Using drawings to understand the child's experience of child-centred care on admission to a paediatric high dependency unit

J Child Health Care. 2019 Mar;23(1):102-117. doi: 10.1177/1367493518778389. Epub 2018 May 28.

Abstract

Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.

Keywords: Children’s participation; family-centred care; nurse–child relationships; nurse–family relationships; paediatric.

MeSH terms

  • Adolescent
  • Art Therapy*
  • Child
  • Child, Hospitalized / psychology*
  • Child, Preschool
  • Cross-Sectional Studies
  • Family / psychology
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • New Zealand
  • Patient-Centered Care*
  • Pediatrics*
  • Professional-Family Relations*
  • Qualitative Research