title: Children's participation in consultations and decision-making at health service level: a review of the literature.
abstract: BACKGROUND
  The past decade has seen a growing recognition in Ireland and internationally that children and young people have a right to participate in matters that affect their lives.
  
  
  OBJECTIVE
  To critique the research literature on children's, parents and healthcare professionals' experiences of children's participation in consultations and decision-making within the healthcare setting.
  
  
  METHODS
  The literature was obtained from electronic databases, books, and journals focusing on work published in between 1993 and 2007.
  
  
  RESULTS
  Despite the importance of consulting with sick children, their views are rarely sought nor acknowledged within the healthcare setting. Children are rarely involved in decision-making process and appear to occupy a marginalized position in healthcare encounters. Healthcare professionals and parents play a significant influence on whether children's efforts to participate are facilitated and supported in the hospital setting.
  
  
  CONCLUSIONS
  There is a need for further research to explore health professionals' and parents' perspectives on children's participation in consultations and decision-making, as clearly they have reservations/concerns about children's active involvement in such matters. This information could be used to develop guidelines that will assist professionals and parents in facilitating and supporting children's participation.
authors.affiliation: School of Nursing & Midwifery, Faculty of Health Sciences, 24 D'Olier Street, Trinity College Dublin, Dublin 2, Ireland. coynei@tcd.ie
authors.forename: Imelda
authors.initials: I
authors.lastname: Coyne
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D002651:Child Advocacy; D002673:Child, Hospitalized / Q000523:psychology* / Q000706:statistics & numerical data; D003142:Communication; D003657:Decision Making; D005610:Freedom; D006301:Health Services Needs and Demand; D006801:Humans; D007258:Informed Consent; D015399:Nursing Research; D010290:Parents / Q000193:education / Q000523:psychology; D010353:Patient Education as Topic; D010358:Patient Participation / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D011209:Power, Psychological; D017410:Practice Guidelines as Topic; D002666:Psychology, Child; D012017:Referral and Consultation / Q000458:organization & administration*; D012380:Role; D020377:Self Efficacy; D012944:Social Support