Peer-reviewed article
Exploring children's participation in nursing care: A qualitative systematic review.
Loureiro F, de Fátima Frade M, Malheiro MI ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined qualitative research on how children participate in decisions about their nursing care. The analysis of 20 studies found that children's participation depends on the relationship with nurses, access to understandable information, and support from adults. Trust and good communication between children and nurses encouraged children to share their views, while play and child-friendly settings also helped. However, most research focused on school-age children and adolescents, with little evidence about how younger children experience participation in care.
Key points
- The child-nurse relationship, built on trust and supportive communication, was identified as central to children's participation in care decisions
- Adult dominance in the child-parent-professional triad often restricted children's participation to minor decisions rather than meaningful involvement
- Access to developmentally appropriate information was essential for children to understand and engage in decisions about their care
- Non-verbal expression, play, and child-friendly physical environments supported children's participation experiences
- Evidence predominantly reflects school-aged children and adolescents, with limited research on younger children's participation
Limitations
The review does not specify which countries or healthcare settings the included studies came from, limiting understanding of whether findings apply globally. The review acknowledges that most evidence concerns older children, so conclusions about younger children's participation cannot be drawn.
Abstract
Background Participation in healthcare is recognised as a fundamental right of children and a key component of child-centred care. However, evidence remains fragmented, particularly regarding the role of nursing care in supporting participation. Aim This systematic review aimed to identify, critically appraise, and synthesise qualitative evidence on children's experiences of participation in nursing care and the factors influencing this participation. Methods A qualitative systematic review was conducted in accordance with JBI methodology. Databases searched included CINAHL, MEDLINE, ScieLo, Scopus, APA PsyArticles, Web of Science, ERIC, ProQuest and OpenAIRE with no date or language restrictions. 20 qualitative studies (2002-2025) were included and analysed using thematic synthesis. Results Four themes were identified. Across predominantly school-aged children and adolescents, the child-nurse relationship emerged as an important aspect of participation, with trust, familiarity and supportive communication linked to opportunities for children to express their views. Participation was shaped by the child-parent-professional decisional triad, where adult dominance often restricted involvement to 'small' decisions. Access to developmentally appropriate information was described as important for understanding and engagement in care. Embodied and environmental factors, including non-verbal expression, play and child-friendly settings, also shaped participation experiences. Although participation generally increased with age, evidence relating to younger children was limited. Conclusions Children's participation in nursing care appears to be relational, developmental and context-dependent. The findings suggest that participation experiences are shaped by interpersonal, communicative and organisational factors. However, the available evidence predominantly reflects the experiences of school-aged children and adolescents, highlighting the need for further research involving younger children.