Children's participation in the decision-making process during hospitalization: an observational study

Area of Science:

• Pediatric Healthcare
• Medical Ethics
• Patient Autonomy

Background:

• Children's involvement in healthcare decisions is crucial for their well-being.
• Understanding the extent of pediatric participation in medical decision-making is essential.

Purpose of the Study:

• To describe the degree of children's participation in decisions regarding their own healthcare.
• To assess optimal participation levels and compare them with actual involvement.
• To explore interactions between children, parents, and healthcare staff during decision-making.

Main Methods:

• Observation of 24 pediatric patients (5 months to 18 years) over 135 hours in a university hospital.
• Utilized a 5-point scale to grade children's participation in healthcare decisions.
• Assessed optimal participation levels for each situation.

Main Results:

• Children were not consistently involved in decision-making to the optimal extent.
• Parents sometimes failed to support children in challenging situations.
• Healthcare staff often informed children without offering alternatives or seeking their input.
• No child was forced into decisions beyond their capacity.

Conclusions:

• Children's participation in healthcare decisions is often suboptimal.
• Healthcare professionals must recognize children as autonomous individuals.
• Facilitating children's participation in healthcare decisions is a core duty for staff.