Children and young people's participation in decision-making within healthcare organisations in New Zealand: An integrative review.
Mandie Foster, Julie Blamires, Chris Moir and 4 others
PMID 36809178WHAT IT FOUND
Most evidence on child participation in New Zealand healthcare comes from adult opinions, not children's own voices.
Barriers include lack of time, resources, and belief in children's competence. Few studies directly consulted children under five.
Key findings
01The review identified only four peer-reviewed manuscripts where children self-reported their experiences of participation, compared to twelve documents representing adult perceptions or policy.
02Barriers to involving children include adults' perceptions of children's lack of agency, communication difficulties with younger or disabled children, and a lack of resources or tools for developmentally appropriate engagement.
03There was no published literature in this review from children under five years of age, limiting understanding of how the youngest patients participate.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
The review included very few studies with direct child self-reports (only four), meaning most findings reflect adult perspectives. No literature was available from children under five years of age. The review was limited to New Zealand, so findings may not apply to other healthcare systems. The authors noted potential bias due to the large number of expert opinion documents included. Children were not consulted on the results of the review itself.
Declared interests
One author is an Associate Editor for the journal publishing the review. The work was funded by Auckland University of Technology.
The easy way to misread this
Do not assume that policy mandates for child participation mean it is happening in practice. The review found that most evidence comes from adult opinions, and actual child-led participation is rare and poorly documented, especially for young children.