Peer-reviewed article
Child participation in triadic medical consultations: A scoping review and summary of promotive interventions
Christiaan S. van Woerden, Heleen H. Vroman, Paul L.P. Brand ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined how children participate in medical consultations involving a doctor, parent, and child. Researchers found that children speak only 4-14% of the time during these visits, and participation increases with age. While doctors and parents try various approaches to encourage children to speak, including seating arrangements and educational tools, child participation has not improved over 50 years. The review concludes that children have a right to be heard in medical decisions but are largely excluded from conversations.
Key points
- Child participation in triadic medical consultations ranges between 4% and 14% of consultation time
- Participation increases with age
- Equidistant seating arrangements, child-directed gaze and appropriate tone of voice by physicians promoted child participation
- No increase in child participation was observed over the last 50 years despite facilitative efforts such as social talk, eHealth tools and consultation education
- Children desire to be involved in clinical encounters and have a right to have their voice heard
Limitations
This is a scoping review synthesizing existing literature rather than primary research, so it identifies patterns in the field but cannot determine causal relationships. The review does not appear to assess the quality of included studies or provide detailed analysis of why interventions have failed to increase participation over time.
Abstract
OBJECTIVES: To promote patient centered care, children with health issues should be supported to participate in consultations with health care professionals. We aimed to summarize, in a scoping review, the evidence on child participation in triadic encounters and its promotive interventions. METHODS: Two researchers systematically searched four major databases, and included studies on child participation in medical consultations. A synthesis of quantitative and qualitative data was made. RESULTS: Of 1678 retrieved records, 39 papers were included: 22 quantitative, 14 qualitative and 3 mixed-methods studies. Child participation, measured by utterances, turns or speech time, ranged between 4% and 14%. Participation increased with age. Equidistant seating arrangements, child-directed gaze and finding the appropriate tone of voice by the physician promoted child participation. Despite all facilitative efforts of doctors and parents, such as social talk, eHealth tools or consultation education, no increase in child participation was observed over the last 50 years. CONCLUSIONS: Children continue to participate only marginally in medical consultations, despite their desire to be involved in various aspects of the clinical encounter and their right to have their voice heard. PRACTICE IMPLICATIONS: Health care professionals should provide more opportunities for children to participate in triadic medical encounters and create an inclusive environment.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Various approaches to promote child participation including equidistant seating arrangements, child-directed gaze, appropriate physician tone, social talk, eHealth tools, and consultation education
- Population
- Children of various ages attending medical consultations with parents and healthcare professionals
Key finding
Child participation measured by utterances, turns or speech time ranges between 4% and 14%