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Using drawings to understand the child's experience of child-centred care on admission to a paediatric high
Mandie Foster1, Lisa Whitehead2
11 Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.
Insights
Hospitalized children view themselves as active participants in their care, blending child-centred and family-centred approaches. This research highlights their co-creation of healthcare experiences.
Area of Science:
- Pediatric healthcare
- Child psychology
- Nursing care philosophies
Background:
- Family-centred care and child-centred care are key pediatric philosophies.
- Understanding child-centred care from the child's perspective is crucial for effective healthcare delivery.
- Hospitalized children's experiences require in-depth exploration to inform practice.
Purpose of the Study:
- To explore the lived experiences of hospitalized school-aged children in a pediatric high dependency unit.
- To gain insight into child-centred care through the child's own perspective.
- To understand how children perceive their role in healthcare delivery.
Main Methods:
- An interpretive thematic approach was employed.
- Children created drawings of 'a person in the hospital' to initiate interviews.
- Inductive thematic analysis of transcribed interviews was conducted, guided by a child-centred care framework.
Main Results:
- Twenty-six school-aged children participated, with drawings depicting family, staff, and themselves.
- Key themes included self-relationships, family and staff relationships, and psychosocial, emotional, and physical support.
- Children identified as co-creators of their healthcare, aligning with child-centred care principles and utilizing family-centred care concepts.
Conclusions:
- Hospitalized children actively engage in their healthcare, demonstrating principles of child-centred and family-centred care.
- Further research into 'participation versus protection' and 'child as becoming versus child as being' is needed.
- Integrating these insights can enhance child-centred and family-centred care in practice, theory, research, and policy.
Abstract:
Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.