medigraphic.com
ISSN 0035-0052 (Print)

2023, Number 2

<< Back Next >>

Rev Mex Pediatr 2023; 90 (2)

Should we include children? Parent and child preferences in clinical decision making

Calderón-Ardila AF, Estrada-Cano DC, Moreno-Luna S

Language: Spanish
References: 28
Page: 48-56
PDF size: 256.71 Kb.


ABSTRACT

Introduction: shared decision-making is the ideal method in clinical practice to involve both health personnel and the patient. Objective: to explore the preferences of both school-age participants and their primary caregivers regarding the inclusion of pediatric patients themselves in the health decision-making. Material and methods: qualitative study, which is based on individual interviews of 12 children (ages 11 and 12) and 15 mothers or caregivers. Interview responses were transcribed verbatim in two cycles of data coding, using NVivo version 12 software. Themes and subthemes were identified according to participants responses. Results: it was found that the inclusion of children in the transmission of information about their health increased trust in the doctor, adherence to treatment and understanding of the disease. Parents agreed that it was favorable to include children in this process. Children wanted to be included with their opinions, doubts, and authorization. All participants agreed to consider the child's opinion when making decisions, as well as to try to reconcile when disagreements arise. Conclusions: children and their parents prefer that the pediatric patient be included both in discussions with their doctors and in decision-making about their health.


REFERENCES

  1. Wangmo T, De Clercq E, Ruhe KM, Beck-Popovic M, Rischewski J, Angst R et al. Better to know than to imagine: Including children in their health care. AJOB Empir Bioeth. 2017; 8(1): 11-20.

  2. Congreso de Colombia. Convención Internacional sobre los derechos del niño. Colombia; 1991. p. 6.

  3. Congreso de Colombia. Código de la infancia y la adolescencia. Colombia; 2006. p. 72.

  4. Wyatt KD, List B, Brinkman WB, Prutsky Lopez G, Asi N, Erwin P et al. Shared decision making in pediatrics: a systematic review and meta-analysis. Acad Pediatr. 2015; 15(6): 573-583.

  5. Opel DJ. A push for progress with shared decision-making in pediatrics. Pediatrics. 2017; 139(2): e20162526.

  6. Coughlin KW. Medical decision-making in paediatrics: infancy to adolescence. Paediatr Child Health. 2018; 23(2): 138-146.

  7. Vemuri S, Hynson J, Williams K, Gillam L. Decision-making approaches for children with life-limiting conditions: results from a qualitative phenomenological study. BMC Med Ethics. 2022; 23(1): 52.

  8. Park ES, Cho IY. Shared decision-making in the paediatric field: a literature review and concept analysis. Scand J Caring Sci. 2018; 32(2): 478-489.

  9. Butz AM, Walker JM, Pulsifer M, Winkelstein M. Shared decision making in school age children with asthma. Pediatr Nurs. 2007; 33(2): 111-116.

  10. Kilkelly U, Donnelly M. The child's right to be heard in the healthcare setting: perspectives of children, parents and health professionals [Internet]. 2006 [cited 2019 Feb 21]. p. 105. Available in: https://www.researchgate.net/publication/279638240

  11. Moore L, Kirk S. A literature review of children's and young people's participation in decisions relating to health care. J Clin Nurs. 2010; 19(15-16): 2215-2225.

  12. Vessey JA, Miola ES. Teaching adolescents self-advocacy skills. Pediatr Nurs. 1997; 23(1): 53-56.

  13. Holzheimer L, Mohay H, Masters IB. Educating young children about asthma: comparing the effectiveness of a developmentally appropriate asthma education video tape and picture book. Child Care Health Dev. 1998; 24(1): 85-99.

  14. de Winter M, Baerveldt C, Kooistra J. Enabling children: participation as a new perspective on child-health promotion. Child Care Health Dev. 1999; 25(1): 15-23; discussion 23-25.

  15. Allen KA. Parental decision-making for medically complex infants and children: an integrated literature review. Int J Nurs Stud. 2014; 51(9): 1289-1304.

  16. Fiks AG, Hughes CC, Gafen A, Guevara JP, Barg FK. Contrasting parents' and pediatricians' perspectives on shared decision-making in ADHD. Pediatrics. 2011; 127(1): e188-e196.

  17. Coyne I, O'Mathúna DP, Gibson F, Shields L, Sheaf G. Interventions for promoting participation in shared decision-making for children with cancer. Cochrane Database Syst Rev. 2013; (6): CD008970. doi: 10.1002/14651858.CD008970.pub2.

  18. Alderson P, Sutcliffe K, Curtis K. Children as partners with adults in their medical care. Arch Dis Child. 2006; 91(4): 300-303.

  19. Rousseau K. Children as young as 4 years of age with type 1 diabetes showed understanding and competence in managing their condition. Evid Based Nurs. 2007; 10(1): 28.

  20. Quaye AA, Coyne I, Soderback M, Hallstrom IK. Children's active participation in decision-making processes during hospitalisation: An observational study. J Clin Nurs. 2019; 28(23-24): 4525-4537.

  21. Jordan A, Wood F, Edwards A, Shepherd V, Joseph-Williams N. What adolescents living with long-term conditions say about being involved in decision-making about their healthcare: A systematic review and narrative synthesis of preferences and experiences. Patient Educ Couns. 2018; 101(10): 1725-1735.

  22. Day E, Jones L, Langner R, Bluebond-Langner M. Current understanding of decision-making in adolescents with cancer: A narrative systematic review. Palliat Med. 2016; 30(10): 920-934.

  23. Brody JL, Scherer DG, Annett RD, Turner C, Dalen J. Family and physician influence on asthma research participation decisions for adolescents: the effects of adolescent gender and research risk. Pediatrics. 2006; 118(2): e356-e362.

  24. Malone H, Biggar S, Javadpour S, Edworthy Z, Sheaf G, Coyne I. Interventions for promoting participation in shared decision-making for children and adolescents with cystic fibrosis. Cochrane Database Syst Rev. 2019; 5(5): CD012578. doi: 10.1002/14651858.CD012578.pub2.

  25. Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012; 27(10): 1361-1367.

  26. Dixon-Woods M, Young B, Heney D. Partnerships with children. BMJ. 1999; 319(7212): 778-780.

  27. Kohrman A, Clayton EW, Frader JE, Grodin MA, Moseley KL, Porter IH et al. Informed consent, parental permission, and assent in pediatric practice. Pediatrics. 1995; 95(2): 314-317.

  28. Harrison C, Kenny NP, Sidarous M, Rowell M. Bioethics for clinicians: 9. Involving children in medical decisions. CMAJ. 1997; 156(6): 825-828.




2020     |     www.medigraphic.com