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Facilitating children's contributions in clinic? Findings from an in-depth qualitative study with children with Type
1School of Health Sciences, City University, London, UK. katherine.tyler.1@city.ac.uk
Insights
Young children with Type 1 diabetes have unique insights into their condition and care, often differing from clinical perspectives. Understanding their experiences is key to improving healthcare engagement for pediatric diabetes management.
Area of Science:
- Pediatric Endocrinology
- Child Psychology
- Qualitative Health Research
Background:
- Policy encourages children's direct involvement in clinic visits.
- Limited understanding exists regarding younger children's perspectives on Type 1 diabetes and their care.
- This study addresses the gap in knowledge about children aged 10 and under with Type 1 diabetes.
Purpose of the Study:
- To explore the lived experiences of children 10 years or younger with Type 1 diabetes.
- To understand their views on their illness and healthcare interactions.
- To inform practices that facilitate children's contributions in clinical settings.
Main Methods:
- Qualitative study involving 17 children under 11 with Type 1 diabetes.
- Data collected through home visits, discussion groups, and clinic observations.
- Participants recruited from two outpatient clinics in a multicultural urban setting.
Main Results:
- Children possess deep experiential knowledge of their condition.
- Their social positioning significantly impacts their healthcare experiences.
- Children actively participate in managing their diabetes regimen, often contrary to clinical perceptions.
Conclusions:
- Clinical settings may not align with children's understanding and experiences of Type 1 diabetes.
- Findings highlight the need to re-evaluate how children's perspectives are incorporated into care.
- Supports clinicians in engaging with children's capacities and priorities in long-term illness management.
Aims:
There is a policy drive for children to contribute more directly in clinic visits. However, this has yet to be routinely achieved in practice and relatively little is known to date about younger children's views of their illness and care. This in-depth qualitative study set out to explore the experiences of children 10 years or younger living with Type 1 diabetes.
Methods:
The sample of 17 children was self-selecting from a population of 140 children under 11 years receiving treatment for Type 1 diabetes at two outpatient clinics in a large, multicultural city. Fieldwork comprised home visits, discussion groups and observation in outpatient clinics.
Results:
Children's strong experiential understandings of their condition, the impact of their social position on experiences of care and their active role in maintenance of the regimen were at odds with how they were positioned, and how the disease was discussed, in clinic.
Conclusion:
Findings have implications for facilitating children's contributions in clinic, understanding how ideas about children are reproduced in clinical settings and supporting clinicians to engage with the capacities and priorities of children living with long-term illness.
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