Exploring young patients’ perspectives on rehabilitation care: methods and challenges of organizing focus groups for children and adolescents

Development of a Digital Decision Support Tool to Aid Participation of Children With Disabilities in Pediatric Rehabilitation Services: Explorative Qualitative Study

BACKGROUND

Building a health care system in accordance with the rule of law requires child-centered care, where children and young people, regardless of ability, are allowed to participate in visits with their health care professionals. As part of an overall project focusing on developing and implementing a digital decision support tool to increase the participation of children with disabilities in pediatric rehabilitation, this study brings new knowledge as to how this specific patient group views participation.

OBJECTIVE

The aim of this formative study was to explore the experiences of children and young people with disabilities concerning increasing their participation in the pediatric rehabilitation services.

METHODS

The formative study had an explorative design, based on a latent qualitative content analysis with an inductive approach. Interviews were conducted with 20 children (6-17 years) and 8 young people (19-30 years) with disabilities about their experiences of participation in pediatric rehabilitation services.

RESULTS

A total of 3 categories emerged reflecting the participants' possibilities of participation in the pediatric rehabilitation services: to feel involved, to feel independent, and to work in partnership. To feel involved meant being listened to and being connected, to feel independent meant being admitted and being enabled, and to work in partnership meant being supported and being able to entrust others with the decision making. With the overall theme moving toward empowerment of children in pediatric rehabilitation, a true feeling of participation can be experienced.

CONCLUSIONS

The views of children and young people with disabilities are that children should be given the prerequisites for empowerment by being allowed to feel involved and independent as well as to work in partnership to experience true participation in the pediatric rehabilitation services. This finding is essential in the design of a digital decision support tool based on the children's needs and perspectives.

Children's and Parents’ Evaluations of ‘FRIENDS for Life’, an Indicated School-Based Prevention Program for Children With Symptoms of Anxiety and Depression

There is evidence that the school-based program FRIENDS for Life is effective in preventing childhood anxiety and depression. Effectiveness is, however, not the only prerequisite for successful implementation. Participants’ evaluation of a prevention program may provide suggestions about how to fine-tune it to fit the needs of the target population. This study investigated children's and parents’ evaluations of the Dutch version of FRIENDS for Life. Forty-four participants of FRIENDS for Life (9–13 years) participated in online focus groups and 38 parents were interviewed in 2011–2012. Questions concerned the general opinion about the program, its perceived effectiveness and group atmosphere, and suggestions for program improvement. Most children (95.5%) and parents (65.8%) evaluated the program positively, and the majority (61.4% and 76.3%) thought that it had been useful in changing the child's behaviour. Children and parents expressed complementary views about the behaviours the child had learned. Some children (38.6%) expressed negative opinions about the program. Parents’ attendance at parent meetings was low (31.6–36.8%). Considered together with the growing evidence of the effectiveness of FRIENDS for Life, we concluded that it can be successfully implemented as an indicated prevention program in primary schools for children who show symptoms of anxiety or depression. Efforts could be made to increase parents’ involvement in the program.

Advantages of asynchronous online focus groups and face-to-face focus groups as perceived by child, adolescent and adult participants: a survey study

Background

Online focus groups (OFGs) are increasingly used as a method of data collection. Although their advantages for research have repeatedly been described, participants’ opinions about OFGs have seldom been studied. We investigated OFG participants’ preference for participation in an OFG or a face-to-face focus group (FTF), as well as their perceptions of the advantages of both methods. We also investigated whether any differences exist between the perceptions of child, adolescent, and adult participants.

Methods

Participants’ opinions were studied by means of a questionnaire completed by 284 persons (aged 8–72 years) after their participation in one of 50 OFGs. The OFGs were conducted between December 2005 and December 2013 as part of 19 separate studies. Chi square tests with p <0.05 were used to test differences in perceived advantages of OFGs and FTFs between children, adolescents and adults.

Results

The most important advantage of OFGs as perceived by OFG participants was the possibility to participate at a moment most convenient to them. Adolescents and adults (90.5% and 95.9%) more often reported this as an advantage than children did (30.8%, p < 0.02). Another important perceived advantage of OFGs was the possibility to participate from home (69.1%). The most important advantage of FTFs was respondents’ perception that it is easier to have a discussion with the whole group when there is personal contact with others (48.5%). This advantage was mentioned significantly more often by adults (78.4%) than by children and adolescents (4.8% and 17.7%, p < 0.02).

Conclusions

Participants’ perceptions of OFGs partly concur with the advantages of OFGs as a research method. Whereas respondents generally value the convenience of participating at their own time and place, the anonymity of OFGs and the increased ease to discuss personal issues were mentioned less often as advantages by the participants. An aspect that may need more attention when conducting an OFG, is the absence of a fluid discussion, which is, according to our respondents, easier to achieve in an FTF. This underlines the importance of the moderator in enabling a constructive discussion.