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Mihandoust S, Joseph A, Browning MHEM, Cha JS, Gonzales A, Markowitz J. Can pre-visit exposure to virtual tours of healthcare facilities help reduce child and parent anxiety during outpatient surgical procedures? APPLIED ERGONOMICS 2024; 119:104308. [PMID: 38761553 DOI: 10.1016/j.apergo.2024.104308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/11/2024] [Accepted: 05/03/2024] [Indexed: 05/20/2024]
Abstract
AIM The study aims to evaluate the impact of exposure to a highly realistic virtual facility tour prior to the on-site visit on patients and their parent/care partner's self-reported anxiety and physiological measures on the day of the procedure. BACKGROUND Preoperative anxiety impacts pediatric surgical outcomes; therefore, it is important for healthcare providers to address and manage preoperative anxiety in pediatric patients to promote better outcomes and overall wellbeing. Providing patients with a preview of the care setting before the actual procedure can be highly beneficial in mitigating preoperative anxiety. METHODOLOGY In this pilot randomized experimental study, sixteen patient-care partner dyads scheduled to undergo a gastrointestinal procedure either received a virtual tour identical to the places experienced on the day of the procedure (experimental group) or received no virtual tour (control group). Self-reported measures of anxiety were collected from participants before and on the day of the procedure. Physiological measures of heart rate variability and skin conductance were collected on the day of the procedure from both groups. RESULTS There were no significant differences between the self-reported and physiological measures of anxiety between the child groups. However, parents in the control group reported lower levels of anxiety and demonstrated lower levels of stress based on their physiological measures. CONCLUSION Exposure to virtual facility tours days before the surgery was not helpful in positively impacting the psychological measures related to preoperative anxiety levels for the participants.
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Affiliation(s)
- Sahar Mihandoust
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, Clemson, SC, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, Clemson, SC, USA.
| | - Matthew H E M Browning
- Virtual Reality and Nature Lab, Department of Parks, Recreation and Tourism Management, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA
| | - Jackie S Cha
- Department of Industrial Engineering, Clemson University, USA
| | - Alec Gonzales
- Department of Industrial Engineering, Clemson University, USA
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2
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Davies C, Waters D, Fraser J. Factors that support children and young people to express their views and to have them heard in healthcare: An inductive qualitative content analysis. J Child Health Care 2024:13674935241258515. [PMID: 38832575 DOI: 10.1177/13674935241258515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Despite development of healthcare charters supporting Article 12 of The United Nations Convention on the Rights of the Child, children and young people remain largely silenced in discussions about their healthcare. This article is based on the premise that children and young people should be able to exercise their right to express their views and be heard in all matters that affect their lives. This study examined children's and young people's experiences of expressing their views and having them heard in an Australian healthcare context. Using child-centred inquiry and 'draw, write, and tell' methods, data were collected from 20 children and young people. Five factors that supported children and young people to express their views and have their views heard were identified: time, relationships with health professionals, communication, teamwork, and family support. By paying attention to these factors, clinicians and others in health settings can better facilitate child-centred practices and support children and young people to express their views and have those views heard.
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Affiliation(s)
- Clare Davies
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Donna Waters
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Fraser
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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3
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Pallini S, Lonigro A, Barcaccia B, Laghi F, Schneider BH. Aggressive and Withdrawn Behaviour at School through the Lens of Teachers and Peers: A Qualitative Study. Behav Sci (Basel) 2024; 14:412. [PMID: 38785903 PMCID: PMC11117799 DOI: 10.3390/bs14050412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
We explored teachers' understanding of children with aggressive or socially withdrawn behaviour in their classes and we associated our findings with a status of rejected, neglected, or popular, as provided by peer nominations. Five kindergarten and elementary school teachers scored their 143 pupils with the Child Behaviour Checklist for Withdrawal and Aggression. Subsequently, only those children whose scores were 1 standard deviation above the mean for withdrawal or for aggression were included in the final sample (n = 46; Mage = 6.5 years, SD = 1.7; age range = 4-9 years). The final sample included 31 children (21.67%; females = 16) who were assessed as displaying withdrawn behaviour, and 15 (10.48%; females = 5) displaying aggressive behaviour. An open-ended semi-structured interview was administered to teachers, who described children with socially withdrawn behaviour as introverted and untalkative, children with aggressive behaviour as hostile, rule-breaking and highly active, and children with socially withdrawn or aggressive behaviour as isolated, even though different reasons were provided. The results of the sociometric status in children with socially withdrawn or aggressive behaviour are discussed.
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Affiliation(s)
- Susanna Pallini
- Department of Education, Roma Tre University, 00185 Rome, Italy
| | - Antonia Lonigro
- Department of Education, Roma Tre University, 00185 Rome, Italy
| | - Barbara Barcaccia
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Associazione di Psicologia Cognitiva APC and Scuola di Psicoterapia Cognitiva Srl SPC, 00185 Rome, Italy
| | - Fiorenzo Laghi
- Department of Social and Developmental Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Thestrup J, Sørensen JL, Hybschmann J, Topperzer MK, Graber K, O'Farrelly C, Gibson J, Ramchandani P, Frandsen TL, Gjærde LK. Establishing consensus on principles and competencies for the use of play in clinical practice in hospitals: An international Delphi study. Eur J Pediatr 2024; 183:1595-1605. [PMID: 38183437 PMCID: PMC11001713 DOI: 10.1007/s00431-023-05411-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/20/2023] [Accepted: 12/23/2023] [Indexed: 01/08/2024]
Abstract
Although play has existed in paediatric hospitals for decades, a shared understanding of why and how healthcare professionals use play in clinical practice is lacking. This study aims to reach consensus on a common set of principles and competencies for play interventions and practices in hospitals. We conducted a three-round Delphi study that included healthcare professionals selected by hospital management. The first round comprised open-ended questions on the use of play in clinical practice. Principles and competencies, including learning objectives, were established using content analysis through an iterative process. Participants rated the importance of each principle and learning objective in the second and third rounds. Among the 66 participants, 45 (68%) responded in round 1 and 41 (62%) in rounds 2 and 3. The participants represented ten countries and nine different health professions. After the three rounds, we identified 33 principles and six overall competencies: building trusting relationships; delivering information and increasing understanding; promoting cooperation and participation; reducing procedure-related anxiety and pain; supporting coping and development; and ensuring a professional approach to play, which comprised 20 learning objectives. Conclusion: According to healthcare professionals, play in clinical practice can be used to communicate and build relationships with paediatric patients and thus potentially help provide patient-centred care. Our findings may help guide and prioritize future research initiatives and operationalize play interventions and practices in hospitals. What is Known: • Evidence suggests that using play in clinical practice can help paediatric patients during hospitals stays. • Despite the evidence supporting the use of play, a shared understanding of why and how paediatric healthcare professionals use play is needed. What is New: • This international Delphi study contributes to a shared interprofessional understanding of the principles, competencies and learning objectives for the use of play in clinical practice. • The findings have the potential to aid initiatives in developing training programmes for healthcare professionals in using play to provide care with a patient-centred approach.
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Affiliation(s)
- Jakob Thestrup
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark.
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jane Hybschmann
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
| | | | - Kelsey Graber
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Christine O'Farrelly
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Jenny Gibson
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Paul Ramchandani
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Thomas Leth Frandsen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
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Williamson FA, Lester JN, Woods C, Kaye EC. Questions to promote child-centered care in racially discordant interactions in pediatric oncology. PATIENT EDUCATION AND COUNSELING 2024; 121:108106. [PMID: 38123375 DOI: 10.1016/j.pec.2023.108106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To examine questioning practices in racially discordant interactions and describe how these practices engendered child-centered care. METHODS We used applied conversation analysis to analyze a collection of 300 questions directed to children across 10 cases involving children of color and their families in disease reevaluation appointments in pediatric oncology. RESULTS Our analysis generated two patterns: 1) both the pediatric oncologists' and caregivers built upon one another's talk to enable the child's conversational turn, and 2) the oncologists' reformulated requests as questions to invite the child's permission and cooperation for completing exams and understanding symptoms. CONCLUSION Children, pediatric oncologists, and caregivers coordinated their actions to enable children to participate as recipients of and respondents to questions. The analysis of real-time interactions illuminates practices for centering children in clinical encounters and the benefits of doing so. PRACTICAL IMPLICATIONS This study's findings have implications for defining competencies and practices for fostering child-centered communication, creating training materials based on real-time encounters, and identifying strategies for humanizing pediatric patient experiences.
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Affiliation(s)
| | - Jessica Nina Lester
- Department of Counseling Education and Psychology, Indiana University, Bloomington, USA
| | - Cameka Woods
- St. Jude's Children's Research Hospital, Memphis, USA
| | - Erica C Kaye
- St. Jude's Children's Research Hospital, Memphis, USA
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Carter B, Young S, Ford K, Campbell S. The Concept of Child-Centred Care in Healthcare: A Scoping Review. Pediatr Rep 2024; 16:114-134. [PMID: 38391000 PMCID: PMC10885088 DOI: 10.3390/pediatric16010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine the following: (1) What constitutes the concept of child-centred care in healthcare? (2) How has the concept of child-centred care developed? (3) What is the applicability of child-centred care and what are its limitations? (4) How does the concept of child-centred care benefit and inform children's healthcare? In total, 2984 papers were imported for screening, and, following the removal of duplicates and screening, 21 papers were included in the scoping review. The findings suggest that child-centred care is an emerging, ambiguous poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact and benefit of child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care, it needs to establish robust evidence of its effectiveness, the impact on children and their families, as well as the wider impacts on the healthcare system.
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Affiliation(s)
- Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk L39 4QP, UK
| | - Sarah Young
- Launceston Clinical School, Tasmanian School of Medicine, College of Health & Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Karen Ford
- School of Nursing, College of Health & Medicine, University of Tasmania, Hobart, TAS 7000, Australia
| | - Steven Campbell
- School of Nursing, College of Health & Medicine, University of Tasmania, Hobart, TAS 7000, Australia
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Collan C, Dahl L, Henström M, Nyström CD, Löf M, Andermo S. To capture the child's interest - nurses experiences of 'Saga stories in health talks'. BMC Nurs 2024; 23:8. [PMID: 38163869 PMCID: PMC10759488 DOI: 10.1186/s12912-023-01661-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND As unhealthy lifestyle habits have been found to be established early in life and often track into adulthood, early preventive initiatives are important. 'Saga Stories in health talks' is a newly developed material that is intended to be used as a support for nurses at child health care (CHC) centers in their health talks with children and parents in Sweden. The aim of this study is to explore how CHC nurses experience the usability of the 'Saga Stories in health talks' material. METHODS This study used a qualitative design. The material 'Saga Stories in health talks' was tested by 33 CHC nurses working in 11 CHC centers in three regions in Sweden. All CHC nurses were invited to participate in the interviews and 17 agreed. The interviews were transcribed and analysed using content analysis. RESULTS Three categories and eight sub-categories emerged. The categories were: (1) An appreciated tool suitable for health talks, (2) Illustrations to capture children's interest in the conversation with families, and (3) Barriers and facilitators. Saga Stories in health talks' was experienced by the CHC nurses as an appreciated tool with content highly relevant to what should be discussed during the health talks. The CHC nurses described the material as well-designed with illustrations that helped them capture the child's interest and increase their participation, while still involving the parents. Support from colleagues, the researchers, and managers were seen as important facilitators. Challenges included structural factors such as how and when to best use the material, especially concerning that the 4-year visit contained many other mandatory parts. CONCLUSIONS This pilot study show that the material 'Saga Stories in health talks' was highly appreciated by CHC nurses and facilitated their health talks with families in CHC. Important aspects with the material were the relevant content and the focus on healthy living habits, as well as the child friendly illustrations. These findings can be used when similar material is developed to facilitate health talks with families in other contexts. Our results also highlight the importance to adjust the implementation of a new material with already established practice and routines.
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Affiliation(s)
- Camilla Collan
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden
| | - Lina Dahl
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden
| | - Maria Henström
- Department of Biosciences and Nutrition, Karolinska Institutet, Neo, Huddinge, 141 83, Sweden
| | | | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Neo, Huddinge, 141 83, Sweden
- Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, 581 83, Sweden
| | - Susanne Andermo
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden.
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, 114 33, Sweden.
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Nordlind A, Anderzén‐Carlsson A, Sundqvist A, Ängeby K, Wray J, Oldham G, Almblad A. Translation, cultural adaptation and validation of a patient-reported experience measure for children. Health Expect 2023; 27:e13924. [PMID: 38062673 PMCID: PMC10768864 DOI: 10.1111/hex.13924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/19/2023] [Accepted: 11/14/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND There is no national, validated, generic patient-reported experience measure (PREM) for children under 15 years of age in Sweden. A recent cross-sectional study found no consensus in how children's voices are heard in paediatric health care, as well as a lack of validated questionnaires. AIM The aim of this study is to translate, adapt and validate the six versions of the Children's and Young People's PREM for use in a Swedish health care context. DESIGN An exploratory sequential mixed-method design including cognitive interviews and content validity index (CVI) was used. The interviews focused on evaluating children's understanding of the questionnaire, and the CVI was used to further adjust the relevance of the questionnaire. PARTICIPANTS A convenience sample of 62 children participated in the cognitive interviews and an additional convenience sample of 42 children was included in the CVI testing. The children, aged 8-16 years, were attending routine visits at paediatric departments in a county hospital and a children's hospital in the mid-Sweden region between October 2020 and June 2022. RESULTS The translation, adaptation and validation process identified several issues regarding the understanding of the questionnaire in a Swedish context. Adaptations were made based on issues related to context, wording and the structure of the questions. CVI testing resulted in the removal of 3-10 questions in each of the different versions of the questionnaire. CONCLUSION The study has resulted in six face- and content-validated Swedish versions of the questionnaire ready for pilot testing. Although the versions of the original questionnaire were developed in collaboration with children in the United Kingdom, this did not mean that they could automatically be used in a Swedish health care context. This study confirms the importance of a rigorous process of adaptation and validation to ensure quality and applicability to children accessing health care in different countries. PATIENT OR PUBLIC CONTRIBUTION Children's views have guided the development of the original instrument and its adaptation to the Swedish health care context. Due to the strong patient involvement in the process of developing the Swedish versions of the questionnaire, the research group made a pragmatic decision to have no other patient contribution in the study.
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Affiliation(s)
- Anna Nordlind
- School of Health Sciences, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- Department of Paediatric MedicineCounty Hospital KarlstadKarlstadSweden
| | - Agneta Anderzén‐Carlsson
- University Health Care Research Centre, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Ann‐Sofie Sundqvist
- University Health Care Research Centre, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Karin Ängeby
- Centre for Clinical Research and EducationRegion VärmlandKarlstadSweden
- School of Education, Health and Social StudiesDalarna UniversityFalunSweden
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID)Great Ormond Street Hospital for Children NHS Foundation TrustLondonUK
| | - Geralyn Oldham
- Data Research, Innovation and Virtual Environments (DRIVE) UnitGreat Ormond Street Hospital for Children NHS Foundation TrustLondonUK
| | - Ann‐Charlotte Almblad
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
- Children Hospital and EmergencyRegion UppsalaUppsalaSweden
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Bray L, Carter B, Kiernan J, Horowicz E, Dixon K, Ridley J, Robinson C, Simmons A, Craske J, Sinha S, Morton L, Nafria B, Forsner M, Rullander AC, Nilsson S, Darcy L, Karlsson K, Hubbuck C, Brenner M, Spencer-Little S, Evans K, Rowland A, Hilliard C, Preston J, Leroy PL, Roland D, Booth L, Davies J, Saron H, Mansson ME, Cox A, Ford K, Campbell S, Blamires J, Dickinson A, Neufeld M, Peck B, de Avila M, Feeg V, Mediani HS, Atout M, Majamanda MD, North N, Chambers C, Robichaud F. Developing rights-based standards for children having tests, treatments, examinations and interventions: using a collaborative, multi-phased, multi-method and multi-stakeholder approach to build consensus. Eur J Pediatr 2023; 182:4707-4721. [PMID: 37566281 PMCID: PMC10587267 DOI: 10.1007/s00431-023-05131-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/23/2023] [Accepted: 06/12/2023] [Indexed: 08/12/2023]
Abstract
Children continue to experience harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. The international ISupport collaboration aimed to develop standards to outline and explain good procedural practice and the rights of children within the context of a clinical procedure. The rights-based standards for children undergoing tests, treatments, investigations, examinations and interventions were developed using an iterative, multi-phased, multi-method and multi-stakeholder consensus building approach. This consensus approach used a range of online and face to face methods across three phases to ensure ongoing engagement with multiple stakeholders. The views and perspectives of 203 children and young people, 78 parents and 418 multi-disciplinary professionals gathered over a two year period (2020-2022) informed the development of international rights-based standards for the care of children having tests, treatments, examinations and interventions. The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds. Conclusion: This is the first study of its kind which outlines international rights-based procedural care standards from multi-stakeholder perspectives. The standards offer health professionals and educators clear evidence-based tools to support discussions and practice changes to challenge prevailing assumptions about holding or restraining children and instead encourage a focus on the interests and rights of the child. What is Known: • Children continue to experience short and long-term harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. • Professionals report uncertainty and tensions in applying evidence-based practice to children's procedural care. What is New: • This is the first study of its kind which has developed international rights-based procedural care standards from multi-stakeholder perspectives. • The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds.
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Affiliation(s)
| | | | - Joann Kiernan
- Edge Hill University and Alder Hey Children’s Hospital, Liverpool, UK
| | | | | | - James Ridley
- Edge Hill University and National Restraint Reduction Network, Ormskirk, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Carol Hilliard
- Children’s Health Ireland (CHI) at Crumlin, Dublin, Ireland
| | | | - Piet L. Leroy
- Maastricht University Medical Centre / Maastricht University, Maastricht, The Netherlands
| | - Damian Roland
- University Hospitals of Leicester NHS Trust and Leicester University, Leicester, UK
| | | | | | | | | | - Ann Cox
- Midlands Partnership NHS Foundation Trust & Keele University, Keele, UK
| | - Karen Ford
- University of Tasmania and the Royal Hobart Hospital, Tasmani, Australia
| | | | - Julie Blamires
- Auckland University of Technology, Auckland, New Zealand
| | | | | | - Blake Peck
- Federation University, Victoria, Australia
| | | | - Veronica Feeg
- Molloy College in Rockville Centre, New York City, USA
| | | | | | | | - Natasha North
- The Harry Crossley Children’s Nursing Development Unit, University of Cape Town, Cape Town, South Africa
| | | | - Fanny Robichaud
- Ulluriaq, Ungava Tulattavik Health Center and UQAM UQO, Québec, Canada
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Giles ML, Ball GDC, Bonder R, Buchholz A, Gorter JW, Morrison KM, Perez A, Walker M, McPherson AC. Exploring the complexities of weight management care for children with spina bifida: a qualitative study with children and parents. Disabil Rehabil 2023:1-9. [PMID: 37665663 DOI: 10.1080/09638288.2023.2251878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE 1) To explore how children with spina bifida (SB) and their parents understand bodyweight, health and weight management; and 2) To identify what services and supports children with SB and their families feel are most appropriate to help them manage their health and weight. METHODS The study used interpretive description within a qualitative design. Participants were children with SB (aged 10-18) attending two Canadian SB clinics and their parents. Data were collected through individual interviews and analyzed using inductive thematic analysis. RESULTS Five children and five parents participated in the study. Children and parents had a weight-centric approach to health, which was related to the child's mobility. Weight was considered to be under individual control and mostly through diet. Trusting relationships between healthcare providers, children and families were important to discuss weight in a non-judgemental manner. Children should be involved in setting meaningful and achievable weight management goals. CONCLUSION Greater knowledge of how children with SB and their families understand weight and health offers opportunities for non-judgemental discussions about their needs and wishes. Helping families to place more value on health over weight may reduce feelings of stigma, while allowing children to develop some autonomy over health-related decisions.
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Affiliation(s)
- Madison L Giles
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Revi Bonder
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Annick Buchholz
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Jan Willem Gorter
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands. Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- CanChild, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Katherine M Morrison
- Centre for Metabolism, Obesity and Diabetes Research, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Arnaldo Perez
- Educational Research & Scholarship Unit, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Meaghan Walker
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Amy C McPherson
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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11
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Näsström M, Junehag L, Häggström M, Holmström-Rising M. A reflexive thematic analysis of ambulance nurses' experience of facilitating child-centered care. Int Emerg Nurs 2023; 70:101324. [PMID: 37597278 DOI: 10.1016/j.ienj.2023.101324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/21/2023] [Accepted: 07/07/2023] [Indexed: 08/21/2023]
Abstract
INTRODUCTION Ambulance nurses' (ANs) feel less confident treating children. According to the United Nations Convention on Child Rights, there is a provision to safeguard children's rights. Child-Centered Care (CCC) strives to lift children's voices in healthcare. AIM To describe ambulance nurses' experiences of facilitating child-friendly care. METHOD A qualitative approach with Reflexive Thematic Analysis was performed on seventeen individual semi-structured interviews. RESULT One overarching theme, caring with the child in center, and three themes were developed: adapting to follow the child's lead, being reliable by balancing the trust, stepping back and supporting. DISCUSSION The ANs' communication with the children was honest and straightforward. Letting the child and the parents perform the care together reduced the child's anxiety. Guided participation was used by ANs, expanding the child's initiative. CONCLUSION The ANs work according to CCC, but unknowingly. It is important and beneficial to elevate the CCC to a conscious level. The ANs could refer to CCC in training new colleagues, reflecting on cases, and incorporating the Child Act in their work.
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Affiliation(s)
- Mathias Näsström
- Mid Sweden University, Department of Health Sciences, Nursing, 83125 Östersund, Sweden.
| | - Lena Junehag
- Mid Sweden University, Department of Health Sciences, Nursing, 83125 Östersund, Sweden.
| | - Marie Häggström
- Mid Sweden University, Department of Health Sciences, Nursing, 85170 Sundsvall, Sweden.
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Svendsen EJ, Killi EM, Rohrer-Baumgartner N, Holthe IL, Sandhaug M, Borgen IMH, Wade SL, Hauger SL, Løvstad M, Bragstad LK. Children's, parents', and teachers' experiences of the feasibility of a telerehabilitation intervention for children with acquired brain injury in the chronic phase - a qualitative study of acceptability and participation in the Child In Context Intervention (CICI). BMC Health Serv Res 2023; 23:603. [PMID: 37291543 DOI: 10.1186/s12913-023-09589-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/16/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND This is a qualitative feasibility study of the Child in Context Intervention (CICI). The CICI is an individualized, goal-oriented and home-based tele-rehabilitation intervention which targets everyday functioning of children (6-16 years) with acquired brain injury in the chronic stage, and their families, one year or more after insult, who have ongoing challenges (physical, cognitive, behavioral, social and/or psychological). The aim of this study is to better understand how children, parents and teachers experienced participation and acceptability; to develop knowledge about the mechanisms of change, and to explore how the CICI was tailored to the context. METHODS Six families and schools participated in the intervention, which comprised seven tele-rehabilitation sessions in which the child and parent participated, one in-person parent seminar and four digital school meetings. A multidisciplinary team delivered the intervention to 23 participants over a 4- to 5-month period. The intervention involved psychoeducation about targeted acquired brain injury-related problems, such as fatigue, pain, or social challenges. All but one consented to participate in the current digital interview study. The data were analyzed using content analysis. RESULTS The experience of participation and acceptability varied among the children. Attendance was consistently high; the child participants felt mostly listened to and could influence goal setting and strategies. However, engaging and motivating the child participants proved somewhat challenging. The parents found the CICI rewarding, useful and relevant. However, they had different experiences regarding which intervention component they perceived as most helpful. Some argued in favor of the 'whole intervention', while others highlighted new knowledge, SMART goals or the school collaboration. The teachers found the intervention acceptable and useful but wanted a better meeting plan. They had difficulties in finding time for meetings, emphasized the involvement of school leaders, and appreciated the digital format. CONCLUSIONS Overall, the intervention was perceived as acceptable, and the participants felt that the various intervention components contributed to improvements. The CICI's flexibility facilitated tailoring to different contexts based on the children's functional level. The digital format saved time and provided flexibility regarding the amount of attendance but limited full participation from children with more severe cognitive impairments. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04186182.
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Affiliation(s)
- Edel Jannecke Svendsen
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.
- Oslo Metropolitan University, Oslo, Norway.
- CHARM - Research Centre for Habilitation and Rehabilitation Models & Services, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Eli Marie Killi
- Department of Profession Strategy and Knowledge Brokering, Norwegian Service for Special Needs Education, Oslo, Norway
| | | | - Ingvil Laberg Holthe
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Maria Sandhaug
- Department of Profession Strategy and Knowledge Brokering, Norwegian Service for Special Needs Education, Oslo, Norway
| | - Ida M H Borgen
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Shari L Wade
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, OH, 45229, Cincinnati, USA
- University of Cincinnati College of Medicine, OH, Cincinnati, USA
| | - Solveig Laegreid Hauger
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Line Kildal Bragstad
- Oslo Metropolitan University, Oslo, Norway
- CHARM - Research Centre for Habilitation and Rehabilitation Models & Services, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Schulz I, O'Neill J, Gillam P, Gillam L. The scope of ethical dilemmas in paediatric nursing: a survey of nurses from a tertiary paediatric centre in Australia. Nurs Ethics 2023; 30:526-541. [PMID: 36877536 DOI: 10.1177/09697330231153916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND No previous study has provided evidence for the scope and frequency of ethical dilemmas for paediatric nurses. It is essential to understand this to optimise patient care and tailor ethics support for nurses. RESEARCH AIM The aim of this study was to explore the scope of nurses' ethical dilemmas in a paediatric hospital and their engagement with the hospital clinical ethics service. RESEARCH DESIGN This study used a cross-sectional survey design. PARTICIPANTS AND RESEARCH CONTEXT Paediatric nursing staff in a tertiary paediatric centre in Australia completed an online survey asking about their exposure to a range of ethical dilemmas and their knowledge of the clinical ethics service. Analysis used descriptive and inferential statistics. ETHICAL CONSIDERATIONS Ethical approval was granted from the hospital research committee. The survey was anonymous, and no identifying details of participants were collected. RESULTS Paediatric nurses experienced a wide range of ethical dilemmas frequently, both in the intensive care and general areas. Knowledge and use of the clinical ethics service was poor and the most frequent challenge for nurses in managing dilemmas was feeling powerless. CONCLUSION There is a need to recognise the moral burden of ethical dilemmas for paediatric nurses in order to foster ethical sensitivity, and to provide adequate support to improve care and mitigate nursing moral distress.
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Affiliation(s)
- Ingrid Schulz
- The Victorian Paediatric Palliative Care Program, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Jenny O'Neill
- The Department of Nursing Research, The Royal Children's Hospital, Melbourne, VIC, Australia; Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia; The Children's Bioethics Centre, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Peter Gillam
- Department of Psychology, The University of Melbourne, Melbourne, VIC, Australia
| | - Lynn Gillam
- The Children's Bioethics Centre, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
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Davison G, Conn R, Kelly MA, Thompson A, Dornan T. Fifteen-minute consultation: Guide to communicating with children and young people. Arch Dis Child Educ Pract Ed 2023; 108:91-95. [PMID: 34857651 DOI: 10.1136/archdischild-2021-323302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/15/2021] [Indexed: 11/03/2022]
Abstract
This article suggests communicative steps and strategies to help healthcare professionals achieve the ideals of child-centred care, which place children and young people at the centre of policy and practice. For those with 15 s, not 15 min, our suggestions can be summarised like this: help children be active agents in their own care by asking, listening well, being curious and explaining things clearly in an accessible but not condescending way.
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Affiliation(s)
- Gail Davison
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
- Children's Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Richard Conn
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
- General Paediatrics, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Martina Ann Kelly
- Department of Family Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Andrew Thompson
- General Paediatrics, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Tim Dornan
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
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"The only thing I wonder is when I will have surgery again": everyday life for children with right ventricle outflow tract anomalies during assessment for heart surgery. Cardiol Young 2023; 33:396-401. [PMID: 35351230 DOI: 10.1017/s1047951122000907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Children with right ventricle outflow tract anomalies require repeated heart surgeries, thereby needing regular preoperative assessments throughout their lifetime. This situation puts a heavy burden on these children. Thus, the aim of this study was to explore how children diagnosed with right ventricle outflow tract anomalies experience their heart disease and their everyday life during the preoperative assessment and after the decision on whether to perform a new cardiac surgery. METHODS Individual interviews were conducted with nine children between 9 to 17 years of age on three occasions from 2014 to 2016. In total there were 27 interviews which all were analyzed with thematic analysis. RESULTS The analysis yielded three themes and eight subthemes. The theme Me and my heart disease concerns children's experiences of the heart disease. Almost all described symptoms and how they adapt in their everyday life. The theme Being me concerns the children's sense of self, where their heart disease was not prominent. The theme Being placed in someone else's hands describes how the assessment was more of a safety net at least until the decision of heart surgery. CONCLUSION The children's symptoms, their experiences during the assessment, their future surgeries and how the heart disease affects their everyday life could be better understood as elements of their adaptation to the heart disease. In order to achieve individualized support based on the child's experiences and to ensure that these children are involved in their own care a child-centered approach is recommended.
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Mårtensson U, Nilsson S, Nolbris MJ, Wijk H, Mellgren K. Pain and discomfort in children with gastrostomy tubes - In the context of hematopoietic stem cell transplantation. J Pediatr Nurs 2023; 70:79-89. [PMID: 36848740 DOI: 10.1016/j.pedn.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/05/2023] [Accepted: 02/11/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND In children with malignant and severe non-malignant disorders undergoing hematopoietic stem cell transplantation (HSCT), treatment related pain and discomfort are common. Food consumption may become troublesome, making the use of a gastrostomy tube (G-tube) necessary and resulting in complications, why the purpose was to explore pain and discomfort during the transplantation and post-transplantation time. METHODS This was a mixed methods study where data were collected along the child's total health-care process between 2018 and 2021. Questions with fixed answer options were used, simultaneously, semi-structured interviews were performed. In total, sixteen families participated. Descriptive statistics and content analysis were used to describe analysed data. FINDINGS Intense pain was common during the post-surgery phase, especially in conjunction with G-tube care, which is why the children needed support to manage the situation. After the post-surgery phase when the skin has healed, most of the children experienced minor to no pain or bodily discomfort, why the G-tube became a well-functioning and supportive tool in daily life. CONCLUSIONS This study describes variations in and experiences of pain and bodily discomfort in conjunction with G-tube insertion in a unique sample of children who had undergone HSCT. In conclusion, the children's comfort in daily life after the post-surgery phase seemed to be only marginally affected by G-tube insertion. Children with severe non-malignant disorders seemed to experience a higher frequency and intensity of pain and bodily discomfort due to the G-tube than children with malignant disorders. PRACTICE IMPLICATIONS The paediatric care team need competence in assessing G-tube related pain and awareness that experiences may differ depending on the child's disorder.
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Affiliation(s)
- Ulrika Mårtensson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30 Gothenburg, Sweden.
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30 Gothenburg, Sweden; Department of Pediatrics, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
| | - Margaretha Jenholt Nolbris
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30 Gothenburg, Sweden; Department of Pediatrics, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30 Gothenburg, Sweden; Chalmers Technology University, Centre for Health Care Architecture, SE- 405 30 Gothenburg, Sweden.
| | - Karin Mellgren
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 416 85 Gothenburg, Sweden.
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Foster M, Blamires J, Moir C, Jones V, Shrestha-Ranjit J, Fenton B, Dickinson A. Children and young people's participation in decision-making within healthcare organisations in New Zealand: An integrative review. J Child Health Care 2023:13674935231153430. [PMID: 36809178 DOI: 10.1177/13674935231153430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
There is a paucity of literature on children and young people's participation in decision-making within healthcare organisations in New Zealand. This integrative review examined child self-reported peer-reviewed manuscripts and published guidelines, policy, reviews, expert opinion and legislation to explore how New Zealand children and young people participate in discussions and decision-making processes within healthcare settings and what are barriers and benefits to such participation. Four child self-reported peer-reviewed manuscripts and twelve expert opinion documents were retrieved from four electronic databases including academic, government and institutional websites. Inductive content thematic analysis generated one theme (a discourse in children and young people's participation within healthcare settings), four sub-themes, 11 categories, 93 codes and 202 findings. It is evident within this review that there is a discourse between what expert opinion are stating is required to promote children and young people's participation in discussions and decision-making processes within healthcare settings and what is occurring in practice. Despite literature reporting on how children and young people's participation and voice were essential for healthcare provision, there was sparse literature published on children and young people's participation in discussions and decision-making processes in healthcare delivery in New Zealand.
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Affiliation(s)
- Mandie Foster
- School of Clinical Sciences, 1410Auckland University of Technology, Auckland, New Zealand
- School of Nursing and Midwifery, Edith Cowan University, Perth, WA, Australia
- Child and Youth Health Research Centre, 1410AUT, Auckland, New Zealand
| | - Julie Blamires
- School of Clinical Sciences, 1410Auckland University of Technology, Auckland, New Zealand
- Child and Youth Health Research Centre, 1410AUT, Auckland, New Zealand
| | - Chris Moir
- Child and Youth Health Research Centre, 1410AUT, Auckland, New Zealand
- Centre for Postgraduate Nursing Studies, 2494University of Otago, Christchurch, New Zealand
| | - Virginia Jones
- Child and Youth Health Research Centre, 1410AUT, Auckland, New Zealand
- Centre for Postgraduate Nursing Studies, 2494University of Otago, Christchurch, New Zealand
| | - Jagamaya Shrestha-Ranjit
- School of Clinical Sciences, 1410Auckland University of Technology, Auckland, New Zealand
- Child and Youth Health Research Centre, 1410AUT, Auckland, New Zealand
| | - Brie Fenton
- School of Clinical Sciences, 1410Auckland University of Technology, Auckland, New Zealand
- Child and Youth Health Research Centre, 1410AUT, Auckland, New Zealand
| | - Annette Dickinson
- School of Clinical Sciences, 1410Auckland University of Technology, Auckland, New Zealand
- Child and Youth Health Research Centre, 1410AUT, Auckland, New Zealand
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Kayes NM, Papadimitriou C. Reflecting on challenges and opportunities for the practice of person-centred rehabilitation. Clin Rehabil 2023:2692155231152970. [PMID: 36726297 DOI: 10.1177/02692155231152970] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To (1) reflect on challenges to the practice of person-centred rehabilitation; and (2) propose opportunities for the development of person-centred rehabilitation. CHALLENGES Person-centred practice has received widespread endorsement across healthcare settings and is understood to be an important, positive approach in rehabilitation. However, the rhetoric of this approach does not always translate meaningfully into practice. Emphasis on patient choice, patient involvement in decision making, and increasing patient capacity for self-management have become a proxy for person-centred rehabilitation in lieu of a more fundamental shift in practice and healthcare structures. System (e.g. biomedical orientation), organisational (e.g. key performance indicators) and professional (e.g. identity as expert) factors compete with person-centred rehabilitation. OPPORTUNITIES Four key recommendations for the development of person-centred rehabilitation are proposed including to: (1) develop a principles-based approach to person-centred rehabilitation; (2) move away from the dichotomy of person-centred (or not) rehabilitation; (3) build person-centred cultures of care in rehabilitation; and (4) learn from diverse perspectives of person-centred rehabilitation. CONCLUSION Fixed assumptions about what constitutes person-centred rehabilitation may limit our ability to respond to the needs of persons and families. Embedding person-centred ways of working is challenging due to the competing drivers and interests of healthcare systems and organisations. A principles-based approach, enabled by person-centred cultures of care, may achieve the aspirations of person-centred rehabilitation.
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Affiliation(s)
- Nicola M Kayes
- Faculty of Health and Environmental Sciences, Centre for Person Centred Research, School of Clinical Sciences, 1410Auckland University of Technology, Auckland, New Zealand
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Ryberg AM, Nielsen PB, Graarup KS, Ingeman K, Thellefsen MR, Jensen CS. Danish translation and cultural adaptation of the 'What do you think of hospital' patient reported experience measure for children and adolescents in outpatient settings. J Pediatr Nurs 2023; 68:e36-e42. [PMID: 36372698 DOI: 10.1016/j.pedn.2022.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/28/2022] [Accepted: 10/30/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of this study was to translate the patient reported experience measure (PREM) questionnaire"What do you think of the hospital? Help us to get better!" into Danish used in outpatient clinics and to explore its face and content validity. DESIGN AND METHODS The translation process followed WHO recommendations and included forward translation, expert panel evaluation, back translation, pre-testing and cognitive interviews with 23 children and adolescents. RESULTS Children and adolescents were positive to using PREM as a way to express their experiences. The layout of the questionnaire was important as use of colours was more appealing and the topics of the questionnaire were better visualised. The concepts in the original questionnaire related to distinguishing between different rooms for examination and conversation are not used in a Danish context. Otherwise, only minor translation adjustments were needed to match the Danish target group. CONCLUSION Children and adolescents found that the Danish version of the PREM questionnaire tool was easy to read and understand, and the layout emphasised that they are the target group. After pre-testing among 23 children and adolescents, the questionnaire is now ready for pilottest in a larger group. PRACTICE IMPLICATIONS The present study provides a tool to generate knowledge and evaluate the experiences of children and adolescents in an outpatient clinic. Using the questionnaire, healthcare staff may monitor the quality of the experiences of children and adolescents and collect data for research purposes. Likewise, it will be possible to compare hospitals and organizations nationally.
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Affiliation(s)
- Anne Marie Ryberg
- Master in Clinical Nursing, Project nurse, RN, Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, N, Denmark.
| | - Pia Bonde Nielsen
- Staff Development Nurse, Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, N, Denmark.
| | - Karen Sønderby Graarup
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, N, Denmark.
| | - Katrine Ingeman
- Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital, Psychiatry, The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark.
| | - Mette Ramskov Thellefsen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Blegdamsvej 9, 2100 København, Denmark.
| | - Claus Sixtus Jensen
- Clinical Nurse Specialist and Postdoctoral researcher, Department of Paediatrics and Adolescent Medicine, Aarhus University, Hospital, Aarhus, Denmark; Research Centre for Emergency Medicine, Emergency Department, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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Castro MC, Ramos I, Carvalho IP. The Influence of Patient-Centered Communication on Children's Anxiety and Use of Anesthesia for MR. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:414. [PMID: 36612736 PMCID: PMC9819401 DOI: 10.3390/ijerph20010414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
Background: The aim of this study was to inspect the influence of patient-centered communication (PCC) with 4- to 10-year-old children on the use of anesthesia for magnetic resonance imaging exams (MRs). Methods: A total of thirty children received the PCC and pre-simulated the exam with an MR toy. Another 30 children received routine information about the MR and pre-simulated the exam with the toy. Anesthesia use in these two groups was additionally compared with a previously existing group of children (n = 30) who had received only routine information about the exam (CG). Children’s anxiety was assessed with a self-report question plus heartbeat frequency. Children’s satisfaction was assessed through several questions. The analyses were based on group comparisons and regression. Results: A total of two children (7%) in the PCC + simulation group used sedation compared with 14 (47%) in the simulation group and 21 (70%) in the CG. Differences between the PCC + simulation and the other two groups were significant (p < 0.001), although not between the simulation and the CG. The decrease in anxiety was significantly greater (self-reported p < 0.001; heart rate p < 0.05) and satisfaction was higher (p = 0.001) in the PCC + simulation, when compared with the simulation group. Reduced anxiety was associated with less anesthesia use (OR 1.39; CI 1.07−1.79; p = 0.013). Conclusions: PCC + simulation was more effective than simulation and routine practice in decreasing children’s anxiety, increasing satisfaction, and reducing the use of anesthesia for MRs.
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Affiliation(s)
- M. Conceição Castro
- Department of Radiology, Centro Hospitalar Universitário de São João–Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Isabel Ramos
- Faculty of Medicine, University of Porto-Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Irene Palmares Carvalho
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto-Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- CINTESIS@RISE, Faculty of Medicine, University of Porto-Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
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Involving Children in Health Literacy Research. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010023. [PMID: 36670574 PMCID: PMC9856879 DOI: 10.3390/children10010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022]
Abstract
Despite the volume and breadth of health literacy research related to children, children's involvement in that research is rare. Research with children is challenging, but the principles of involvement and engagement underpin all health promotion work, including health literacy. This commentary reflects on the process of setting up a Children's Advisory Group to consult on an institutional ethnography study of health literacy work from children's standpoint. The Children's Advisory Group contributed feedback on the study ethics and design and piloted methods for rapport-building and data collection, including livestreamed draw-and-describe and modified Interview to the Double. Consulting with the Children's Advisory Group highlighted the importance of listening to children and recognizing and valuing children's imaginative contributions to methods for involving children in health literacy research. Insights from this commentary can be used to foreground equity-focused approaches to future research and practice with children in the field of health literacy.
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Davies C, Waters D, Fraser JA. Implementing Article 12 of the United Nations Convention on the Rights of the Child in health care: a scoping review. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2022. [DOI: 10.1108/ijhrh-07-2022-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose
The purpose of this paper is to present the results of a scoping review on the implementation of Article12 in health care. The scoping review will provide a summary and overview of the key concepts and published literature on this topic internationally. Article 12 of the United Nations Convention on the Rights of the Child (1989) states that children have a right to express their views, to have them heard and for their views to be given due weight in all matters that affect them. Despite increased calls for Article 12 to be given attention in health care, there is little evidence to suggest this has been well implemented and embedded in Australian health-care delivery. The scoping review was undertaken to provide a summary and overview of the key concepts and published literature on this topic internationally.
Design/methodology/approach
A five-step methodological framework described by Arksey and O’Malley (2005) was used to undertake the scoping review. Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used as a guideline for undertaking the study selection.
Findings
Children are still not routinely involved in health-care decision-making, are frequently left out of service planning and evaluation and the perception that they lack the capability to make rational decisions persists.
Originality/value
While there has been a focus on research that investigates children’s participation in health-care decision-making in recent years, there is little that directs attention specifically to the implementation of Article 12, particularly in Australian health care. Recommendations are made for further research in these areas.
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Walker M, Mistry B, Amin R, McAdam L, Kalnins D, Lui T, McPherson AC. A qualitative exploration of the priorities and experiences of children with Duchenne muscular dystrophy, their parents, and healthcare professionals around weight management. Disabil Rehabil 2022; 44:8234-8242. [PMID: 34889714 DOI: 10.1080/09638288.2021.2008528] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE The quality and length of life for boys with Duchenne muscular dystrophy (DMD) has improved due to medical advancements, but obesity has emerged as and may pose a risk to their physical health. Clinical guidelines recommend attention to weight management, but healthcare professionals (HCPs) find implementing them in clinical care challenging. Little information is available about the perspectives of children with DMD and their families around weight management. This study explored the key priorities of children with DMD, their parents, and HCPs who treat them, around weight management. METHODS Qualitative, individual, semi-structured interviews were conducted and analyzed using a qualitative descriptive approach. RESULTS Participants included parents of children with DMD (n = 13), children with DMD (n = 10), and HCPs (n = 14). Theme one: "Competing priorities between healthcare providers, parents, and boys" contained two sub-themes: (i) Body mechanics and function; and (ii) Psychosocial well-being. Theme two: "The realities of living with Duchenne's Muscular Dystrophy," with subthemes: (i) Striving for normality; (ii) The trajectory of DMD; (iii) The labour associated with DMD. CONCLUSION HCPs, parents, and boys have diverging worldviews around weight management, highlighting the importance of integrating the priorities of families into care, even when not aligned with guideline recommendations.IMPLICATIONS FOR REHABILITATIONHCPs must understand the competing priorities in the lives of children with DMD and their families when discussing weight, weight management, and lifestyle changes.Quality of life and living a "normal" life are prioritized by children and families over the surveillance and time demands of lifestyle routines recommended by clinicians for weight management.Weight management recommendations should be based upon the individual needs and priorities of the family.
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Affiliation(s)
- Meaghan Walker
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Bhavnita Mistry
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Reshma Amin
- University of Toronto, Toronto, Canada.,The Hospital for Sick Children, Toronto, Canada
| | - Laura McAdam
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,University of Toronto, Toronto, Canada
| | | | - Toni Lui
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,University of Toronto, Toronto, Canada
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Taylor AJ, Baker S, Gallegos D. Intersection of food insecurity and moral experiences of those involved in paediatric healthcare: A scoping review of child, caregiver and healthcare provider perspectives. J Child Health Care 2022:13674935221133476. [PMID: 36384283 DOI: 10.1177/13674935221133476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Food insecurity is a significant social and health issue for children in high-income countries and contributes to sub-optimal child outcomes. This scoping review examines how food insecurity intersects with the moral experiences of those involved in providing and receiving paediatric health care. Multiple databases were searched using a priori inclusion criteria, papers were screened by multiple reviewers. Searches yielded nine papers. Descriptive data was summarised and qualitative results extracted from included papers were analysed using inductive and deductive thematic analysis. Four main themes emerged: Food insecurity threatens caregiver and healthcare provider identity; is food insecurity the business of health? is screening for food insecurity surveillance or facilitating assistance? and the lived experience of navigating the tension of managing food insecurity and a child's health condition. The moral experiences lens has magnified the countless everyday encounters in which values and beliefs about what is 'right' or 'just' can be realised or thwarted in the context of the intersection between healthcare and food insecurity. Review findings have implications relating to the inclusion of children's voices in healthcare settings, healthcare practice and policy design, and the development and use of FI screening tools.
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Affiliation(s)
- Amanda J Taylor
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, 1969Queensland University of Technology, South Brisbane, QLD, Australia.,School of Exercise and Nutrition Science, Faculty of Health, 1969Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Sabine Baker
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, 1969Queensland University of Technology, South Brisbane, QLD, Australia.,School of Exercise and Nutrition Science, Faculty of Health, 1969Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Danielle Gallegos
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, 1969Queensland University of Technology, South Brisbane, QLD, Australia.,School of Exercise and Nutrition Science, Faculty of Health, 1969Queensland University of Technology, Kelvin Grove, QLD, Australia
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25
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Wiljén A, Chaplin JE, Crine V, Jobe W, Johnson E, Karlsson K, Lindroth T, Schwarz A, Stenmarker M, Thunberg G, Öhlén J, Nilsson S. The Development of an mHealth Tool for Children With Long-term Illness to Enable Person-Centered Communication: User-Centered Design Approach. JMIR Pediatr Parent 2022; 5:e30364. [PMID: 35258466 PMCID: PMC8941441 DOI: 10.2196/30364] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/19/2021] [Accepted: 11/07/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Children with long-term illnesses frequently experience symptoms that could negatively affect their daily lives. These symptoms are often underreported in health care. Despite a large number of mobile health (mHealth) tools, few are based on a theoretical framework or supported by scientific knowledge. Incorporating universal design when developing a product can promote accessibility and facilitate person-centered communication. OBJECTIVE The aim of this study is to identify the symptom-reporting needs of children with cancer and congenital heart defects that could be satisfied by using a mobile app. Another aim is to evaluate how the child might interact with the app by considering universal design principles and to identify parents' views and health care professionals' expectations and requirements for an mHealth tool. METHODS User-centered design is an iterative process that focuses on an understanding of the users. The adapted user-centered design process includes 2 phases with 4 stages. Phase 1 involved interviews with 7 children with long-term illnesses, 8 parents, and 19 health care professionals to determine their needs and wishes for support; a workshop with 19 researchers to deepen our understanding of the needs; and a workshop with developers to establish a preliminary tool to further investigate needs and behaviors. Phase 2 involved interviews with 10 children with long-term illnesses, 9 parents, and 21 health care professionals to evaluate the mock-up (prototype) of the mHealth tool. Data were synthesized using the interpretive description technique. RESULTS A total of 4 aspects of needs emerged from the synthesis of the data, as follows: different perspectives on provided and perceived support; the need for an easy-to-use, non-clinic-based tool to self-report symptoms and to facilitate communication; the need for safety by being in control and reaching the child's voice; and a way of mapping the illness journey to facilitate recall and improve diagnostics. The children with long-term illnesses expressed a need to not only communicate about pain but also communicate about anxiety, fatigue, fear, and nausea. CONCLUSIONS The findings of this study indicated that the PicPecc (Pictorial Support in Person-Centered Care for Children) app is a potential solution for providing communicative support to children with long-term illnesses dealing with multiple symptoms and conditions. The interview data also highlighted symptoms that are at risk of being overlooked if they are not included in the mobile app. Further studies are needed to include usability testing and evaluation in hospitals and home care settings.
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Affiliation(s)
- Angelica Wiljén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics, Region Västra Götaland, Södra Älvsborg Hospital, Borås, Sweden
| | - John Eric Chaplin
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Vanessa Crine
- University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - William Jobe
- Department of Informatics, School of Business, Economics and IT, University West, Trollhättan, Sweden
| | - Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa.,Department of Inclusive Education, University of South Africa, Pretoria, South Africa
| | - Katarina Karlsson
- Department of Health Sciences, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Tomas Lindroth
- Department of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden
| | - Anneli Schwarz
- Department of Research, Education and Innovation, Region Västra Götaland, Södra Älvsborg Hospital, Borås, Sweden
| | - Margaretha Stenmarker
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics, Region Jönköping County, Jönköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Gunilla Thunberg
- University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Dart Centre for Augmentative and Alternative Communication and Assistive Technology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Speech and Language Pathology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Gothenburg, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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26
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‘Fussy eating’ and feeding dynamics: School children's perceptions, experiences, and strategies. Appetite 2022; 173:106000. [DOI: 10.1016/j.appet.2022.106000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/30/2022] [Accepted: 03/04/2022] [Indexed: 11/02/2022]
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DeCosta P, Grabowski D, Jespersen LN, Skinner TC. Playful Communication and Care: Exploring Child-Centred Care of Young Children With Type 1 Diabetes Through the Framework of Zone of Proximal Development. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 2:707553. [PMID: 36994334 PMCID: PMC10012162 DOI: 10.3389/fcdhc.2021.707553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 12/23/2021] [Indexed: 01/19/2023]
Abstract
IntroductionLittle is known about the psychosocial experiences and care needs of young children under the age of 7 years who have been diagnosed with type 1 diabetes. To address this knowledge gap, we examine children’s psychosocial care needs through the lens of child-centred care and the framework of Zone of Proximal Development.ObjectivesTo explore current care practices for young children with diabetes and identify aspects of child-centred care already successfully integrated into current practice.MethodIndividual face-to-face, semi-structured interviews were conducted with 20 Healthcare Professionals, representing 11 of 17 paediatric diabetes clinics in Denmark.ResultsOur data provided valuable insights into existing child-centred practices. Our analysis identified practices covering four main themes: 1. Accommodating immediate emotional needs, 2. Putting children before diabetes, 3. Encouraging meaningful participation, 4. Playful communication.DiscussionHealthcare Professionals provided child-centred care, largely through play-based approaches that make diabetes care meaningful and relevant. Such practices provide the scaffolding necessary to enable young children to gradually engage, comprehend and participate in their own care.
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Affiliation(s)
- Patricia DeCosta
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Patricia DeCosta,
| | - Dan Grabowski
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | | | - Timothy C. Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Department of Rural Health, La Trobe University, Bendigo, VIC, Australia
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28
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Meulendijks P, van Haren NEM, Gielen MA, van Veelen-Vincent MLC. A self-portrait: Design opportunities for a tool that supports children's involvement in brain-related health care. Health Expect 2022; 25:2235-2245. [PMID: 35084076 PMCID: PMC9615056 DOI: 10.1111/hex.13431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/02/2021] [Accepted: 12/27/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Paediatric patients with disorders that involve brain functioning are particularly vulnerable with respect to including them in shared decision‐making. Current tools are mostly paper or digital patient information. We lay the groundwork for improving engagement with a concept that we coined ‘the Self‐Portrait’. The main goals were to identify (1) obstacles and (2) design parameters that enable patient participation. Methods A research‐through‐design approach was utilized in nine patients with brain‐related disorders (4–12 years), 15 parents and 15 medical professionals, involving contextual research (interviews and observations) within the paediatric hospital and patients' homes and codesign. Sensitizing materials and early instances of design solutions were deployed as catalysts for communication. Five rounds of enriched interviews and design reviews were thematically analysed to answer the research questions. Results Obstacles to child involvement were related to children's level of understanding, the time and energy necessary for information processing and lack of perceived relevance of the information. Patients' engagement is supported by design features that extend the time frame of interaction beyond the consultation, transfer information interactively and give control and influence during the consultation. Conclusion Obstacles were detected that complicate child engagement, which differ between stakeholders. Promising design features were identified that have the potential to play an important role in enabling active child involvement. These findings show that applying principles of human‐centred design research and codesign can bring together patients, parents and medical professionals around a tool that provides a shared language and focus, which are prerequisites to increase child engagement. Patient or Public Contribution Patients, parents and clinicians contributed as design informants during contextual research and design reviews. Clinicians provided feedback on the initial outcomes of thematic analysis. Two researchers assisted in consensus sessions during the thematic analysis.
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Affiliation(s)
- Paul Meulendijks
- Department of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Neeltje E M van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Mathieu A Gielen
- Department of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
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29
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Teleman B, Svedberg P, Larsson I, Karlsson C, Nygren JM. A Norm-Creative Method for Co-constructing Personas With Children With Disabilities: Multiphase Design Study. J Particip Med 2022; 14:e29743. [PMID: 34989695 PMCID: PMC8778551 DOI: 10.2196/29743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 10/29/2021] [Accepted: 11/22/2021] [Indexed: 11/20/2022] Open
Abstract
Background An increase in the demand for child participation in health care requires tools that enable and empower children to be involved in the co-production of their own care. The development of such tools should involve children, but participatory design and research with children have challenges, in particular, when involving children with disabilities where a low level of participation is the norm. Norm-creative and participatory approaches may bring more effective design solutions for this group. “Personas” is a methodology for increasing user perspectives in design and offers representation when users are absent. However, research on participatory persona generation in this context is limited. Objective The objective of this study was to investigate how norm-creative and participatory design approaches can be integrated in a persona generation method to suit children with disabilities in the design of games for health that target this group. Methods The method development involved interview transcripts and image-based workshops. Sixteen children with various disabilities participated in persona generation through co-creation of characters and scenarios. The results from the workshops were validated together with 8 children without disabilities, 1 young adult with a disability, and 1 rehabilitation professional. A qualitative thematic design analysis was iterated throughout the process. Results The results consisted of an image-based and iterative co-construction method. It was accompanied by examples of personas that were generated and validated within a games for health case. The method showed effectiveness in enabling flexible co-construction and communication. The data resonated with social model perspectives, and the development is discussed in terms of participation levels, salutogenic descriptions of barriers, and norm-creative tradeoffs. Conclusions The resulting method may influence future design projects toward more inclusiveness and enable increased representation for children with disabilities in research and design. Using this method to its full potential requires a norm-critical awareness as well as extensive facilitation. Suggestions for further research include the application of the method to design processes in similar contexts or user groups.
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Affiliation(s)
- Britta Teleman
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ingrid Larsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | - Jens M Nygren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Segers EW, Ketelaar M, Taddio A, de Man MACP, Schoonhoven L, van de Putte EM, van den Hoogen A. Exploring key elements of approaches that support childrens' preferences during painful and stressful medical procedures: A scoping review. J Pediatr Nurs 2022; 62:e16-e24. [PMID: 34266719 DOI: 10.1016/j.pedn.2021.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/17/2022]
Abstract
PROBLEM Children undergoing medical procedures can experience pain and distress. While numerous interventions exist to mitigate pain and distress, the ability to individualize the intervention to suit the needs and preferences of individual children is emerging as an important aspect of providing family-centered care and shared decision making. To date, the approaches for supporting children to express their preferences have not been systematically identified and described. A scoping review was conducted to identify such approaches and to describe the elements that are included in them. ELIGIBILITY CRITERIA Studies that (a) described approaches with the aim to support children to express their coping preferences during medical procedures; (b) included the option for children to choose coping interventions; (c) included a child (1--18 years). SAMPLE Searches were conducted in December 2019 and November 2020 in the following databases: Cinahl, Embase, PubMed and Psycinfo. RESULTS Thirteen studies were identified that included six distinct approaches. Four important key elements were identified: 1) Aid to express preferences or choice, 2) Information Provision, 3) Assessment of feelings/emotions, 4) Feedback/Reflection and Reward. CONCLUSIONS Identified approaches incorporate components of shared decision-making to support children in expressing their preferences during medical procedures and treatments. IMPLICATIONS Children undergoing medical procedures can be supported in expressing their coping needs and preferences by using components of shared decision-making.
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Affiliation(s)
- Elisabeth W Segers
- Department of Children, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands.
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicin, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario M5S 3M2, Canada
| | - Marjorie A C P de Man
- Department of Children, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands
| | - Lisette Schoonhoven
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, UK
| | - Elise M van de Putte
- Department of Children, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands
| | - Agnes van den Hoogen
- Department of Children, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, the Netherlands; Utrecht University, Utrecht, the Netherlands
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31
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Nordlind A, Sundqvist AS, Anderzén-Carlsson A, Almblad AC, Ängeby K. How paediatric departments in Sweden facilitate giving children a voice on their experiences of healthcare: A cross-sectional study. Health Expect 2021; 25:384-393. [PMID: 34856647 PMCID: PMC8849245 DOI: 10.1111/hex.13396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/17/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022] Open
Abstract
Background In January 2020, the United Nations Convention on the Rights of the Child was incorporated into Swedish law. According to Swedish regulations, patients are to be given the opportunity to participate in quality improvement. Sometimes, the patients are children who have the right to be heard on matters concerning them, such as their experience of a hospital visit. Objective This study aimed to describe how Swedish paediatric departments facilitate children's voices on their healthcare experiences and how their perspectives are taken into account in quality improvement work. Methods This study has a descriptive cross‐sectional design. Data were collected using a study‐specific survey sent by e‐mail to all the heads of the paediatric departments in Sweden, with both inpatient and outpatient care. The response rate was 74% (28 of 38 departments). Results The results demonstrated a variation in questionnaires used and to whom they were targeted; less than half of the participating departments reported having had questionnaires aimed at children. The results also indicated a major variation in other working methods used to allow children to voice their experiences in Swedish paediatric departments. The results indicate that the national co‐ordination in facilitating the children's rights to be heard on their experiences in healthcare organisations can be improved. Conclusion Further research is required to ascertain which method is the most practically effective in paediatric departments, in what way children prefer to be heard regarding their experience of and perspectives on healthcare, and what questions need to be asked. A validated national patient‐reported experience measure developed with and aimed at children could provide them with equal opportunities to voice their experiences in healthcare, regardless of their diagnoses or which paediatric department they visit.
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Affiliation(s)
- Anna Nordlind
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Department of Paediatric Medicine, County Hospital Karlstad, Karlstad, Sweden
| | - Ann-Sofie Sundqvist
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden.,Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Agneta Anderzén-Carlsson
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Ann-Charlotte Almblad
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Children Hospital and Emergency, Region Uppsala, Uppsala, Sweden
| | - Karin Ängeby
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Lundberg V, Eriksson C, Lind T, Coyne I, Fjellman-Wiklund A. How children with juvenile idiopathic arthritis view participation and communication in healthcare encounters: a qualitative study. Pediatr Rheumatol Online J 2021; 19:156. [PMID: 34727931 PMCID: PMC8561993 DOI: 10.1186/s12969-021-00642-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/10/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Children report that they do not participate in their healthcare as much as they want, despite having the lawful right to form their own views and the right to express those views freely in all matters affecting them. Children and parents appeared to be more satisfied when healthcare professionals (HCP) use a participatory style in healthcare encounters. AIM To explore how children, adolescents and young adults with Juvenile Idiopathic Arthritis (JIA) and parents of children with JIA view their participation and communication in healthcare encounters with healthcare professionals. METHODS Using a qualitative study design, participatory workshops were held separately for children and young adults with JIA and parents of children with JIA. The workshop data were analysed with Graneheim and Lundman's Qualitative Content Analysis resulting in one main theme and two subthemes. RESULTS The theme "Feeling alienated or familiar with healthcare encounters" illuminates how children felt alienated at healthcare encounters if they found the encounters emotionally distressing. Children could withhold information regarding their health and function from both HCPs and their family and friends. The subtheme "Distancing oneself from healthcare" describe why children felt reluctant to engage in the healthcare encounters and experienced difficulty expressing how they really felt. The subtheme "Being a normal event in life" describe how children felt more comfortable over time engaging with HCPs when they knew what would happen, and felt that HCPs gave them the necessary support they needed to participate. CONCLUSIONS Children's participation in healthcare encounters varied depending if children felt alienated or familiar to the healthcare situations. Children distance themselves and are reluctant to engage in healthcare encounters if they find them emotionally distressing and feel disregarded. Over time, children can become more familiar and at ease with healthcare situations when they feel safe and experience personal and positive encounters. When the children are prepared for the encounter, provided with the space and support they want and receive tailored help they are more enabled to participate.
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Affiliation(s)
- Veronica Lundberg
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE 901 87, Umeå, Sweden. .,Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 85, Umeå, Sweden.
| | - Catharina Eriksson
- grid.12650.300000 0001 1034 3451Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 85 Umeå, Sweden ,Department of Public Health and Clinical Medicine/Rheumatology, SE 901 87 Umeå, Sweden
| | - Torbjörn Lind
- grid.12650.300000 0001 1034 3451Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 85 Umeå, Sweden
| | - Imelda Coyne
- grid.8217.c0000 0004 1936 9705School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Anncristine Fjellman-Wiklund
- grid.12650.300000 0001 1034 3451Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE 901 87 Umeå, Sweden
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Stålberg A. Design and Redesign of the IACTA App, an Interactive Communication Tool Intended to Facilitate Young Children's Participation in Healthcare Situations. J Pediatr Nurs 2021; 61:260-268. [PMID: 34333243 DOI: 10.1016/j.pedn.2021.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/15/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To develop the storyboard of IACTA further, based on the child''s perspective, by testing and evaluating both re-designed and newly designed scenes. DESIGN AND METHOD A participatory design was used involving preschool children (n = 18) aged three to five who tested and evaluated evolving prototypes of the IACTA application. Think aloud and Active intervention were used to elicit verbal responses from the children. Additionally, observational protocols were used to capture, in a structured way, the children's interaction with the app. RESULTS By testing evolving prototypes, the children confirmed previous developments and challenged the newly added scenes of the app. By their interaction, important information regarding the children's ways of navigating the storyboard was obtained. Ways of becoming immersed in the storyboard and the eagerness of dealing with each scene provided information regarding likeability. CONCLUSIONS Overall, this article presents a participatory design process in which preschool aged children were involved in testing and evaluating prototypes of the re-designed IACTA app. In the process, the children provided their perspective on the design and content and eventually, based on their feedback, IACTA was proven to be an age-appropriate tool. PRACTICAL IMPLICATIONS Children are frequent visitors to healthcare services. Lack of knowledge might trigger fear and anxiety, whereas information provides understanding. Interactive, mobile solutions enable children to receive information within paediatric healthcare contexts. The IACTA application intends to provide children a situated understanding that facilitates their participation in healthcare situations.
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Affiliation(s)
- Anna Stålberg
- Swedish Red Cross University College, Huddinge, Sweden.
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Mendoza BA, Fortier MA, Trinh LN, Schmid LN, Kain ZN. Factors impacting parental and child satisfaction in the perioperative setting. Paediatr Anaesth 2021; 31:932-943. [PMID: 34096658 DOI: 10.1111/pan.14236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/28/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022]
Abstract
Understanding the different modifiable and non-modifiable factors and their positive or negative influence on parental and child satisfaction is essential to providing high-quality perioperative care. The purpose of this review is to focus on the perioperative environment and to report the various modifiable and non-modifiable factors that are associated with satisfaction. We found that factors such as quality of clinician-patient communication, clinician attitudes, teamwork, shared decision-making, and improved perioperative information were associated with increased parent and child satisfaction. Interventions such as preparation programs integrating role-play, teaching of coping skills, and family-centered programs were highly rated by parents and children. Healthcare providers and institutions should consider the above variables when treating children and their parents in the perioperative setting.
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Affiliation(s)
- Beverly A Mendoza
- Center on Stress & Health, University of California School of Medicine, Irvine, USA.,Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA
| | - Michelle A Fortier
- Center on Stress & Health, University of California School of Medicine, Irvine, USA.,Department of Pediatric Psychology, Children's Hospital of Orange County, Orange, CA, USA.,Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA.,Department of Psychological Science, University of California, Irvine, CA, USA
| | - Lily N Trinh
- Center on Stress & Health, University of California School of Medicine, Irvine, USA
| | - Lauren N Schmid
- Center on Stress & Health, University of California School of Medicine, Irvine, USA.,Hahn School of Nursing and Health Science, University of California, San Diego, CA, USA
| | - Zeev N Kain
- Center on Stress & Health, University of California School of Medicine, Irvine, USA.,Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA.,Department of Pediatrics, CHOC Children's, Orange, CA, USA.,Yale Child Study Center, Yale University, New Haven, CT, USA
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Siedlikowski M, Curiale L, Rauch F, Tsimicalis A. Experiences of Children With Osteogenesis Imperfecta in the Co-design of the Interactive Assessment and Communication Tool Sisom OI: Secondary Analysis of Qualitative Design Sessions. JMIR Pediatr Parent 2021; 4:e22784. [PMID: 34383677 PMCID: PMC8386389 DOI: 10.2196/22784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 03/13/2021] [Accepted: 04/21/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Children with osteogenesis imperfecta (OI) experience a diversity of symptoms that expose them to difficult physical, mental, and social challenges. Sisom (DHealth) is an interactive assessment and communication tool designed to help children aged 6-12 years with chronic conditions express their symptoms. Recently, the co-design of the Sisom OI paper prototype was launched by seeking the perspectives of end users, including children with OI and their clinicians. OBJECTIVE The aim of this study is to describe the experiences that children with OI were prompted to share with researchers during the co-design of the Sisom OI paper prototype. METHODS A secondary analysis of qualitative data was conducted at a university-affiliated, pediatric, orthopedic hospital. The data sources consisted of interview transcripts, drawings, field notes, and observations derived from interviewing 12 children with OI who participated in the co-design of the Sisom OI paper prototype. The themes and subthemes identified from the data sources were generated using qualitative description. RESULTS Three themes were identified. The first, Relating to Others, described the balance between feeling different versus feeling similar to other children. The subthemes were Common OI Experience, Feeling Different, and Feeling Just Like Others. The second, Relating to Their Condition, described children's positive and negative interactions with their own condition and health care. The subthemes were Understanding Their Condition, Special Relationship with the Hospital, and Difficult Treatments and Procedures. The third, Reflecting on Capabilities, described children's recognition of their strengths and limitations. The subthemes were Perceiving Limitations, Overcoming Isolation, and Celebrating Strengths. CONCLUSIONS This co-design process provided children with OI the space to not only contribute to the development of the end product but also eloquently describe their experiences. These findings, based on the descriptions given by the children themselves, offer us a unique understanding of what it means to grow up with OI.
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Affiliation(s)
| | - Lianna Curiale
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Frank Rauch
- Shriners Hospitals for Children-Canada, Montreal, QC, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC, Canada.,Shriners Hospitals for Children-Canada, Montreal, QC, Canada
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Derwig M, Tiberg I, Hallström I. Elucidating the child's perspective in health promotion: children's experiences of child-centred health dialogue in Sweden. Health Promot Int 2021; 36:363-373. [PMID: 32620968 PMCID: PMC8049549 DOI: 10.1093/heapro/daaa060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Promoting young children’s health through health promotion activities is an investment for the future. In the Child Health Services in the south of Sweden a structured Child-Centred Health Dialogue (CCHD) directed to all 4-year-old children was developed using illustrations based on the most important health messages associated with the promotion of healthy lifestyle in preschool children. The aim of this study was to explore the experiences of children participating in CCHD using 21 non-participant observations during their 4-year health visit and additionally 16 individual interviews 0–7 days after their visit, conducted in the child’s home in the presence of a caregiver. Children participated as social actors when guided to express their views based upon their own understanding was the overall main category generated from the qualitative content analysis. The children showed that they liked to participate actively but could influence their choice to participate. They expressed their views based on their daily life and wanted to understand the meaning of the information with which they interacted. The study revealed that 4-year-old children given the opportunity to speak for themselves—elucidating the child’s perspective—interpreted the health messages in a different way than the intended meaning of the illustrations developed by adults. These findings are important for the improvement of CCHD and underline the utmost importance of including children in research on health promotion. This study supports the view that 4-year-old children can take an active role in their health and are capable of making health information meaningful.
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Affiliation(s)
- Mariette Derwig
- Faculty of Medicine, Department of Health Sciences, Lund University, Margaretavägen 1 B, 22240, Lund, Sweden
| | - Irén Tiberg
- Faculty of Medicine, Department of Health Sciences, Lund University, Margaretavägen 1 B, 22240, Lund, Sweden
| | - Inger Hallström
- Faculty of Medicine, Department of Health Sciences, Lund University, Margaretavägen 1 B, 22240, Lund, Sweden
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Davison G, Kelly MA, Conn R, Thompson A, Dornan T. How do children and adolescents experience healthcare professionals? Scoping review and interpretive synthesis. BMJ Open 2021; 11:e054368. [PMID: 34244289 PMCID: PMC8273482 DOI: 10.1136/bmjopen-2021-054368] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/22/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Explore children's and adolescents' (CADs') lived experiences of healthcare professionals (HCPs). DESIGN Scoping review methodology provided a six-step framework to, first, identify and organise existing evidence. Interpretive phenomenology provided methodological principles for, second, an interpretive synthesis of the life worlds of CADs receiving healthcare, as represented by verbatim accounts of their experiences. DATA SOURCES Five key databases (Ovid Medline, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Web of Science), from inception through to January 2019, reference lists, and opportunistically identified publications. ELIGIBILITY CRITERIA Research articles containing direct first-person quotations by CADs (aged 0-18 years inclusive) describing how they experienced HCPs. DATA EXTRACTION AND SYNTHESIS Tabulation of study characteristics, contextual information, and verbatim extraction of all 'relevant' (as defined above) direct quotations. Analysis of basic scope of the evidence base. The research team worked reflexively and collaboratively to interpret the qualitative data and construct a synthesis of children's experiences. To consolidate and elaborate the interpretation, we held two focus groups with inpatient CADs in a children's hospital. RESULTS 669 quotations from 99 studies described CADs' experiences of HCPs. Favourable experiences were of forming trusting relationships and being involved in healthcare discussions and decisions; less favourable experiences were of not relating to or being unable to trust HCPs and/or being excluded from conversations about them. HCPs fostered trusting relationships by being personable, wise, sincere and relatable. HCPs made CADs feel involved by including them in conversations, explaining medical information, and listening to CADs' wider needs and preferences. CONCLUSION These findings strengthen the case for making CADs partners in healthcare despite their youth. We propose that a criterion for high-quality child-centred healthcare should be that HCPs communicate in ways that engender trust and involvement.
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Affiliation(s)
- Gail Davison
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
- Children's Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Martina Ann Kelly
- Department of Family Medicine, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada
| | - Richard Conn
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
- General Paediatrics Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Andrew Thompson
- General Paediatrics Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Tim Dornan
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
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Lumia CM, Arbour-Nicitopoulos KP, Moola FJ, McPherson AC. Using photo-elicitation to explore health promotion concepts with children and adolescents with disabilities: a rapid scoping review. Disabil Rehabil 2021; 44:5708-5718. [PMID: 34227449 DOI: 10.1080/09638288.2021.1945690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE It is important to directly engage children and adolescents with disabilities (CAWD) in health promotion research to ensure their health needs are met. Arts-based research methods may help CAWD better express their ideas; photo-elicitation is one such technique, using self-captured photographs to enhance verbal descriptions of complex concepts. This review 1) summarizes findings from health promotion studies using photo-elicitation with CAWD; 2) explores benefits and challenges of using photo-elicitation; 3) identifies recommended photo-elicitation practices. MATERIALS AND METHODS A scoping review was conducted using rapid review principles. Four health and social science databases were searched (2009-2019) using terms related to children, adolescents, disability, and photo-elicitation. Articles meeting inclusion criteria were summarized and analyzed thematically. RESULTS Eight studies met inclusion criteria and explored a range of health promotion topics. Benefits of photo-elicitation included the ability to mediate communication and direct participants' focus. Challenges included difficulty operating a camera and understanding instructions about photograph subject matter. Four recommended practices were identified: 1) brainstorming photograph ideas; 2) photograph-taking training; 3) having CAWD select photographs for discussion; 4) limiting the number of photographs CAWD could capture. CONCLUSIONS Integrating practices to support CAWD in using photo-elicitation can help researchers more fully understand their health experiences.Implications for RehabilitationThere is a need to directly engage children and adolescents with disabilities to express themselves in health promotion research.The arts-based method of photo-elicitation may help children and adolescents with disabilities convey how they view and experience health.Children and adolescents with disabilities may need supports, including camera training, to participate in photo-elicitation.
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Affiliation(s)
- Celeste M Lumia
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Kelly P Arbour-Nicitopoulos
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Fiona J Moola
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,School of Early Childhood Studies, Ryerson University, Toronto, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Harden J, Black R, Pickersgill M, Shetty J, McLellan A, Brand C, Small M, McDonnell J, Clarke L, Chin RF. Children's understanding of epilepsy: A qualitative study. Epilepsy Behav 2021; 120:107994. [PMID: 33964537 PMCID: PMC8259124 DOI: 10.1016/j.yebeh.2021.107994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 04/14/2021] [Accepted: 04/14/2021] [Indexed: 12/04/2022]
Abstract
PURPOSE To use a qualitative research approach to determine children's understandings of epilepsy and their epilepsy treatment. METHODS Children aged 7-16 years with physician-confirmed active epilepsy (i.e., having had an epileptic seizure in the past year and or currently taking antiepileptic drugs (AEDs), and not known to have an intellectual disability, were invited to participate. Children had semi-structured interviews separately on two occasions. Between the first and second interviews, an observation of a routine epilepsy clinic appointment of individual children was conducted, and was then discussed during the second interview. Participatory research tools were used in both child interviews to facilitate discussions. Interviews were audio recorded and transcribed, pseudonymized and entered into NVivo (version 12, QSR International). Data were analyzed using a thematic approach. RESULTS Twenty-three children of mean age 10.1 years (range 8-14), mean duration of epilepsy of 4.6 years (range 2-10) were enrolled. Twelve were 12 female; 7 had focal, 14 had generalized, and 2 had combined epilepsy; 20 were on monotherapy; and 16 had tried previous AEDs. All had an initial (first) interview; 20 were observed during a clinic appointment and had a second interview. Five broad themes emerged: understanding of epilepsy; understanding of seizures; understanding of medication; understanding of children's role in clinical appointments; influences on children's understanding. Children spoke about what epilepsy meant by describing the physical sensations of having a seizure or through the act of taking medication. Children described the role they had, or felt they should have, but reported challenges in being meaningfully involved in clinical appointments. While healthcare professionals were initial information nodes, epilepsy information from parents appeared to be more significant for children. CONCLUSIONS The perspectives of children with epilepsy are valuable for clinicians to understand; assumptions should not be made that children's views can be accessed via parents. Clinicians need to be constantly aware of children's views and ways of understanding and communicating about their epilepsy. To support this, the research - drawing on children's words, meanings, and stories - was used to inform an easily accessible, gender-neutral, animation about epilepsy that provides information about the condition, seizures, and medication (https://youtu.be/MO7xXL2ZXP8).
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Affiliation(s)
- Jeni Harden
- Usher Institute, The University of Edinburgh, UK; Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, UK.
| | - Rebecca Black
- Usher Institute, The University of Edinburgh, UK,Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, UK
| | - Martyn Pickersgill
- Usher Institute, The University of Edinburgh, UK,Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, UK
| | - Jay Shetty
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, UK,Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK,Child Life and Health, MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - Ailsa McLellan
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, UK,Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK,Child Life and Health, MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - Celia Brand
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, UK,Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK
| | - Michelle Small
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, UK,Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK
| | | | | | - Richard F. Chin
- Usher Institute, The University of Edinburgh, UK,Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, UK,Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK,Child Life and Health, MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
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40
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Mårtensson U, Cederlund M, Jenholt Nolbris M, Mellgren K, Wijk H, Nilsson S. Experiences before and after nasogastric and gastrostomy tube insertion with emphasis on mealtimes: a case study of an adolescent with cerebral palsy. Int J Qual Stud Health Well-being 2021; 16:1942415. [PMID: 34167445 PMCID: PMC8231357 DOI: 10.1080/17482631.2021.1942415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose: Adolescents with cerebral palsy may need a feeding tube due to feeding challenges, since nutritional intake and mealtimes may be negatively affected. The purpose of the study was to describe and better understand how one adolescent with cerebral palsy and her parents experienced mealtimes before and after a nasogastric and gastrostomy tube insertion and how the use of these feeding tubes was experienced in daily life. Methods: Individual interviews were performed with one adolescent and each of her parents. In total, six interviews were conducted on two separate occasions. The qualitative approach known as Interpretive Description was used during the analysis. Results: Four thematic patterns were identified within the data: (i) struggling with nutritional intake, (ii) the paradox of using an aid, (iii) being different, and (iv) challenges of public mealtimes. Conclusions: The results showed that four themes influenced daily mealtimes in adolescents with cerebral palsy and a gastrostomy tube. Nutritional intake and mealtimes may be difficult, which is why using a gastrostomy tube can be a relief. However, the gastrostomy tube can also pose a challenge and a paradox. Time of change and acceptance seems necessary in order to meet these challenges.
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Affiliation(s)
- Ulrika Mårtensson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden
| | - Mats Cederlund
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margaretha Jenholt Nolbris
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Gothenburg, Sweden and Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karin Mellgren
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Architecture and Civil Engineering, Chalmers Technology University/Centre for Health Care Architecture, Gothenburg, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden
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41
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Quaye AA, Castor C, Coyne I, Söderbäck M, Hallström IK. How are children's best interests expressed during their hospital visit?-An observational study. J Clin Nurs 2021; 30:3644-3656. [PMID: 34080241 DOI: 10.1111/jocn.15886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To describe ways in which children's best interests were observed to be expressed in paediatric settings during their hospital visit. BACKGROUND The best interests of the child are embodied in national and international legal systems, although the definition remains problematic. The child's limited autonomy mandates duty bearers to have both a child perspective and the child's perspective when considering what the best interest of the child entails in care situations. DESIGN A qualitative descriptive study with overt, non-participant observations fulfilling the COREQ criteria. METHODS Thirty-two observations of interactions between children aged 2 to 17 years with both acute and chronic conditions, their parents and healthcare professionals were conducted at three paediatric hospitals in Sweden. Inductive and abductive reasoning were used in the content analysis of data, which followed the identification, coding, categorising and abstraction of observed patterns of the best interest of the child. RESULTS Findings reveal facilitating and obstructing factors for the child's best interests to be safeguarded in healthcare situations. Children were guided in or hindered from exercising their competence. The observations showed a variation in actions taken by both parents and healthcare professionals to safeguard the best interests of the child. CONCLUSIONS Determining the best interest of the child requires a case-by-case basis, as it is context-dependent, situational, flexible and dependent on all actors involved and actual decisions made. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals' actions can facilitate or obstruct observed expressions of the child's best interest. It is essential to enhance healthcare professionals' communication skills, knowledge awareness and continuing education about the rights of children receiving healthcare services. Reflections and discussions on how to protect the best interests of children may help healthcare professionals to uphold children's best interest in daily clinical practice.
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Affiliation(s)
- Angela Afua Quaye
- Department of Health Science, Faculty of Medicine, Lund University, Lund, Sweden
| | - Charlotte Castor
- Department of Health Science, Faculty of Medicine, Lund University, Lund, Sweden
| | - Imelda Coyne
- School of Nursing and Midwifery, Faculty of Science and Health, Trinity College Dublin, Dublin, Ireland
| | - Maja Söderbäck
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Wingler D, Liston D, Joseph A, Wang Y, Feng H, Martin L. Perioperative anxiety in pediatric surgery: Induction room vs. operating room. Paediatr Anaesth 2021; 31:465-473. [PMID: 33278852 DOI: 10.1111/pan.14098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 11/08/2020] [Accepted: 11/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Perioperative anxiety can have a profound and lasting effect on children and their parents, with up to 70 percent of children undergoing outpatient surgery experiencing significant physiologic and/or psychological manifestations of anxiety throughout the ambulatory surgical process. The physical healthcare environment itself can contribute to these feelings, substantially impacting the level of anxiety experienced by both the child and their parent. OBJECTIVE This study sought to examine whether a difference exists between utilization of an induction room vs. the operating room on child and parent perioperative anxiety for parent present induction. METHODS A single institution multi-site prospective observational study was conducted with a cohort of 51 healthy children aged 6-12 years, receiving an outpatient tonsillectomy and/or adenoidectomy and their parent. The methodological approach utilized for this study was Ecological Momentary Assessment. Two psychological measures of anxiety, (i) momentary and (ii) environmental, and one physiologic measure of anxiety (i) electrodermal activity were used. Data were captured separately for child and parent. RESULTS For children who underwent anesthetic induction in the induction room, all three anxiety responses were significantly lower and exhibited a large positive effect [momentary (P = .0002, d = 1.984, induction room = 3.76, operating room = 7.07), environmental (P = .018, d = 1.160, induction room = 1.72, operating room = 0.85), and electrodermal activity (P = .039, d = 1.007, induction room = 0.76, operating room = 1.51)], as compared to children who were induced in the operating room. Electrodermal activity was also statistically significantly lower, with a large positive effect, in the postoperative environment (P = .004, d = 1.454, induction room = 0.21, operating room = 0.60) for Children who were induced in the induction room, as compared to the operating room cohort. No significant differences were found between parents for momentary and environmental anxiety, and electrodermal anxiety. CONCLUSIONS The nonpharmacological strategy of using an induction room for anesthetic induction of children may be clinically effective in reducing anxiety as compared to an operating room.
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Affiliation(s)
- Deborah Wingler
- The Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
| | - David Liston
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Anjali Joseph
- The Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
| | - Yifan Wang
- Seattle Children's Hospital, Seattle, WA, USA
| | - Haotian Feng
- Statistics and Mathematics Consulting Center, Clemson University, Clemson, SC, USA
| | - Lynn Martin
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
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Behan JM, Arora RS, Carnevale FA, Bakhshi S, Bhattacharjee B, Tsimicalis A. An Ethnographic Study of the Moral Experiences of Children with Cancer in New Delhi, India. Glob Qual Nurs Res 2021; 8:2333393621995814. [PMID: 33748333 PMCID: PMC7905724 DOI: 10.1177/2333393621995814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 11/15/2022] Open
Abstract
There is a paucity of research examining children’s experiences with cancer in India. Childhood ethics is an emerging field, focusing on the moral dimension of children’s experiences, to promote children’s participation in their health care. A focused ethnography, using a moral experience framework, was conducted to better understand children’s participation in decisions, discussions, and actions in three oncology settings in New Delhi, India. We interviewed key informants, retrieved key documents, and conducted semi-structured interviews and participant observations with children. All 22 children demonstrated interest in varying aspects of their cancer care. Certain factors facilitated or impeded their participation. Some children became distressed when they lacked information about their treatment or were not given opportunities to enhance their understanding. The results advance our understanding of the moral experiences of children with cancer in India for healthcare professionals, policy makers, families, and interested others.
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Affiliation(s)
| | | | | | - Sameer Bakhshi
- All India Institute of Medical Sciences, New Delhi, India
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44
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Weiner C, Pergert P, Molewijk B, Castor A, Bartholdson C. Perceptions of important outcomes of moral case deliberations: a qualitative study among healthcare professionals in childhood cancer care. BMC Med Ethics 2021; 22:27. [PMID: 33731101 PMCID: PMC7970765 DOI: 10.1186/s12910-021-00597-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 03/04/2021] [Indexed: 11/29/2022] Open
Abstract
Background In childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for clinical ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was to describe the MCD-related outcomes that healthcare professionals in childhood cancer care considered important, before MCDs were implemented, in order to facilitate the implementation of MCDs in childhood cancer care in Sweden.
Methods This study is based on qualitative data. Healthcare professionals, mostly representing registered nurses, nursing assistants and physicians, working at childhood cancer care centres in Sweden, were invited to respond to the translated and content validated European MCD Outcomes Instrument, before participating in regular MCDs. Answers to the main open-ended question, included in the questionnaire, was analysed according to systematic text condensation. Results Data was collected from 161 responses from the healthcare professionals. The responses included healthcare professionals’ perceptions of which MCD-related outcomes they found important for handling moral challenges. Three different themes of important outcomes from the analysis of the data are presented as follows: Interprofessional well-being in team interactions on a team level; Professional comfort when dealing with moral challenges on a personal level; and Improved quality of care for the child and the family on a care level. Conclusions Healthcare professionals in childhood cancer care considered it important that ethics support could enhance the well-being of interprofessional teams, support healthcare professionals on an individual level and improve quality of care. The results of this study can be used in current and future training for MCD-facilitators. When knowing the context specific important MCD-outcomes, the sessions could be adapted. Managers in childhood cancer care would benefit from knowing about the specific important outcomes for their target group because they could then create relevant working conditions for clinical ethics support.
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Affiliation(s)
- Charlotte Weiner
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Paediatric Regional Health Care, Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Pernilla Pergert
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Paediatric Haematology and Oncology, Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Bert Molewijk
- Department of Medical Humanities, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands.,Center for Medical Ethics, University of Oslo, Oslo, Norway
| | - Anders Castor
- Paediatrics, Lund University, Lund, Sweden.,Pediatric Oncology, Hematology, Immunology and Nephrology, Skåne University Hospital, Lund, Sweden
| | - Cecilia Bartholdson
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. .,Paediatric Neurology and Musculoskeletal Disorders and Homecare, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
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Children and young people's experiences of living with developmental coordination disorder/dyspraxia: A systematic review and meta-ethnography of qualitative research. PLoS One 2021; 16:e0245738. [PMID: 33661934 PMCID: PMC7932121 DOI: 10.1371/journal.pone.0245738] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 01/06/2021] [Indexed: 12/01/2022] Open
Abstract
Background To date services for children with Developmental Coordination Disorder (DCD) have not been informed by the perspective of children with DCD. This study aimed to synthesise the findings of discrete qualitative studies reporting the lived experiences views and preferences of children and young with DCD using a meta-ethnographic approach to develop new conceptual understandings. Methods A systematic search of ten databases; Academic Search Complete, AMED, CINAHL, ERIC, MEDLINE, PsychArticles, PsychInfo, EMBASE, SPORTDiscus, and Web of Science, was conducted between March and April 2019, and updated in early June 2020. Meta-ethnography, following the method described by Noblit and Hare was used to synthesise included studies. The Joanna Briggs Institute Checklist was used to appraise all included papers. PROSPERO registration number CRD42019129178. Results Fifteen studies met the inclusion criteria. Meta-ethnographic synthesis produced three themes; a) ‘It’s harder than it should be’: Navigating daily activities b) Fitting in, and c) ‘So what? I drop things’: Strategies and supports to mitigate challenges. Children with DCD describe a mismatch between their abilities and performance norms for daily activities that led to a cascade of negative consequences including negative self-appraisal, bullying and exclusion. In the face of these difficulties children described creative and successful strategies they enacted and supports they accessed including; assistance from others (parents, friends and teachers), focusing on their strengths and talents, accepting and embracing their difference, adopting a “just do it” attitude, setting personal goals, self-exclusion from some social activities, using humour or sarcasm, viewing performance expectations as a social construct, and enjoying friendships as a forum for fun, acceptance and protection against exclusion. Conclusion Service provision for children and young people with DCD should address the social and attitudinal environments, focus on friendship and social inclusion and address stigma-based bullying particularly within the school environment. Furthermore, practitioners should identify and foster children’s own strategies for navigating daily life activities with DCD. The identified themes resonate with contemporary disability theory and the International Classification of Functioning. The social and attitudinal environmental context of children and young people with DCD profoundly influences their experiences. Future intervention development and service provision for children and young people with DCD should consider opportunities to address social and attitudinal environmental factors.
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Carlsson IM, Arvidsson S, Svedberg P, Nygren JM, Viklund Å, Birkeland AL, Larsson I. Creating a communication space in the healthcare context: Children’s perspective of using the eHealth service, Sisom. J Child Health Care 2021; 25:31-43. [PMID: 32048874 PMCID: PMC7897780 DOI: 10.1177/1367493520904804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
According to the United Nation's Convention of the Rights of the Child, children have the right to participate in their own healthcare and make their opinions heard. The aim of this study was thus to explore the impact of using an eHealth service, Sisom, to gain the children's perspectives during their healthcare appointments. Data were gathered through individual interviews with a purposeful sample of 16 children, aged 6-13 years old, treated for different diseases and using the eHealth service, Sisom, during their healthcare appointments. The interviews were analysed using a constructivist grounded theory. The results showed that using Sisom made children's voice heard by creating a communication space in the healthcare setting. This meant that the children got involved in the communication, were acknowledged as an important person who could give the answers to questions and were given time. Implementing the use of Sisom is a way to make children's needs and preferences explicitly visible for decision-making in practice and thereby supporting the further development of child-centred care in practice.
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Affiliation(s)
- Ing-Marie Carlsson
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden,Ing-Marie Carlsson, Department of Health and Welfare, Halmstad University, SE-823, SE-301 18 Halmstad, Sweden.
| | - Susann Arvidsson
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
| | - Petra Svedberg
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
| | - Jens M Nygren
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
| | - Åsa Viklund
- Department of Social Work, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anna-Lena Birkeland
- Department of Social Work, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid Larsson
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
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47
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O'Dea Á, Coote S, Robinson K. Children and young people's experiences of living with developmental coordination disorder/dyspraxia: study protocol for a qualitative evidence synthesis. HRB Open Res 2021; 2:28. [PMID: 32104780 PMCID: PMC7017181 DOI: 10.12688/hrbopenres.12958.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2020] [Indexed: 12/20/2022] Open
Abstract
Background Children with developmental coordination disorder (DCD) face significant challenges to deal with everyday activities due to underlying motor proficiency difficulties. These challenges affect children and young people's participation; that is, involvement in daily life situations. Recent years have seen a growing body of qualitative research examining children's experiences of living with DCD. Meta-ethnographic synthesis offers a rigorous approach to bring together the findings of discrete qualitative studies to be synthesised in order to advance the conceptual understanding of living with DCD, which is not well conceptualised in the literature to date. Conducting a meta-ethnographic synthesis will help to illuminate the meaning of children and young people's experiences of DCD regarding their involvement in everyday activities and situations. Aim This study aims to systematically review and synthesise qualitative literature regarding children and young people's experiences and views of everyday life and living with DCD. Methods The method of qualitative evidence synthesis that will be followed in this review is a meta-ethnography. The eMERGe and PRISMA reporting guidelines will be adhered to. Ten databases will be searched; Academic Search Complete, AMED, CINAHL, ERIC, MEDLINE, PsychArticles, PsychInfo, EMBASE, SPORTDiscus, and Web of Science. The Joanna Briggs Institute Checklist will be used by two independent reviewers to appraise all included papers. PROSPERO registration number CRD42019129178 Discussion The findings of this meta-ethnography will endeavour to inform future research, policy and practice. In particular, the results will help to inform the design of future complex interventions to meet the needs of children and young people with DCD. Dissemination will involve the publication of the results in a peer-reviewed journal. Increasingly researchers and policymakers are calling for services to be informed by the perspective and voice of children with DCD. Therefore, a policy brief will be published so that the findings are widely available.
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Affiliation(s)
- Áine O'Dea
- School of Allied Health, University of Limerick, Castletroy, Limerick, Ireland
| | - Susan Coote
- School of Allied Health, University of Limerick, Castletroy, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, University of Limerick, Castletroy, Limerick, Ireland.,Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland.,Ageing Research Centre, University of Limerick, Castletroy, Limerick, Ireland
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Mårtensson U, Jenholt Nolbris M, Mellgren K, Wijk H, Nilsson S. The five aspect meal model as a conceptual framework for children with a gastrostomy tube in paediatric care. Scand J Caring Sci 2021; 35:1352-1361. [PMID: 33512004 DOI: 10.1111/scs.12957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/23/2020] [Accepted: 01/04/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cancer treatments may induce side effects and cause eating problems. A gastrostomy tube may be required in order to maintain and optimise the child's nutritional needs. Despite the use of a gastrostomy tube, it is important to maintain a natural and attractive mealtime for the child. The Five Aspect Meal Model is age neutral and originally designed to improve restaurant visits. Its five aspects conceptualise what is necessary to ensure a complete meal experience. To date, there is lack of knowledge to guided model development about mealtimes adapted to children and limited knowledge regarding mealtime experiences for children with a gastrostomy tube. AIM The aim was to investigate whether the Five Aspect Meal Model could be appropriate to be used for children with a gastrostomy tube in caring science and paediatric care. METHODS The design followed steps retrieved from Renjith and colleagues. Seven interviews were performed with the Five Aspect Meal Model as a base in the interview guide. The transcripts were analysed by using a qualitative directed content analysis with a deductive approach, which finally passed into a more inductive one. FINDINGS All aspects of the Five Aspect Meal Model were represented in the interviews. There were also experiences related to the gastrostomy tube and the mealtimes that did not fit into any of the five predetermined categories. As a result, the modified version was developed, an adapted prescribing practice model that includes seven aspects, whereof bodily discomfort and time for change and acceptance are specific to children with a gastrostomy tube. CONCLUSION Based on children and their parent's experiences, the Five Aspect Meal Model has been developed and adapted into a modified version, which includes seven aspects. The modified version seems to be appropriate to use within caring science and paediatric care.
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Affiliation(s)
- Ulrika Mårtensson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margaretha Jenholt Nolbris
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karin Mellgren
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Health Care Architecture, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Corazza I, Gilmore KJ, Menegazzo F, Abols V. Benchmarking experience to improve paediatric healthcare: listening to the voices of families from two European Children's University Hospitals. BMC Health Serv Res 2021; 21:93. [PMID: 33504331 PMCID: PMC7839229 DOI: 10.1186/s12913-021-06094-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 01/17/2021] [Indexed: 11/20/2022] Open
Abstract
Background Patient Reported Experience Measures (PREMs) are recognized as an important indicator of high quality care and person-centeredness. PREMs are increasingly adopted for paediatric care, but there is little published evidence on how to administer, collect, and report paediatric PREMs at scale. Methods This paper describes the development of a PREMs questionnaire and administration system for the Meyer Children’s University Hospital in Florence (Meyer) and the Children’s Clinical University Hospital in Riga (CCUH). The system continuously recruits participants into the electronic administration model, with surveys completed by caregivers or adolescents at their convenience, post-discharge. We analyse 1661 responses from Meyer and 6585 from CCUH, collected from 1st December 2018 to 21st January 2020. Quantitative and qualitative experience analyses are included, using Pearson chi-square tests, Fisher’s exact tests and narrative evidence from free text responses. Results The large populations reached in both countries suggest the continuous, digital collection of paediatric PREMs described is feasible for collecting paediatric PREMs at scale. Overall response rates were 59% in Meyer and 45% in CCUH. There was very low variation in mean scores between the hospitals, with greater clustering of Likert scores around the mean in CCUH and a wider spread in Meyer for a number of items. The significant majority of responses represent the carers’ point of view or the perspective of children and adolescents expressed through proxy reporting by carers. Conclusions Very similar reported scores may reflect broadly shared preferences among children, adolescents and carers in the two countries, and the ability of both hospitals in this study to meet their expectations. The model has several interesting features: inclusion of a narrative element; electronic administration and completion after discharge from hospital, with high completion rates and easy data management; access for staff and researchers through an online platform, with real time analysis and visualization; dual implementation in two sites in different settings, with comparison and shared learning. These bring new opportunities for the utilization of PREMs for more person-centered and better quality care, although further research is needed in order to access direct reporting by children and adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06094-z.
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Affiliation(s)
- Ilaria Corazza
- Management and Healthcare Laboratory (MeS Lab), Institute of Management and EMbeDS, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà 33, 56127, Pisa, Italy.
| | - Kendall Jamieson Gilmore
- Management and Healthcare Laboratory (MeS Lab), Institute of Management and EMbeDS, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà 33, 56127, Pisa, Italy
| | - Francesca Menegazzo
- Azienda Ospedaliero Universitaria Meyer, Viale Pieraccini 24, 50139, Florence, Italy
| | - Valts Abols
- Children's Clinical University Hospital, Vienības gatve 45, Rīga, LV-1004, Latvia
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50
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Abstract
The vast majority of students in Sweden are healthy and live good lives, but rising health problems and declining academic performance pose risks to the country’s student population. School health services (SHS) in Sweden have a long tradition of hosting health dialogues (HD) with students to support their health and its repercussions on their learning. Purpose: To describe experiences from 6- to 16-year-old students participating in the health dialogue in school. Method: Descriptive qualitative design. Data were collected from 734 open-ended responses on a questionnaire distributed among students ranging in age from 6 to 16. The data were subjected to qualitative content analysis. Findings: The analysis identified five categories: Important to identify health and health problems, School nurse, a key profession, School environment important for both health and learning, Importance of health screening and Important to have a healthy lifestyle. The findings revealed that students aged 6 to 16 years old consider health and health problems, school environment, health screening and healthy lifestyle to be important areas for health and learning School nurses were identified as key persons in HD and for student’s experience of health and learning. Conclusion: HD is an opportunity for students to participate and influence decisions concerning their health and education, to actively engage in their own health and learning in areas that affect them for example, the school environment.
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Affiliation(s)
| | - Lena Boström
- Department of Education, Mid Sweden University , Sundsvall, Sweden
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