Better to know than to imagine: Including children in their health care.
Better to know than to imagine: Including children in their health care.
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DOI：
10.1080/23294515.2016.1207724
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发表时间：
2017-01-01
影响因子：
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通讯作者：
Elger, Bernice S
中科院分区：
文献类型：
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作者：
Wangmo, Tenzin;De Clercq, Eva;Elger, Bernice S
背景技术背景：本文介绍了儿童的整体态度，他们的父母，主治医生对包括或排除儿科患者在医疗通信和医疗保健决策processing.METHODS：五十二个采访进行了儿科患者（n = 17），他们的父母（n = 19），并参加肿瘤学家（n = 16）在8个瑞士儿科肿瘤中心。访谈进行了分析，使用主题coding.RESULTS：父母教养方式，孩子的个性，成熟度的因素，有很大的影响后，包括儿童在他们的医疗保健过程。儿童报告说，他们希望被倾听和参与，但他们不想主导决策过程。确保父母与子女和医生与病人之间的信任以及尊重儿童作为受影响者是决定儿童参与的重要价值观。这两个考虑与幻想往往比现实更糟糕的关注密切相关。寻求儿童对治疗的依从性是向他们告知其保健的一个实际但关键的原因。保护他们免受令人不安的消息的冲动，有时会导致他们（部分）exclusions.CONCLUSIONS：在他们的医疗保健选择纳入儿童的道德义务是没有这么多的自决权，但需要包括他们。如果孩子们被排除在外，他们会想象事情，变得更加孤立，独自面对恐惧。尽管如此，保护儿童的愿望是与生俱来的，因为成年人往往低估儿童的应对能力。
BACKGROUND: This article describes the overall attitudes of children, their parents, and attending physicians toward including or excluding pediatric patients in medical communication and health care decision-making processes.METHODS: Fifty-two interviews were carried out with pediatric patients (n = 17), their parents (n = 19), and attending oncologists (n = 16) in eight Swiss pediatric oncology centers. The interviews were analyzed using thematic coding.RESULTS: Parenting styles, the child's personality, and maturity are factors that have a great impact upon the inclusion of children in their health care processes. Children reported the desire to be heard and involved, but they did not want to dominate the decision-making process. Ensuring trust in the parent-child and physician-patient relationships and respecting the child as the affected person were important values determining children's involvement. These two considerations were closely connected with the concern that fantasies are often worse than reality. Seeking children's compliance with treatment was a practical but critical reason for informing them about their health care. The urge to protect them from upsetting news sometimes resulted in their (partial) exclusion.CONCLUSIONS: The ethical imperative for inclusion of children in their health care choices was not so much determined by the right for self-determination, but by the need to include them. If children are excluded, they imagine things, become more isolated, and are left alone with their fears. Nevertheless, the urge to protect children is innate, as adults often underestimate children's coping capacities.