Kinderrechte in der Kindermedizin

[Participation in children's hospitals: approaches to participatory formats for paediatric patients]

Based on the UN Convention on the Rights of the Child, children and young people have the right to participate in all matters and decisions that affect them. This applies in particular when they are patients in a children's hospital. In the international context, established formats for the participation of young patients regarding health issues already exist, for example "Children's Councils" or "Young Person's Advisory Groups". In Germany, such approaches are still mostly lacking. It thus remains important to develop suitable formats that enable meaningful and effective participation of young patients in the health system. These formats must be chosen in such a way that they can realistically be implemented in clinical settings as well as in pediatric research, and that they can be sustained in the long term. In order to strengthen the consideration of children's rights in the health system, the advancement of such participatory formats as well as their sustainable implementation and evaluation are desirable.

[Children's rights in Austrian hospitals: implementation factors for children's participation]

Background

Various studies show that it is important for children and adolescents (as well as their parents) to be involved and have a say in decisions regarding treatment. Nevertheless, it seems that participation processes are not necessarily implemented into hospital routines everywhere. So far, no study has been conducted on the implementation of children's rights or participation in Austrian hospitals.

Objective

Our study aimed at investigating the extent to which children's rights (especially the right to participation) and the European Association of Children in Hospital (EACH) Charter are known in Austrian hospitals, how they are implemented, and which facilitating and hindering factors can be identified.

Methods

A questionnaire survey was conducted among the chief medical and nursing staff on wards where children and adolescents are treated (n = 133), and qualitative interviews were conducted with experts on children's rights, medical and nursing staff, parents and one adolescent girl (n = 15). The results and recommendations for action that were derived from the data were discussed and validated in an expert workshop.

Results

The medical and nursing staff in Austrian children's and adolescents' wards are already doing a lot to implement and uphold children's rights. There is awareness of the need for child-centered treatment and the need to allow children and adolescents to participate during their hospital stay. Nevertheless, the interviews with parents show that there are large differences between hospitals and that there is still a lot to be done.

Conclusion

Based on the results, three areas for recommendations for action were identified: 1) anchoring children's rights, both legally and in the training of medical and nursing staff, 2) strengthening the team and feedback culture, e.g., through more staff resources for good teamwork and 3) good health information and good conversation quality. This means that health information for children and adolescents should be quality assured, comprehensible, evidence-based and on aspects relevant to them. Conversations between health professionals and patients and their relatives, should be patient-centered, which can be promoted through training, introduction of quality standards and guidelines.