Nurses’ perspectives on children’s participation in shared decision-making while hospitalised

Abstract

Background: Malta ratified the Convention on the Rights of the Child in the year 1990. The declaration holds information regarding the fundamental principles which mainly include education, healthcare, child protection, and the right to voice their opinion in decisions concerning themselves. The process of shared decision-making is significant in paediatric care, enabling children to voice their opinion, participate, and become active agents in their medical care. However, according to various research studies, such a concept is often overlooked by many nursing professionals. Objectives: To understand paediatric nurses’ perspectives on shared decision-making with hospitalised children. Design: This research project adheres to the principles of interpretative phenomenological analysis. Setting: Interviews took place face-to-face and via Zoom (an online method), at a day and time most convenient to the participants. Participants: Eight paediatric nurses working in medical, surgical, and oncological departments in MDH and SAMOC, with a minimum of two years of experience. Methodology: Participants were chosen via purposeful sampling. Intermediary persons (charge nurses) provided potential participants with the information letter and consent form. Following approval, one-to-one semi-structured interviews were conducted. Findings: Five emergent themes were noted; (1) parental involvement in paediatric shared decision-making, (2) concept of an evolving capacity, (3) maintaining ethical and legal considerations, (4) compassionate care: empowering peadiatric shared decision-making, and (5) collaborative support, along with their corresponding sub-themes. Conclusions: Shared decision-making in the paediatric sector is undervalued by many nursing professionals and even family members. Therefore, education and training in the field of paediatric shared decision-making is required.