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A Systematic Review on Children's Participation in Healthcare From a Child's Perspective
Merja Hietanen1,2, Catarina Nahlén Bose2, Anna Stålberg3
1KTH Royal Institute of Technology, Stockholm, Sweden.
Insights
Child participation in healthcare is crucial. Children want to be informed, communicate with professionals, and make decisions, but unfamiliar environments and parental obstruction can hinder their involvement.
Area of Science:
- Pediatric Healthcare
- Child Psychology
- Health Services Research
Background:
- Children possess a right to express opinions on matters affecting them.
- Recognizing children as active participants in healthcare requires understanding their unique perspectives.
- Both the child's viewpoint and the perspective of the child are essential for effective healthcare engagement.
Purpose of the Study:
- To explore child participation in healthcare from the perspective of children aged 3-12 years.
- To identify what constitutes participation in healthcare for children.
- To determine factors that hinder and promote child participation in healthcare settings.
Main Methods:
- Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Comprehensive database searches in MEDLINE, CINAHL, and Web of Science Core Collection.
- Interpretive data synthesis of 28 included studies.
Main Results:
- Six key themes emerged regarding child participation.
- Children identified participation as deciding actions, communicating with health professionals, being informed, and making decisions.
- Hindering factors included unfamiliar venues and parental obstruction, while security and comfort promoted participation.
Conclusions:
- Child participation in healthcare is contingent on their perception of the situation and opportunities for influence.
- Decision-making in practical matters is developmentally significant for children's skill acquisition.
- A knowledge gap exists regarding preschool-aged children's preferences for healthcare participation.
Background:
Children have a right to express their opinion on all matters concerning them. For children to be seen as actors in healthcare situations, both the child perspective and the child's perspective are needed.
Aim:
To explore child participation in healthcare from the child's perspective through the following questions: Question 1: What is considered participation in healthcare among children aged 3-12 years? Question 2: What factors hinder and promote child participation in healthcare?
Methods:
Systematic review reported following PRISMA guidelines. Database search was conducted in MEDLINE, Cumulative Index to Nursing and Allied Health Literature and Web of Science Core Collection, and 28 studies were included in the review. The data were analysed using interpretive data synthesis.
Results:
Six themes were identified: Question 1: 1 being able to decide how to act in the situation, 2 communicating with health professionals, 3 being adequately informed, 4 being allowed to make decisions; Question 2: 5 unfamiliar venues, parental obstruction and children's needs not being considered and 6 security, comfort and space.
Conclusion:
Child participation in healthcare depends on their perception of the situation and opportunities created for their influence. Decision-making on simple practical matters offers meaningful opportunities to acquire and refine decision-making skills and these decisions are therefore developmentally significant. This review identified a gap in knowledge on pre-school-aged children's preferences in participation in healthcare situations.
Implications For Care Practices:
Children should be recognised as unique individuals and asked about their preferences for participation in healthcare situations. They should be handed over a degree of power, as much as they are able and willing to take. Nurses have a central role in facilitating and encouraging participation by listening to and respecting children's views. Digital communication tools are one way to implement child-centred care and increase children's participation, but more research is needed.
Reporting Method:
This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.
Patient Or Public Contribution:
No Patient or Public Contribution.
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