Context Of Pediatric Care Research Articles

Patient participation, a prerequisite for care: A grounded theory study of healthcare professionals' perceptions of what participation means in a paediatric care context.

AimsTo explore healthcare professionals’ perceptions of what patient participation means in a paediatric care context. DesignA qualitative explorative design with grounded theory.MethodsFifteen healthcare professionals who worked in paediatric care settings were either interviewed or asked open‐ended questions in a survey, during December 2015–May 2016. Grounded theory was used as a method.ResultsThe study results provide a theoretical conceptualization of what patient participation meant for healthcare professionals in paediatric care and how participation was enabled. The core category “participation a prerequisite for care” emerged as the main finding explaining the concept as ethical, practical and integrated in the care givers way of working. However, the concept was implicit in the organization. Four additional categories illustrated the healthcare professionals’ different strategies used to enhance patient participation; “meeting each child where the child is,” “building a relationship with the child,” “showing respect for each individual child” and “making the most of the moment.”

Putting on a Happy Face: Emotional Expression in Parents of Children With Serious Illness

ContextCommunication is widely acknowledged as a crucial component of high-quality pediatric medical care, which is provided in situations in which parents typically experience strong emotions. ObjectivesTo explore emotion using the Linguistic Inquiry and Word Count (LIWC) and a self-report questionnaire to better understand the relationship between these two measures of emotion in a pediatric care context. MethodsSixty-nine parents of 47 children who were participants in the Decision Making in Pediatric Palliative Care Study at The Children's Hospital of Philadelphia took part in this study. Parents completed the Positive and Negative Affect Schedule (PANAS) and a semistructured interview about their children and experience with medical decision making. The transcribed interviews were analyzed with the LIWC program, which yields scores for positive and negative emotional expression. The association between LIWC and PANAS scores was evaluated using multivariate linear regression to adjust for potential confounders. ResultsParents who used more positive words when speaking about the illnesses of their children and the experience of medical decision making were more likely to report lower levels of positive affect on the PANAS: increase in the standard deviation of positive emotional expression was associated with an unadjusted 7.4% decrease in the self-reported positive affect (P = 0.015) and an adjusted 7.0% decrease in the self-reported positive affect (P = 0.057) after modeling for potential confounders. Increase in the standard deviation of negative emotional expression was associated with an adjusted 9.4% increase in the self-reported negative affect (P = 0.036). ConclusionThe inverse relationship between parents' positive emotional expression and their self-reported positive affect should remind both researchers and clinicians to be cognizant of the possibilities for emotional miscues, and consequent miscommunication, in the pediatric care setting.

Pediatrics: A unique and volatile risk

Pediatric risk is both unique and volatile. Children are more vulnerable when treated in any healthcare environment, but especially in the acute care setting. Children with chronic healthcare conditions are more challenging to treat and more susceptible to medical errors. Despite marked improvement in the national medical malpractice environment, the most volatile claims involve severely injured patients under age eighteen and especially those patients in the first year of life. This article provides the context of pediatric care in reviewing the demographics of children and the healthcare delivery system. The unique factors of pediatric care that create increased risk are also reviewed. Low frequency/high severity claims involving children are discussed in detail as well as physician claims in the specialty of general pediatrics. Risk management solutions for pediatric issues are proposed.