Involving Children in Healthcare Communication and Decision-Making

The Convention on the Rights of the Child emphasizes that whenever children are being medically treated, they must be duly informed about their disease and their decisions regarding the treatment must be respected. In spite of this, children’s participation in health communication is dismal. There have been very few studies so far on the problems faced by children in communicating with healthcare professionals. This study was done to understand the experiences of children regarding healthcare communication, and to find out the factors that hinder free communication. According to the authors of this study, “Children wanted to be included in communication exchanges but appeared to occupy a marginal role with discussions largely carried out between parents and healthcare professionals.”

Involving children in healthcare communication provides children an opportunity to convey their feelings, apart from generating confidence and the ability to adapt to the treatment. Several studies have shown that involving children in healthcare communication increases their adherence to the treatment, resulting in better treatment outcomes. However, by doing so, there is a risk of burdening children with additional stress. It has been observed that doctors talk more with parents and ignore the children, because they feel that children are not competent enough to understand the situation and make proper decisions. In this study, apart from assessing the children’s experiences concerning healthcare communication, the researchers also tried to find out what kind of information the children wanted to be told by a healthcare professional.

* The present study involved 55 participants aged between 7 and 18 years.
* Out of the 55 participants, 28 were suffering from acute disorders such as appendicitis, while 27 had chronic illnesses such as asthma.
* All the participants were individually interviewed. Questions regarding their experience in the hospital, their involvement in healthcare communication, their preferences regarding decision-making, and factors that influenced their communication with healthcare professionals were asked.

* Most of the children felt that they must be informed about their disease and its treatment. Children who were involved in the communication regarding their health felt happy, valued and less worried.
* Many children felt that doctors talked less with them. When doctors spoke to their parents in isolation, most of the children felt that they were suffering from some serious illness.
* When questioned about their preferences in decision-making, children tended to categorize the decisions into “small” ones and “serious” ones. The children felt that they should be allowed to take decisions that were “small,” such as those related to diet, medications and other every day events. However, they preferred to leave the “serious” decisions like those related to surgeries to their parents and doctors.
* Factors such as fear of doctors and unfamiliarity with medical terminologies inhibited free communication with healthcare professionals.

Shortcomings/Next steps
This study was completely interview-based. Hence, it may not provide complete details about health care communication involving children. The observations of the researchers are also necessary to get reliable results. Besides, future studies must involve parents too, as they are frequently involved in the health care communication pertaining to the treatment of their children.

Despite the fact that many publications have highlighted the benefits of involving children in healthcare discussions, the importance of involving children in matters concerning their treatment is often ignored. This study has clearly highlighted that children want to be involved in the doctor-parent discussions, especially in everyday events related to their treatment. Such involvement increases their trust in healthcare professionals, which in turn makes children comfortable while undergoing treatment. Hence, there is a need to train healthcare professionals in developing communication skills, to eliminate any communication barriers between them and the children being treated. Hospital policies and guidelines should be framed in such a way that children are involved in the decision-making.

For More Information:
Participation in Communication and Decision-Making: Children and Young People’s Experiences in a Hospital Setting
Publication Journal: Journal of Clinical Nursing, March 2011
By Imelda Coyne, PhD; Pamela Gallagher, PhD; Trinity College and Dublin City University, Dublin, Ireland

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