Qualitative research is highly valued as a means of understanding patients’ experiences of illness and the healthcare system. When seeking to understand the healthcare experiences of children and young people, it is common to see parents and health professionals speaking on behalf of children, rather than children and young people representing themselves.
There are numerous challenges in undertaking research of any kind in a hospital setting, particularly when seeking the participation of children and young people. When qualitative research methods are proposed, children and young people are even more likely to be overlooked.
This article seeks to discuss the inequitable participation of children and young people in qualitative research conducted in a hospital setting. Challenges in undertaking research that acknowledges and values the voice of children are identified and critically examined to consider ways in which children and young people can more readily participate in sharing their own experiences of health and healthcare.
Background Pressure injuries (PI) are serious, preventable complications that can increase morbidity and healthcare costs for acutely ill infants and children. PIs have been historically identified as an adult issue where they have been well studied and documented; however, limited research has been conducted with paediatric populations. Due to their unique anatomical, physiological and developmental differences, research targeting paediatric patients is needed.
Aim The review aimed to identify the current quantitative evidence regarding PI prevention in hospitalised paediatric patients.
Methods A wide range of databases were searched for quantitative studies on PI interventions for hospitalised paediatric patients. The relevant papers were critically appraised using the McMaster University Critical Review Tool for Quantitative Studies; data was extracted and presented as a narrative summary due to the heterogeneity of included studies.
Findings The search strategy identified 214 potential papers and, after removal of duplicates and screening of titles and abstracts, 40 papers were selected for retrieval. Examination of the full-text of the retrieved papers found that 15 met the inclusion criteria. The included studies were low to moderate quality. PI prevention bundles and protocols were found to decrease occurrences and duration of PIs among hospitalised paediatric patients.
Conclusion Educating nursing staff on skin and risk assessments and PI prevention can also contribute to PI prevention. However, further research is needed in relation to PI prevention among hospitalised paediatric patients.
Ngala is an evidence-informed community-based parenting and early childhood organisation in Western Australia. During 2007, a strategic decision was made to forge formal links with universities where researchers could actively participate in the establishment of a research agenda that supported identified priority areas for Ngala. This decision provided strategies for embracing the challenges of evidence-informed practice (EIP) for the organisation alongside competing financial demands which, for many not-for-profit organisations, is an ongoing dilemma.
This paper will discuss the identified trends, changes and examples which informed the foundational components to sustain a research and evaluation culture within an evidence informed community service organisation (CSO). A case study design was used to describe activity and experiences over a decade. Participants included academics from a range of disciplines, and Ngala managers and practitioners. Multiple data sources were analysed – current literature, an audit of organisational documents, and a leadership survey to establish key components necessary to sustain a research culture. Challenges are described as well as examples of success that enabled growth and change.
The sustainability of a culture results in the strength of an organisation to continue building on successes of the past and to focus on the long term. In today’s environment of funders requiring organisations to demonstrate the difference they are making for families with children, it is even more crucial for services to build in resources for research and evaluation, despite growing costs. Senior level leadership and commitment enhances the drive for EIP which takes a whole of organisation approach for sustainability.
Background Many children in out-of-home care (OoHC) have complex healthcare needs. This, paired with the complexity of the healthcare system, resulted in difficulty providing timely, coordinated and effective healthcare in a regional setting in Queensland, Australia. In response, a new model was developed which included the introduction of a unique health advisor (HA) role. This study explored key stakeholders’ perceptions – including facilitators and barriers – regarding the implementation of this new model of care delivery to children in OoHC.
Methods A qualitative study design using face-to-face interviews and focus groups was used to explore key stakeholders’ perspectives relating to issues faced by children in OoHC seeking healthcare and their experiences with the HA role. Purposive sampling was used to recruit participants from four key groups – carers, child safety officers (CSO), paediatricians and general practitioners (GPs). Thematic analysis using a reflexive approach was used to generate themes from qualitative data which was transcribed verbatim.
Findings The responses from interviews (n=20) and two focus groups (n=14) generated four key themes:
Getting in the door: initial access to healthcare
Who’s who in that big zoo: key providers of healthcare
Navigating the maze: communication and collaboration
Working together: coordination, advocacy and support
Discussion The majority of participants reported positive experiences with the new model, particularly relating to improved initial access to healthcare, communication and coordination; however, this varied according to level of engagement with the HA. The dual coordinator–clinician role of the HA was identified as particularly beneficial. Barriers to healthcare included lack of prioritisation and difficulties accessing mental health and allied health services.
Conclusions This study demonstrated the positive impact of the HA model and provides a blueprint for implementation in other healthcare services.