Peer-reviewed article
Parental perspectives on child participation in prehospital emergency care: A rights-based analysis using Shier's pathways to participation
Mathias Näsström, Lena Junehag, Malin Rising Holmström, Marie Häggström ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This Swedish study explored how children participate in ambulance care through interviews with 12 parents of children aged 0-14. Paramedics engaged children at basic participation levels by listening to them, supporting their views, and using age-appropriate communication, including non-verbal interaction with preverbal children. However, participation was inconsistent, depended on individual clinicians' communication styles, and rarely reached higher levels of meaningful decision-making or collaborative involvement.
Key points
- Emergency medical services clinicians used age-appropriate language, adjusted tone and body language, and made meaningful adaptations to include children
- Preverbal children were included through non-verbal interaction and emotional presence
- Participation was limited to lower levels of Shier's model (being listened to, expressing views, views being considered); higher levels of participation were absent
- Participation was inconsistent and dependent on individual clinicians' communication styles rather than embedded in organisational structures
- Participation was more likely when time allowed and less likely during urgent interventions
Limitations
The study is based on parental perceptions rather than direct observation or children's own accounts, and the small sample size of 12 families from one country may limit generalisability to other emergency care settings or contexts.
Abstract
Children have the right to express their views and to have those views considered respectfully in matters affecting them, as articulated in Article 12 of the United Nations Convention on the Rights of the Child. In emergency care, this right must be balanced with the child's best interests, particularly when illness, distress or developmental or cognitive factors limit a child's ability to participate directly (Article 3). Little is known about how this is implemented in prehospital emergency care. This study explores how children's participation occurs during ambulance care, as perceived by their parents, using Shier's ‘Pathways to Participation’ model. A qualitative study involving semi-structured interviews with 12 parents (nine mothers and three fathers) of 12 children (five females and seven males, aged 0–14) who received ambulance care in Sweden was conducted. A deductive content analysis was performed, guided by Shier's five-level participation model. Ethical approval was obtained. Participation was described at the first levels of Shier's model: children being listened to, supported in expressing their views and having their views considered. Parents described how emergency medical services clinicians used age-appropriate language, adjusted tone and body language and made meaningful adaptations. Preverbal children were included through non-verbal interaction and emotional presence. However, higher levels of participation were absent. Participation appeared relational and dependent on individual clinicians’ communication style. Participation was more likely when time allowed and less likely during urgent interventions. Children's participation in prehospital emergency care is not only feasible but already realised through relational and responsive clinical behaviours. However, participation is inconsistent and dependent on individual clinicians rather than embedded structures. To align practice with Article 12, clinicians should consider implementing training and clinical routines that facilitate child participation. These findings contribute to evidence that child-centred care is possible in fast-paced emergency contexts.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Implementation of age-appropriate communication, responsive clinical behaviours, and adaptations by emergency medical services clinicians to facilitate child participation in ambulance care
- Population
- 12 children aged 0-14 who received ambulance care in Sweden, assessed through parental interviews
Key finding
Children's participation was realised at lower levels of Shier's model (being listened to, expressing views, having views considered)
Näsström et al. · OpenAlex · 19 Mar 2026