Towards a theory-informed framework of child-centred care in paediatric healthcare: a systematic scoping review

Child-centred care is increasingly advocated in paediatric healthcare, yet its theoretical foundations remain fragmented and poorly defined. This review aimed to identify and synthesize theoretical perspectives applied to child-centred care in healthcare and to develop a theory-informed framework that clarifies its theoretical foundations and operationalisation.

The review followed the JBI methodology for systematic scoping reviews and was conducted and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). A comprehensive search of MEDLINE, Embase, and CINAHL was conducted for studies published between 1946 and August 2024. Peer-reviewed studies involving children, parents, or healthcare professionals that applied theoretical perspectives to child-centred care were included. Screening and data extraction were conducted independently by multiple reviewers. Data were synthesized in three steps: (1) grouping studies by theoretical framework, (2) analysing shared elements across six theories, and (3) integrating themes to construct a framework and identify core domains.

Thirteen studies were included, identifying six theoretical perspectives underpinning child-centred care. Synthesis of these perspectives resulted in a theory-informed framework comprising three interrelated domains: (1) the competent child, (2) social context and ecologies, and (3) development as a dynamic process. Together, these domains conceptualise child-centred care as a relational, contextual, and developmental process that supports children's participation, agency, and well-being.

This review advances conceptual clarity by integrating six theoretical perspectives into a theory-informed framework of child-centred care. The framework positions child-centred care as a dynamic, relational, and developmental process linking children's agency, social context, and development. The framework provides a tentative, structured foundation for guiding practice, education, and research. Further research is required to test and refine the framework across diverse cultural, geographic and healthcare contexts.