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Children's active participation in decision‐making processesduring hospitalisation: An observational study
Lund University, Lund, Sweden.
Trinity College Dublin, Dublin, Ireland.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (ChiP)ORCID iD: 0000-0001-6163-9690
Lund University, Lund, Sweden.
2019 (English)In: Journal of cilinical Nursing, ISSN 0962-1067Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aims and objectives: The aim was to explore and describe the child's active participationin daily healthcare practice at children's hospital units in Sweden.Objectives: (a) Identify everyday situations in medical and nursing care that illustratechildren's active participation in decision‐making, (b) identify various ways of activeparticipation, actual and optimal in situations involving decision‐making and (c) explorefactors in nursing and medical care that influence children's active participation indecision‐making.Background: Despite active participation being a fundamental right for children, theyare not always involved in decision‐making processes during their health care. Therestill remains uncertainty on how to support children to actively participate in decisionsconcerning their health care.Design: A qualitative study with overt, nonparticipant observations fulfilling theCOREQ checklist criteria.Methods: Observations of interactions between children aged 2 and 17 years withboth acute and chronic conditions, their parents, and healthcare professionals wereconducted at three paediatric hospitals in Sweden. The Scale of Degrees of SelfDetermination was used to grade identified situations. The scale describes five levelsof active participation, with level one being the least and level five being the mostactive level of participation. Normative judgements were also made.Results: Children's active participation was assessed as being generally at levels fourand five. Children demonstrated both verbal and nonverbal ways of communicationduring decision‐making. Findings indicated that children's, parents' and healthcareprofessional's actions influenced children's active participation in decision‐makingprocesses involving healthcare.Conclusions: Healthcare professionals specialised in paediatrics need to embrace botha child perspective and a child's perspective, plan care incorporating key elements of achild‐centred care approach, to ensure children's active participation at a level of theirchoosing.

Place, publisher, year, edition, pages
2019.
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Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-45838DOI: 10.1111/jocn.15042OAI: oai:DiVA.org:mdh-45838DiVA, id: diva2:1365437
Available from: 2019-10-24 Created: 2019-10-24 Last updated: 2019-10-24Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
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Language
  • de-DE
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  • en-US
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  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
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Output format
  • html
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  • asciidoc
  • rtf