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Facilitating participation: A joint use of an interactive communication tool by children and professionals in healthcare situations
Mälardalen University, School of Health, Care and Social Welfare. (CHIP)ORCID iD: 0000-0002-5254-6983
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Children’s right to participation in situations that matter to them is stated in law and convention texts and is emphasized by the children themselves in research studies, too. When actively involved, their perspective is visualized. Children’s use of interactive technology has increased considerably during the last decade. The use of applications and web sites are becoming a regular occurrence in paediatric healthcare.

The overall aim was to develop and test, together with children, an interactive communication tool meant to facilitate young children’s participation in healthcare situations.

To understand children’s varied perceptions of their involvement in healthcare situations, interviews, drawings and vignettes were used in a phenomenographic approach (I). A participatory design iteratively evaluated evolving prototypes of an application (II). Video observations and hermeneutics captured the meanings of the participation cues that the children demonstrated when they used the application in healthcare situations (III). A quantitative approach was used to identify patterns in the children’s cue use (IV). In total, 114 children in two clinical settings and in a preschool were involved.

The result showed that the children perceived themselves, their parents and the professionals as actors in a healthcare situation, although all were perceived to act differently (I). The children contributed important information on age-appropriateness, usability and likeability in the iterative evaluating phases that eventually ended up in the application (II). When using the application in healthcare situations, the cues they demonstrated were understood as representing a curious, thoughtful or affirmative meaning (III). Curious cues were demonstrated to the highest extent. The three-year-olds and the children with the least experience of healthcare situations demonstrated the highest numbers of cues (IV).

Conclusion: when using the application, the children demonstrated a situated participation which was influenced by their perspective of the situation and their inter-inter-action with the application as well as the health professional. The children’s situated participation provided the professionals’ with additional ways of guiding the children based on their perspectives.

Abstract [sv]

I lag- och konventionstexter, liksom i forskning, som använder barnens egna uttryck betonas deras rättighet att vara delaktiga i situationer av betydelse för dem. Genom att delta kan de göra sitt perspektiv synligt. Under det senaste årtiondet har barns användning av interaktiv teknik ökat kraftigt. Applikationer och web-sidor används nuförtiden även flitigt inom barnsjukvården.

Avhandlingens övergripande syfte var att utveckla och pröva, tillsammans med barn, ett interaktivt kommunikationsverktyg avsett att möjliggöra yngre barns delaktighet i vårdsituationer.

Intervjuer, teckningar och vignetter användes för att, fenomenografiskt, förstå barnens uppfattningar av att vara i en vårdsituation (I). En iterativ deltagarbaserad design användes för att utveckla en prototyp av en applikation. En hermeneutisk tolkning av video-observationer fångade meningen i barnens sätt att visa sin delaktighet (hintar) vid användningen av applikationen i vårdsituationer (III). En deduktiv, kvantitativ ansats användes för att identifiera mönster i barnens sätt att visa sin delaktighet när de använde applikationen (IV).

Resultatet visade att barnen uppfattade sig själva, föräldrarna och vårdpersonalen som aktörer i situationen, även om alla uppfattades agera på olika sätt (I). Barnen bidrog i den iterativa processen med viktig information gällande aspekter som åldersanpassning, användbarhet och hur väl den tilltalar dem, vilket slutligen ledde fram till den färdiga applikationen (II). Barnens sätt att visa sin delaktighet när de använde applikationen förstods ha en nyfiken, tankfull och självbekräftande mening (III). Nyfikenheten visades mest vid användningen av applikationen. Treåringarna samt barnen med minst vårderfarenhet använde applikationen i störst utsträckning (IV).

Sammanfattning: när applikationen användes i vårdsituationen visade barnen en situerad delaktighet vilken byggde på deras perspektiv på den aktuella situationen samt på deras inter-inter-aktion med applikationen och vårdpersonalen. Genom detta erbjöds vårdpersonalen ytterligare ett sätt att guida barnet utifrån barnets eget perspektiv.

Place, publisher, year, edition, pages
Västerås: Mälardalen University , 2017.
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 229
Keyword [en]
children, child’ perspective, participation, phenomenography, interactive technology, participatory design approach, application, video observations, cues, hermeneutics
Keyword [sv]
barn, barnets perspektiv, delaktighet, fenomenografi, interaktiv teknik, deltagarbaserad design, applikation, video-observationer, hint, hermeneutik
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-35178ISBN: 978-91-7485-328-5 (print)OAI: oai:DiVA.org:mdh-35178DiVA: diva2:1088677
Public defence
2017-06-16, Beta, Mälardalens högskola, Västerås, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2017-04-28 Created: 2017-04-13 Last updated: 2017-07-10Bibliographically approved
List of papers
1. Younger children's (three to five years) perceptions of being in a health-care situation
Open this publication in new window or tab >>Younger children's (three to five years) perceptions of being in a health-care situation
2015 (English)In: Early Child Development and Care, ISSN 0300-4430, E-ISSN 1476-8275, Vol. 186, no 5, 832-844 p.Article in journal (Refereed) Published
Abstract [en]

Younger children are common users of health-care services. Their perspective on a health-care situation and their ways of communication differ from that of adults. There is a shortness of research of younger children's perceptions of health-care situations. The knowledge that exists indicates the importance of involving the child's perspective to enable understanding and to offer appropriate support. This paper aimed to describe how younger children perceive to be in a health-care situation. Semi-structured interviews, analysed phenomenographically, were used. The main findings revealed that children view themselves as actors, as either main or co-actors, in a health-care situation. Parents and professionals are also understood as actors. The children's perceptions enable professionals to create a mutual understanding which will give openings for increased involvement of the children and an improved level of the children's health literacy.

Keyword
children, health care, social actor, interviews, phenomenography, health literacy
National Category
Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-28811 (URN)10.1080/03004430.2015.1064405 (DOI)000374778700011 ()2-s2.0-84937144969 (Scopus ID)
Available from: 2015-09-01 Created: 2015-09-01 Last updated: 2017-04-13Bibliographically approved
2. The child’s perspective as a guiding principle: Young children as co-designers in the design of an interactive application meant to facilitate participation in healthcare situations
Open this publication in new window or tab >>The child’s perspective as a guiding principle: Young children as co-designers in the design of an interactive application meant to facilitate participation in healthcare situations
2016 (English)In: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 61, 149-158 p.Article in journal (Refereed) Published
Abstract [en]

During the last decade, interactive technology has entered mainstream society. Its many users also include children, even the youngest ones, who use the technology in different situations for both fun and learning. When designing technology for children, it is crucial to involve children in the process in order to arrive at an age-appropriate end product. In this study we describe the specific iterative process by which an interactive application was developed. This application is intended to facilitate young children's, three-to five years old, participation in healthcare situations. We also describe the specific contributions of the children, who tested the prototypes in a preschool, a primary health care clinic and an outpatient unit at a hospital, during the development process. The iterative phases enabled the children to be involved at different stages of the process and to evaluate modifications and improvements made after each prior iteration. The children contributed their own perspectives(the child's perspective) on the usability, content and graphic design of the application, substantially improving the software and resulting in an age-appropriate product.

Keyword
children's perspective, interactive computer design, health care, participation
National Category
Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-31397 (URN)10.1016/j.jbi.2016.03.024 (DOI)000384704300016 ()27050824 (PubMedID)2-s2.0-84962777466 (Scopus ID)
Projects
IACTA Interactive communication tool activities
Available from: 2016-04-08 Created: 2016-04-08 Last updated: 2017-04-13Bibliographically approved

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