/>}},
  author       = {{Afua Quaye, Angela and Coyne, Imelda and Söderbäck, Maria and Kristensson Hallström, Inger}},
  issn         = {{1365-2702}},
  language     = {{eng}},
  number       = {{23-24}},
  pages        = {{4525--4537}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Clinical Nursing}},
  title        = {{Children’s active participation in decision-making processes during hospitalisation: an observational study}},
  url          = {{http://dx.doi.org/10.1111/jocn.15042}},
  doi          = {{10.1111/jocn.15042}},
  volume       = {{28}},
  year         = {{2019}},
}