Background: The Institute of Medicine (IOM) report, Crossing the Quality Chasm recommended an increased focus on patient-centered care to improve patients’ experience in health care; however, patient-centered care aimed directly at children remains elusive. While the IOM report states that health care cannot be improved without the direct engagement of patients, few studies directly engage children, as patients, to better understand children’s experiences in health care from the child’s point of view.
Purpose: The purpose of this study was to describe a child-patient-centered care (C-PCC) perspective to understand the first-time hospital experiences of school-aged children.
Methods: This study used an arts-based, child-centered approach to data collection —the Draw-and-Tell Conversation (DTC)—to help school-aged children talk about their recent experiences in the hospital. In addition to the typical procedures used with DTCs, several specific choices were made to adapt the DTC for use in exploring child-reported experiences of recent hospitalization, including parental presence, iPad technology for drawing, and a child-driven timeline. This is the first time DTCs have been used to explore an experience in this way.
Analysis: Each DTC was recorded, transcribed verbatim, and verified by the data collector. The transcripts were analyzed using conventional content analysis in which results of analysis remain as close to the original data and participants’ language as possible. NVivo software 10 was used to store and organize the data. Codes were continually reviewed and revised, adding new codes and sub-codes to accurately reflect categories of data. Codes were then grouped into meaningful categories.
Results: In their DTCs, children focused on six topics when telling about their hospital experiences: the hospital environment, play, food, parents, nurses, and pain. Across topics, children placed particular emphasis on the space around them in the hospital—mainly their beds and immediate surroundings—where most of them situated themselves both in drawing and in telling their stories. They also focused on the people (parents and nurses) and items in that space to the near exclusion of hospital-specific items.
Conclusion: Learning about children’s current experiences of hospitalization from their own points-of-view may help meet the long-term goal of improving children’s hospital experiences and decreasing the negative sequelae that occur. Exploring the use of DTCs to further investigate other areas that affect children’s health care—for example, their experiences with chronic illness diagnoses, experiences in health care clinics, experiences with communication with health care professionals—may add to the growing body of literature around child-patient-centered care as well as expand the use of DTCs.
|Advisor:||Siegel, Elena O., Driessnack, Martha|
|Commitee:||Lagattuta, Kristin H.|
|School:||University of California, Davis|
|School Location:||United States -- California|
|Source:||DAI-B 79/01(E), Dissertation Abstracts International|
|Subjects:||Nursing, Health care management|
|Keywords:||Children, Drawing, Experience, Hospital|
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