A Systematic Review on Children's Participation in Healthcare From a Child's Perspective.
Merja Hietanen, Catarina Nahlén Bose, Anna Stålberg and 2 others
PMID 41299201WHAT IT FOUND
Children in healthcare situations often participated through small choices, non-verbal cues and questioning.
Fear, unfamiliar settings, brief information and adult control limited their voice.
Key findings
01Children's participation was active, passive or protest-based and depended on the situation, not only age.
02Children wanted information they could understand, time, trust and support, and they used non-verbal or digital tools to take part.
03Adults often limited participation by giving brief information, ignoring views, allowing parents to speak for the child, or offering only choices that did not affect care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review targeted children aged 3 to 12 years, but only 11 of the 28 included studies fell within that age range. Most studies were conducted in Europe, especially Sweden, and all were from Western countries. Adult researchers interpreted children's interviews and observations, so the themes are adult constructions of meaning. Many included studies used broad age ranges, and some did not report medical history, so it is hard to know how age, condition or prior healthcare contact shaped participation. The search was limited to English articles and the listed databases, and the spelling of paediatric was not used, so relevant studies may have been missed.
Declared interests
Funding came from internal funds from Swedish Red Cross University, and the research received no specific grant from a public, commercial or not-for-profit agency. One author was first author of an included study but was not involved in study inclusion or data extraction for that study.
The easy way to misread this
Do not conclude that involving children improves clinical outcomes. This review reports children's experiences and views, not tested interventions or measured health outcomes.