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Excluding children from health care decisions causes unnecessary distress
Coyne I. J Clin Nurs. 2011;20:2334-2343.
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When it comes to making health decisions, most children feel apprehensive and angry when not included in the decision-making process, according to a study.
Children aged 7 to 18 years were selected from 10 wards and two clinics in three Ireland hospitals. Using a combination of focus groups and single interviews, the children in the study were asked a series of questions that focused on “experiences of the hospital, communication interactions with health care staff, taking part (or not) in communication and decision-making, preferences for decision-making and factors that influenced participation.”
The researchers found that when the children were involved they felt valued, happy and less anxious than when they were ignored and not included in the discussion.
“Children in this study wanted to participate in communication exchanges and have their viewpoints and concerns taken seriously,” the researchers wrote. “They wanted to be included and felt that they had a right to participate because it was about matters that affected them and their bodies.”
Children in the study described being left alone while health professionals spoke in private with their parents about procedures, being ignored after giving health professionals specific information about their preferences related to health care, as well as being ignored by their parents. In all these situations, the children recalled feeling more apprehensive and angry than when they were included.
Overall, health professionals’ communication styles and behaviors and parents’ actions played a significant role in supporting or hindering children’s participation, according to the study.
“Communicating with and including children in decisions according to their preferences, conveys respect, enhances and develops their decision-making capabilities and contributes to psychosocial well-being,” the researchers wrote. “Given that children’s participation improves the quality of care provided, it is an important investment and one that requires adults to move to a child-centered approach in how they relate to children.”
Disclosure: The researchers report no relevant financial disclosures.
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