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.
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Target exams
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
- Name the four IPFCC core concepts and the four UNCRC guiding principles, and state how each set shapes this encounter. (5 marks) [1] [5]
- Grade the child's possible participation using Hart's ladder, distinguishing genuine participation from tokenism. (3 marks) [12]
- 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]
References6ShowHide
- [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
- [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
- [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
- [9]Shields L, Nixon J Hospital care of children in four countries. J Adv Nurs, 2004.PMID 15009350
- [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
- [12]Alderson P, Sutcliffe K, Curtis K Children as partners with adults in their medical care. Arch Dis Child, 2006.PMID 16399782