Capturing children's voices for quality improvement.
OBJECTIVE
To query children about the perceptions of their inpatient healthcare experiences in order to improve care to make it more developmentally appropriate and responsive to children's needs and desires.


METHODS
Children (n = 120) were interviewed and their comments were recorded as they described the best and worst things about their hospitalization and made recommendations for change. They were approached at the time of discharge from a tertiary care unit. Content analysis was used to compare their responses within their developmental levels. Themes were developed, and data were co-coded for trustworthiness of findings. Quotes were extracted that illustrated the themes.


RESULTS
Children provided insightful and specific data regarding the perceptions of their hospital experiences. Pain and discomfort were cited most frequently as the worst aspects of hospitalization and the areas most needing improvement. Play activities were valued by children of all ages. Their positive relationships with hospital staff were described frequently. The developmental stage of children determined the specificity and diversity of their comments.


CONCLUSIONS
Children's unique perspectives should be sought regularly and their data included in ongoing programs of quality assessment. When only parents are queried, important and insightful perspectives of children are missed that could improve care quality.
Lindeke
Linda
L
School of Nursing, University of Minnesota, Minneapolis, MN, USA. linde001@umn.edu
Nakai
Miyuki
M
Johnson
Lauren
L
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D002648:Child; D002657:Child Development; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D005190:Family / Q000523:psychology; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D015146:Midwestern United States; D020380:Needs Assessment; D015404:Nursing Methodology Research; D010146:Pain / Q000517:prevention & control / Q000523:psychology; D010371:Pediatric Nursing / Q000592:standards; D010988:Play and Playthings / Q000523:psychology; D011369:Professional-Patient Relations; D002666:Psychology, Child; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration*; D014789:Visitors to Patients / Q000523:psychology