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Williamson FA, Lester JN, Woods C, Kaye EC. Questions to promote child-centered care in racially discordant interactions in pediatric oncology. PATIENT EDUCATION AND COUNSELING 2024; 121:108106. [PMID: 38123375 DOI: 10.1016/j.pec.2023.108106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To examine questioning practices in racially discordant interactions and describe how these practices engendered child-centered care. METHODS We used applied conversation analysis to analyze a collection of 300 questions directed to children across 10 cases involving children of color and their families in disease reevaluation appointments in pediatric oncology. RESULTS Our analysis generated two patterns: 1) both the pediatric oncologists' and caregivers built upon one another's talk to enable the child's conversational turn, and 2) the oncologists' reformulated requests as questions to invite the child's permission and cooperation for completing exams and understanding symptoms. CONCLUSION Children, pediatric oncologists, and caregivers coordinated their actions to enable children to participate as recipients of and respondents to questions. The analysis of real-time interactions illuminates practices for centering children in clinical encounters and the benefits of doing so. PRACTICAL IMPLICATIONS This study's findings have implications for defining competencies and practices for fostering child-centered communication, creating training materials based on real-time encounters, and identifying strategies for humanizing pediatric patient experiences.
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Affiliation(s)
| | - Jessica Nina Lester
- Department of Counseling Education and Psychology, Indiana University, Bloomington, USA
| | - Cameka Woods
- St. Jude's Children's Research Hospital, Memphis, USA
| | - Erica C Kaye
- St. Jude's Children's Research Hospital, Memphis, USA
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Chapman AR, Brunelli L, Forman L, Kaempf J. Promoting children's rights to health and well-being in the United States. LANCET REGIONAL HEALTH. AMERICAS 2023; 25:100577. [PMID: 37650073 PMCID: PMC10462822 DOI: 10.1016/j.lana.2023.100577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/28/2023] [Accepted: 08/03/2023] [Indexed: 09/01/2023]
Abstract
The United States has a highly sophisticated pediatric healthcare system and spends more than any other country per capita on children's healthcare. However, not all children have access to needed and affordable health care and the life expectancy and health outcomes of children in the country are worse than in any other industrialized nation. These nations typically offer universal healthcare for children as part of a robust recognition of a children's rights framework. In 1989 the United Nations adopted the Convention on the Rights of the Child that recognizes the right of the child to the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. Currently the United States is the only United Nations member country that has not ratified the Convention on the Rights of the Child. This paper outlines the potential benefits of adopting a child rights approach based on the principles and provisions of the Convention on the Rights of the Child. The fact that countries who invest much less in healthcare compared to the United States can achieve better health outcomes provides the certainty that a solution is possible and within reach.
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Affiliation(s)
- Audrey R. Chapman
- Department of Public Health Sciences, UConn Health, Farmington, CT, USA
| | - Luca Brunelli
- Department of Pediatrics/Neonatology, University of Utah Health/Primary Children’s Hospital, Salt Lake City, UT, USA
| | - Lisa Forman
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Joseph Kaempf
- Providence Health System, Women and Children’s Services, Portland, OR, USA
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Wightman A, Filler G, Díaz-González de Ferris ME. The urgent need for conducting clinical trials in pediatric nephrology globally. Pediatr Nephrol 2023; 38:2499-2506. [PMID: 36738331 DOI: 10.1007/s00467-023-05877-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/27/2022] [Accepted: 01/02/2023] [Indexed: 02/05/2023]
Affiliation(s)
- Aaron Wightman
- Department of Pediatrics, Divisions of Nephrology, Bioethics and Palliative Care, University of Washington School of Medicine, Seattle, WA, USA
| | - Guido Filler
- Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, London, ON, N6A 5W9, Canada
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, N5A 5A5, Canada
- Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, N6A 5W9, Canada
- The Lilibeth Caberto Kidney Clinical Research Unit, London Health Sciences Centre, London, ON, Canada
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Georgousopoulou V, Voutetakis A, Galanis P, Kourti FE, Zartaloudi A, Koutelekos I, Dousis E, Kosmidis D, Koutsouki S, Pappa D, Igoumenidis M, Dafogianni C. Assessing the Respect of Children's Rights in Pediatric Hospitals. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050955. [PMID: 37241187 DOI: 10.3390/medicina59050955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: In 1989, the United Nations (UN) General Assembly adopted the United Nations Convention on the Rights of the Child (UNCRC), with a considerable number of the Articles of the Convention being related to the health status of children. Therefore, adhering to and assessing the implementation of the rights of children during hospitalization is a very important step towards child protection. Herein, we attempt to highlight the depth of knowledge of employees working in children's hospitals with regard to children's rights as well as the degree of adherence to the UNCRC with respect to hospitalized children. Material and Methods: The target group included all healthcare professionals working in the various general pediatric clinics of the three Children's Hospitals of the Athens metropolitan area in Greece. We conducted a cross-sectional study, with data collection carried out in February and March 2020, using a structured questionnaire consisting of 46 questions which was handed out to all personnel. For the analysis, we used the IBM SPSS 21.0. Results: A total of 251 individuals participated in the study (physicians 20%, nurses 72%, and other employees 8%). A total of 54.5% of health professionals did not know what the UNCRC is, and 59.6% of them were not even aware that their hospital had rules and a bioethical committee related to clinical research involving children. Lack of awareness or trust of health professionals is also observed for other procedures or supervisory measures such as abuse protocols, complaint control, admission control, etc. With regard to the health system, there are shortcomings or weaknesses in (a) procedures followed with regard to respect for gender and privacy, (b) information on basic services provided by pediatric hospitals (such as recreation, education and free meals during hospitalization), (c) the logistical infrastructure (such as recreational facilities and facilities for the disabled), (d) the possibility of recording complaints, and (e) hospitalizations that were not necessary. A difference emerged concerning the nurses' responses between the three hospitals, with nurses participating in relevant seminars held in one of the hospitals being significantly more informed. Conclusions: The majority of healthcare personnel seem unaware of basic principles with respect to children's rights during hospitalization as well as relevant procedures and supervisory measures. Moreover, obvious weaknesses of the health system exist with respect to procedures, services, infrastructure, and complaint recording. There is a need for improved education of health professionals with respect to the implementation of children's rights in pediatric hospitals.
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Affiliation(s)
- Vasiliki Georgousopoulou
- 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Antonis Voutetakis
- Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Petros Galanis
- Center for Health Services Management and Evaluation, Department of Nursing, School of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | | | | | - Evangelos Dousis
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Dimitrios Kosmidis
- Department of Nursing, International Hellenic University, 68300 Didimoteixo, Greece
| | - Sotiria Koutsouki
- Department of Nursing, General Hospital of Kavala, 65500 Kavala, Greece
| | - Despoina Pappa
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Michael Igoumenidis
- Department of Nursing, School of Health Rehabilitation Sciences, University of Patras, 26334 Patras, Greece
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