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Making choices about medical interventions: the experience of disabled young people with degenerative conditions
1Research Fellow, Department of Social Policy and Social Work, Social Policy Research Unit, University of York, York, UK.
Insights
Disabled young people with degenerative conditions navigate complex medical decisions, emphasizing personal values over purely rational choices. Their experiences highlight the need for holistic family support and sensitive practitioner engagement in healthcare decision-making.
Area of Science:
- Pediatric Health
- Disability Studies
- Health Psychology
Background:
- Western policy promotes patient autonomy and involvement in healthcare decisions.
- Research has historically focused less on children's perspectives in health decision-making compared to adults.
Purpose of the Study:
- To explore the perspectives and experiences of disabled young people with degenerative conditions during significant medical interventions.
- To understand their engagement in healthcare decision-making processes.
Main Methods:
- Longitudinal qualitative study involving 10 young people (aged 13-22) with degenerative conditions.
- Semi-structured interviews conducted over three years (2007-2010).
- Focus on significant medical intervention choices identified by participants.
Main Results:
- Young people reported feeling involved in medical decisions, but the decision-making process was complex and varied.
- Identified different roles in decision-making, the influence of information and social support.
- Highlighted the importance of weighing various decisional factors.
Conclusions:
- Health choices for young people are not solely technical or rational; framing is crucial.
- Key themes include living a normal life, independence, and fear of irreversible decisions.
- Practice implications include active listening, sensitivity, and holistic family-centered care.
Background:
Current western policy, including the UK, advocates choice for service users and their families, taking greater control and being more involved in decision making. However, children's role in health decision making, especially from their own perspective, has received less research attention compared to doctors and parents' perspectives.
Objective:
To explore the perspective and experiences of disabled young people with degenerative conditions as they face significant medical interventions and engage in decision-making processes.
Design And Methods:
Findings from a longitudinal qualitative study of 10 young people (13-22 years) with degenerative conditions are reported. Individual semi-structured interviews were conducted with participants over 3 years (2007-2010); the paper reports data from all three interview rounds. Interviews focused on medical intervention choices the young people identified as significant.
Results:
Although the young people in this study felt involved in the medical intervention choices discussed, findings demonstrate a complex and diverse picture of decision making. Results highlighted different decisional roles adopted by the young people, the importance of information heuristics and working with other people whilst engaging in complex processes weighing up different decisional factors.
Discussion:
Young people's experiences demonstrate the importance of moving beyond viewing health choices as technical or rational decisions. How each young person framed their decision was important. Recognizing this diversity and the importance of emerging themes, such as living a normal life, independence, fear of decisions viewed as 'irreversible' and the role of parents and peers in decision making highlights that, there are clear practice implications including, active practitioner listening, sensitivity and continued holistic family working.
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