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Paeds SAQsprofessional-practice-and-evidence

Paeds SAQs · professional-practice-and-evidence

Family-centred and child-rights-based care — formative SAQs

Two formative SAQs on family-centred and child-rights-based care: the four IPFCC core concepts and four UNCRC guiding principles, Hart's ladder of participation, and bedside delivery across complex chronic illness and adolescent settings.

20 marks30 min3 min readVerification in progress

Target exams

RACP General PaediatricsRACP DWEMRCPCH TheoryMRCPCH ClinicalABP General Pediatrics
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Study tools

Target exams

RACP General PaediatricsRACP DWEMRCPCH TheoryMRCPCH ClinicalABP General Pediatrics
Prompt
Family-centred and child-rights-based care

SAQ 1 — Core concepts, rights principles and participation (10 marks)

A 7-year-old with a complex chronic illness is admitted to the ward for a planned procedure. Her care spans four specialists and a school nurse. Her parents speak a language other than English and arrive with her older sibling. [9] [10]

Questions

  1. Name the four IPFCC core concepts and the four UNCRC guiding principles, and state how each set shapes this encounter. (5 marks) [1] [5]
  2. Grade the child's possible participation using Hart's ladder, distinguishing genuine participation from tokenism. (3 marks) [12]
  3. State two concrete bedside actions that would uphold the child's right to be heard here, and one error to avoid. (2 marks) [6]

Model answer

Core concepts and principles (5). The four IPFCC core concepts are dignity and respect, information sharing, participation, and collaboration; they tell you how to partner — in this encounter, by booking a professional interpreter, sharing honest information in plain language, involving the family in the plan, and treating the parents as equal partners. [1] The four UNCRC guiding principles are non-discrimination, the best interests of the child, survival and development, and the right of the child to be heard; they tell you why the child is owed it — here, the child's own views must be sought and given weight regardless of her family's language or background. [5]

Grading participation (3). Hart's ladder places manipulation, decoration and tokenism outside participation — a child asked to hold a prop during a consent conversation she cannot influence is decoration. Genuine participation runs from assigned-but-informed through consultation to child-initiated, shared decisions with adults. For this 7-year-old, genuine participation means telling her in age-appropriate terms what will happen and asking her view, weighted to her developmental stage. [12]

Bedside actions (2). Two concrete actions: greet the child by name first and ask her, in age-appropriate language, what she understands and what matters to her; record her own views in the notes rather than only the parents'. One error to avoid: using the older sibling as interpreter for high-stakes information — a professional interpreter is required. [6] [9]

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References6ShowHide
  1. [1]COMMITTEE ON HOSPITAL CARE, INSTITUTE FOR PATIENT- AND FAMILY-CENTERED CARE Patient- and family-centered care and the pediatrician's role. Pediatrics, 2012.PMID 22291118
  2. [5]Goldhagen JL, Shenoda S, Oberg C, Mercer R, Kadir A, Raman S Rights, justice, and equity: a global agenda for child health and wellbeing. Lancet Child Adolesc Health, 2020.PMID 31757760
  3. [6]Quaye AA, Coyne I, Söderbäck M, Hallström IK Children's active participation in decision-making processes during hospitalisation: An observational study. J Clin Nurs, 2019.PMID 31430412
  4. [9]Shields L, Nixon J Hospital care of children in four countries. J Adv Nurs, 2004.PMID 15009350
  5. [10]O'Connor S, Brenner M, Coyne I Family-centred care of children and young people in the acute hospital setting: A concept analysis. J Clin Nurs, 2019.PMID 31099444
  6. [12]Alderson P, Sutcliffe K, Curtis K Children as partners with adults in their medical care. Arch Dis Child, 2006.PMID 16399782
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