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  • 1.
    Stålberg, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Enabling participation of younger children (3-5 years) in care situations using interactive technology2014Conference paper (Other academic)
    Abstract [en]

    Enabling participation of younger children (3-5 years) in care situations using interactive technology

    Anna Stålberg[1], PhD-student, Mälardalen´s University, Sweden

    Anette Sandberg[2], Professor, Mälardalen´s University, Sweden

    Thomas Larsson[3], Senoir lecturer, Mälardalen´s University, Sweden

    Maja Söderbäck1, Associate professor, Mälardalen´s University, Sweden

     

    Aim: To explore and describe younger children´s (3-5 years) varied perceptions of care situations and to use this knowledge when developing an interactive communication tool, for tablet use, meant for enabling active participation of the children during medical encounters.

    Method: Phenomenographic inspired interviews, combined with vignettes and observations, were conducted searching the children´s varied perceptions of care situations, including medical examinations of the body and needle procedures. These perceptions, combined with earlier knowledge in the field, will initiate the development, through an iterative process, of a communication tool when letting children try a prototype of the tool and give their opinions on content and design on the gradually transformed software.

    Result: Based on the interviews, four areas of perceptions could be described: myself, parents, professionals and the specific situation. All persons involved were perceived as actors. The children perceived themselves as either main actors or co-actors. Parents were understood as actors when being present and close. Professionals, as actors, were perceived as handling situations directed to the body of the children. The perceptions of the specific situation included being in a different environment and that there was focus on the body, i.e. ways of being ill and getting better. Receiving a gift was perceived as either a reward or as a sign that ended the situation. There is still no result of the iterative work, i.e. development of the tool. This study is in progress, and the result is assumed to lead the development to an age appropriate and child friendly final version of the communication tool.

    Conclusions: Children have a right to participate in situations concerning them. To understand the children´s perspective you need to explore their views. During the interviews the children described their perceptions on care situations. This knowledge will later support the development of the communication tool. Forthcoming studies will explore in what way this tool, from both a child and parental perspective, enhances participation of the children.

    [1] School of Health, Care and Social Welfare, Mälardalen´s University, Sweden

    [2] School of Education, Culture and Communication, Mälardalen´s University, Sweden

    [3] School of Innovation, Design and Engineering, Mälardalen´s University, Sweden

  • 2.
    Stålberg, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Facilitating participation: A joint use of an interactive communication tool by children and professionals in healthcare situations2017Doctoral 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.

  • 3.
    Stålberg, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Young children´s (3-6 years) perceptions of care situations including medical examinations and needle procedures2014Conference paper (Other academic)
    Abstract [en]

    Title: Young children´s (3-6 years) perceptions of care situations including medical examinations and needle procedures

    Authors: Anna Stålberg, RN, MSc, PhD-student, School of Health, Care and Social Welfare, Mälardalen University, Sweden; Anette Sandberg, Professor, PhD, School of Education, Culture and Communication, Mälardalen University, Sweden; Maja Söderbäck, PhD, RN, Pediatric Nurse, Associate professor, School of Health, Care and Social Welfare, Mälardalen University, Sweden

    Affiliation: Mälardalen University

    Co-productions partners: Nobab, County council of Sörmland, Quicksearch, the Swedish Heritage Fund

    Aim: To explore and describe young children´s perceptions of being in care situations, including medical examinations and needle procedures.

    Background: Research shows that children express a wish of active involvement in care situations. Barriers for involvement are found to concern weak health literacy among the young children. Young children have limited opportunities to access, comprehend and communicate information on health issues. Further there is a lack of knowledge of the child´s own perspective in perceiving the care situations.

    Method: A phenomenographic inspired approach with interviews and observations was conducted to explore children´s perceptions through their verbal and non-verbal expressions.

    Findings:  The outcome space describe four areas of the children’s perceptions: about myself, about parents, about professionals and about the specific care situation. Myself was understood as being both as main and co-actor. Feelings evoked by the situation were described. Parents were perceived as being present and close. The professionals were understood as actors in care procedures and as different types. The specific care situation was perceived by the body in focus, by being in a different environment and by receiving a benefit.

    Implications: The young children´s perspective, by describing their varied perceptions in a care situation, will improve and support the professionals’ interactive communication and enable joint understanding in a care situation.

     

  • 4.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Coyne, Imelda
    Trinity Coll Dublin, Sch Nursing & Midwifery, Dublin, Ireland..
    Larsson, Thomas B
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Using an interactive communication tool in healthcare situations: Patterns in young children's use of participation cues2019In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, article id UNSP 1367493518814928Article in journal (Refereed)
    Abstract [en]

    This study forms part of a larger project about developing and using interactive technology to facilitate young children's participation in healthcare situations. Children's participation in these situations improves their motivation and situated understanding. Likewise, their participation helps professionals to more fully understand the child's perspective. In the project, an interactive communication tool, that is, an application suitable for tablet use, was developed with children, aged three to five, in two clinical settings. When tested, the children's participation cues, identified from video recordings of healthcare situations, were understood as having curious, thoughtful or affirmative meanings. This study aimed to investigate the similarities and differences in the young children's use of participation cues when using an interactive communication tool in healthcare situations. A secondary analysis of the identified cues was performed focusing on age, setting and examination or procedure. In total, 2167 cues were identified representing either curious, thoughtful or affirmative cues. The curious cues were mainly used (66%), followed by thoughtful (28%) and affirmative (6%) cues. Differences in cue usage were seen in relation to the children's age and setting. Knowing how children may react to common healthcare procedures may help increase healthcare professionals' awareness of the need to support children in an individual and situational way.

  • 5.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Larsson, Thomas B
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Imelda, Coyne
    Trinity College, Dublin, Ireland.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Curious, Thoughtful and Affirmative – Young Children’s Meanings of Participation in Healthcare Situations when using an Interactive Communication Tool2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 1-2, p. 235-246Article in journal (Refereed)
  • 6.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Child-centred Care: Health Professionals' Perceptions of What Aspects are Meaningful When Using Interactive Technology as a Facilitator in Healthcare Situations2018In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, p. E10-E17Article in journal (Refereed)
    Abstract [en]

    Purpose: A prerequisite for child-centred care is children's participation, which in paediatrics can partly be enhanced by using interactive technology solutions, for instance tablet or smartphone-based applications. These applications, however, mainly target older children. In a research project, a tablet-based application, i.e. a communication tool, was developed, meant to facilitate young children's participation in healthcare situations. This study explored health professionals' perceptions of what aspects are meaningful when jointly using such an application in healthcare situations. 

    Design/Methods: Using the critical incident technique, 18 qualitative, semi-structured interviews focusing on critical incidents were performed with four health professionals who had used the interactive communication tool together with children in various healthcare situations. The data were analysed according to inductive content analysis. 

    Results: Results showed that the health professionals described the use of the tool as meaningful because it provided information that helped the children increase their participation, modify their understanding of the situations, and reduce their fear. The tool was also perceived to contribute to a common language between the children and the professionals, which improved their overall communication. 

    Conclusion: The introduction of an interactive communication tool in healthcare situations seemed to be beneficial for both the children and the health professionals.

    Practice Implications: An interactive communication tool, facilitating both verbal and non-verbal communication, can reinforce children's participation in healthcare situations and contribute to positive outcomes in the childprofessional relationship, as well as in the situation itself. 

  • 7.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Younger children's (three to five years) perceptions of being in a health-care situation2016In: Early Child Development and Care, ISSN 0300-4430, E-ISSN 1476-8275, Vol. 186, no 5, p. 832-844Article in journal (Refereed)
    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.

  • 8.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Larsson, Thomas B
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    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 situations2016In: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 61, p. 149-158Article in journal (Refereed)
    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.

  • 9.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Young children´s (aged 3-5 years) experiences of being in care procedures including medical investigations2013Conference paper (Refereed)
    Abstract [en]

    Introduction The Convention of children's rights focuses on protection, promotion as well as participation. Research show that young children's active

    participation in matters affecting them is underrated. Further it is known that improving participation in care procedures enhances both motivation and

    engagement. To achieve active participation in care procedures, the variation of experiences and perceptions, need to be explored and described. Purpose To

    explore and describe children's variations of experiences, perceptions, thoughts and wishes in care procedures including a medical investigation. It is a first

    study in a project aiming to develop and test an IT based interactive communication tool (IACT) for younger children. Material Younger children (3-5 years) in a

    preschool, visiting a health care center and a pediatric day care ward. Methods A phenomenographic approach searching the children's variations of

    experiences, perceptions, thoughts and wishes, in verbally and non-verbally expressions. Semi structured interviews, combined with talks based on vignettes,

    observations and drawings are used. Results The result is still preliminary. However the children studied so long describe experiences and thoughts of varied

    content. There are descriptions how they wished the care procedures to be carried out, as well as what scared them and what they wanted to avoid. The

    descriptions of experiences and perceptions will be contrasted and demonstrated in a hierarchy of variations according to a phenomenographic analyses.

    Conclusions The result will be the starting point to develop an IT-based interactive communication tool (IACT) for younger children, aged 3-5, to improve their

    active participation in care procedures based on their experiences, needs and wishes.

     

  • 10.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Larsson, Thomas B
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    The child’s perspective as the guiding principle: young children as co-designers of an application used for enabling participation in healthcare situations2016Conference paper (Refereed)
    Abstract [en]

    Introduction: To facilitate child´s rights in healthcare situations, professionals need to be aware of, and use, their child perspective and the child´s perspective in the situation. A child´s rights approach requires that the caring culture and ways of working are adapted to the interactive communication tool, based on children´s perceptions of being in healthcare situations, prerequisites of children.

    Aim: To develop an interactive communication tool, based on children´s perceptions of being in healthcare situations, meant to facilitate children´s participation and understanding in these specific situations.

    Method: Children, 3-5 years, in a preschool, a primary health care clinic and a pediatric outpatient unit at a hospital were encountered in interviews which focused the children´s perceptions of being in healthcare situations. Non-verbal perceptions were elicited through drawings. These perceptions were used in the development of the communication tool. In iterative phases the children, as co-designers, tested and evaluated evolving prototypes of the tool. Their feedback were analyzed and used in the ongoing development and improvement of the prototype.

    Result: an iterative, co-designing process of the interactive communication tool transformed children´s verbal and non-verbal perceptions of being in a healthcare situation into an age appropriate and likeable application regarding content, usability and graphic design.

    Conclusion: an interactive communication tool involving visual guidance of healthcare situations facilitates younger children to elicit their perspective in these situations. Children´s participation in healthcare situations is enabled by professionals who use the child´s perspective, expressed with help of the communication tool, combined with their verbal guidance.

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