The School of Nursing, Midwifery and Social Work, The University of Manchester, University Place, Oxford Road, Manchester M13 9PL, UK.
J Clin Nurs. 2010 Aug;19(15-16):2215-25. doi: 10.1111/j.1365-2702.2009.03161.x.
To review and critique the research literature on children's and young people's participation in health care decision-making, to highlight gaps in the research and to identify implications for nursing practice.
Children have a right to participate in decisions about their lives. The recognition of this, along with greater acknowledgement of children's capabilities, has led to an increasing awareness that children's views must be given value in both national policy and individual decisions. Health professionals have also been given explicit direction to ensure that children are actively involved in decision-making.
Literature review.
Search of electronic databases and manual searching of journals and reference lists between 1990-2009.
Children want to be involved in discussions about their care but it is unclear to what extent this happens in practice. The research conducted has interpreted participation in different ways. Studies have compared decisions of differing importance in terms of risk and many have a wide age range in their samples, including children who are arguably too young for meaningful participation. However, this heterogeneity is often overlooked in the reporting of studies. Aspects of practice which can help or hinder participation are identified but there is little evidence on the outcome benefits of participation. In addition, there has been an over-reliance on interviews as the method of data collection.
Research using a combination of observation and interviewing would provide more in-depth knowledge about participation in practice. In addition, studies should consider decisions of similar consequence and children at an age when participation is appropriate.
The need for health professionals to ensure children are protected is undisputed but should not prevent children's rights to participate from being enacted. Practitioners, therefore, need further guidance on how to facilitate the participation of children.
回顾和评价儿童和年轻人参与医疗决策的研究文献，强调研究中的差距，并确定对护理实践的影响。
儿童有权参与与其生活相关的决策。认识到这一点，以及对儿童能力的更大认可，使得人们越来越意识到，必须在国家政策和个人决策中重视儿童的观点。卫生专业人员也被明确指示要确保儿童积极参与决策。
文献回顾。
1990-2009 年间，对电子数据库进行检索，并对期刊和参考文献进行手工检索。
儿童希望参与有关其护理的讨论，但在实践中，他们参与的程度尚不清楚。已进行的研究以不同的方式解释了参与。研究比较了不同风险程度的决策，许多研究的样本年龄范围很广，包括可以说是太小而无法进行有意义参与的儿童。然而，在报告研究时，往往忽略了这种异质性。确定了有助于或阻碍参与的实践方面，但关于参与的结果益处几乎没有证据。此外，研究过度依赖访谈作为数据收集方法。
使用观察和访谈相结合的研究方法可以提供更多关于实践中参与的深入知识。此外，研究应考虑具有相似后果的决策和适合参与的年龄的儿童。
卫生专业人员确保儿童受到保护的必要性是无可争议的，但不应妨碍儿童参与的权利的实施。因此，从业人员需要进一步了解如何促进儿童的参与。
