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      Promoting participation in healthcare situations for children with JIA: a grounded theory study

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          Abstract

          Children's right to participate in their own healthcare has increasingly become highlighted in national and international research as well as in government regulations. Nevertheless, children's participation in healthcare is unsatisfactorily applied in praxis. There is a growing body of research regarding children's participation, but research from the children's own perspective is scarce. The aim of this study was thus to explore the experiences and preferences for participation in healthcare situations among children with juvenile idiopathic arthritis (JIA) as a foundation for creating strategies to promote their participation in pediatric healthcare. Twenty children, aged 8 to 17 years, with JIA were interviewed individually and in focus groups. In order to increase the children's opportunities to express their own experiences, different interview techniques were used, such as draw-and-tell and role play with dolls. The analysis was conducted with a constructivist grounded theory. The result explores children's perspective of influencing processes promoting their participation in healthcare situations. The core category that emerged was, “Releasing fear and uncertainty opens up for confidence and participation,” and the categories related to the core category are, “surrounded by a sense of security and comfort,” and “strengthened and supported to become involved.” In conclusion, the knowledge gained in this study offers new insights from the perspective of children themselves, and can constitute a valuable contribution to the understanding of necessary conditions for the development of specific interventions that promote participation among children in healthcare situations.

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          Most cited references36

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          Where is the evidence? A systematic review of shared decision making and patient outcomes.

          Despite widespread advocacy for shared decision making (SDM), the empirical evidence regarding its effectiveness to improve patient outcomes has not been systematically reviewed. The purpose of this study was to systematically review the empirical evidence linking patient outcomes and SDM, when the decision-making process has been explicitly measured, and to identify under what measurement perspectives SDM is associated with which types of patient outcomes (affective-cognitive, behavioral, and health). PubMed (through December 2012) and hand search of article bibliographies. Studies were included if they empirically 1) measured SDM in the context of a patient-clinician interaction and 2) evaluated the relationship between SDM and at least 1 patient outcome. Study results were categorized by SDM measurement perspective (patient-reported, clinician-reported, or observer-rated) and outcome type (affective-cognitive, behavioral, or health). Thirty-nine studies met inclusion criteria. Thirty-three used patient-reported measures of SDM, 6 used observer-rated measures, and 2 used clinician-reported measures. Ninety-seven unique patient outcomes were assessed; 51% affective-cognitive, 28% behavioral, and 21% health. Only 43% of assessments (n = 42) found a significant and positive relationship between SDM and the patient outcome. This proportion varied by SDM measurement perspective and outcome category. It was found that 52% of outcomes assessed with patient-reported SDM were significant and positive, compared with 21% with observer-rated and 0% with clinician-reported SDM. Regardless of measurement perspective, SDM was most likely to be associated with affective-cognitive patient outcomes (54%), compared with 37% of behavioral and 25% of health outcomes. The relatively small number of studies precludes meta-analysis. Because the study inclusion and exclusion criteria required both an empirical measure of SDM and an assessment of the association between that measure and a patient outcome, most included studies were observational in design. SDM, when perceived by patients as occurring, tends to result in improved affective-cognitive outcomes. Evidence is lacking for the association between empirical measures of SDM and patient behavioral and health outcomes. © The Author(s) 2014.
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            2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features.

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              Making Sense of Intimate Partner Violence in Late Life: Comments From Online News Readers

              The purpose of this study was to gain insight into public awareness of intimate partner violence (IPV) in late life by how individuals respond to incidents of IPV reported in the newspaper.
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                Author and article information

                Contributors
                Role: PhD Student
                Role: Associate Professor
                Role: Associate Professor
                Journal
                Int J Qual Stud Health Well-being
                Int J Qual Stud Health Well-being
                QHW
                International Journal of Qualitative Studies on Health and Well-being
                Co-Action Publishing
                1748-2623
                1748-2631
                10 May 2016
                2016
                : 11
                : 10.3402/qhw.v11.30518
                Affiliations
                [1 ]Region Halland, Halmstad Hospital, Sweden
                [2 ]School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
                Author notes
                [* ]Correspondence: B.-M. Gilljam, School of Social and Health Sciences, Halmstad University, SE-301 18 Halmstad, Sweden. E-mail: Britt-mari.gilljam@ 123456hh.se

                Responsible Editor: Ptlene Minick, Georgia State University, USA.

                Article
                30518
                10.3402/qhw.v11.30518
                4864848
                27172512
                1bbfeedd-62f8-45d9-b1c6-4a85de03da05
                © 2016 B.-M. Gilljam et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

                History
                : 03 March 2016
                Categories
                Empirical Study

                Health & Social care
                children,healthcare,participation,constructivist grounded theory,juvenile idiopathic arthritis

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