Including children in medical decisions and treatments: perceptions and practices of healthcare providers

Background With growing awareness of the need to involve children in their own health-related decisions, attention has primarily focused on the concept of assent, or a minor's participation in a research trial or experimental treatment. This study attempts to broaden that focus by examining the perceptions and practices of healthcare providers with respect to the role of children in more routine healthcare decisions and treatments. Methods In total, 103 nurses and 40 physicians who work in a hospital in Israel completed self-administered perceptions and practices questionnaires. Results Many participants agreed that children should be included in decision making. Factors that respondents felt would influence their approach to a particular child included child behaviour (80%), child communication (66%), experience of child, parent and healthcare provider (90%) and type of medical intervention (60%). Responses differed between physicians and nurses. In response to the question 'How often do you suggest the following methods to achieve child participation in treatment?' most respondents reported that they provide an explanation (98%) and recruit the parents (90%). The use of play was reported by only 63% of the professionals. Conclusion This study demonstrated that many healthcare providers recognize the need to include children in routine health-related practices and outlined factors healthcare providers use in deciding when to include children in medical decisions. Involving children in even the minute aspects of everyday decisions and treatments can allow children to feel part of the process, improve their co-operation, increase their sense of control and affect future healthcare encounters.