Experience of care: Parent vs Child #WILTW

This is the 167th #WILTW

Experiences are very personal. Go to trip advisor and you’ll find, for the same time period, families rating hotels and holidays in completely different ways. The appearance of “colourful’ surroundings to one person may well be perceived as “tacky” by another. This phenomena is not restricted to the leisure industry. It is not uncommon to receive a glowing compliment and devastating complaint within the same 30 minute during busy periods in Emergency Departments.

This happens in part because clinical conditions and the reasons for presentation are obviously different, but also because values and expectations vary widely. Quality in healthcare runs across a number of domains and while healthcare may be delivered well in one area, this may impact detrimentally on a patient’s perception of another.

There is a further intriguing imbalance when you consider intra-family perception of care. In an interesting paper published this month children and young people’s experience of care was compared with those of their parents. A validated questionnaire was used on 257 children (aged 8 to 18) and 257 parents to determine their experience of care in a Children’s Emergency Department. Overall the experience of both children and parents was positive but areas rated poorly included entertainment activities (43.2% of respondents) , waiting time (23.7%) and treatment of pain (10.5%).

Children were more likely to poorly rate their experience of waiting times, explanations, privacy and pain than their parents (further detail of explanation and pain below)

The differences are not huge, but in the case of pain, difficult to ignore. There are many cues that clinicians take from parents to judge the impact of their treatments. In relation to injuries especially, parental acknowledgment that pain has been treated is likely to be taken as a sign no further analgesia is needed. These results emphasise the importance of child centred care. This is not a tokenistic buzz word, if you value your ability to ‘do no harm‘ the child’s perceptions of their illness must be addressed. There are many reasons why there might be dissonance between the pain reported by a child and the amount of pain they are perceived to be in. None of these diminish the need to try and (appropriately) reduce reported distress.

It’s important to remember that experiences are very personal, even between close friends and family.

What have you learnt this week? #WILTW

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