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Perceptions of participation: child patients with a disability in the doctor-parent-child partnership
Belinda Garth1, Gregory C Murphy, Dinah S Reddihough
1School of Public Health, Faculty of Health Science, La Trobe University, Bundoora 3086, Victoria, Australia. B.Garth@latrobe.edu.au
Insights
Children contribute to the doctor-parent-child partnership, but their involvement varies. Understanding these complexities requires moving beyond dyadic models to embrace a social model of care for triadic partnerships.
Area of Science:
- Pediatric healthcare
- Family-centered care
- Qualitative research
Background:
- The traditional doctor-parent partnership often excludes the child.
- Understanding the child's role in healthcare decisions is crucial.
Purpose of the Study:
- To investigate the child's experience and contribution within the doctor-parent-child partnership.
- To explore how children with cerebral palsy participate in healthcare discussions.
Main Methods:
- Qualitative study utilizing semi-structured interviews.
- 33 participants: 9 pediatricians, 14 parents, 10 children (aged 8-12) with cerebral palsy.
- Data collected from a pediatric teaching hospital in Victoria, Australia.
Main Results:
- Children were reported to participate in the doctor-parent-child partnership.
- Child involvement was variable, not perceived as 'equal' or 'regular'.
- Key themes: creating space for involvement, acknowledging preferences, and negotiating age/developmental factors.
Conclusions:
- The doctor-parent-child partnership is often triadic, not exclusively dyadic.
- Children contribute to the partnership, though limitations exist.
- A social model of care is essential for developing effective triadic partnerships.
Objective:
To explore how the doctor-parent-child partnership is experienced and if the child patient is considered a contributor.
Methods:
Qualitative methodology using semi-structured interviews with 33 participants (9 paediatricians, 14 parents, and 10 children aged 8-12 with cerebral palsy) from a paediatric teaching hospital in Victoria, Australia.
Results:
Children were reported to participate in the doctor-parent-child partnership. The child was not perceived to be an 'equal' or 'regular' partner as there were reports of variability in the involvement between children, as well as variability in the progressive involvement of each child. Three categories emerged in relation to the child's position in the partnership: creating a space for the child's involvement; acknowledging the variability of child preferences to be involved; and negotiating the child's age and development.
Conclusion:
The doctor-parent-child partnership was perceived not necessarily to be dyadic, shared exclusively by the parent and paediatrician. Children were reported to contribute to the partnership, although there were limitations to the child's involvement.
Practice Implications:
Previous understandings of partnership are not sufficient to explain the complexities involved in a doctor-parent-child partnership, and a social-model approach to care is highlighted as an important factor for enabling the development of a triadic partnership.
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