A National Survey of Children's Experiences and Needs when Attending Canadian Pediatric Emergency Departments

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Jun 25

PMID 38917134

Authors

Keon Ma

Asa Rahimi

Manasi Rajagopal

Maryna Yaskina

Ran D Goldman

Ashley Jones

Tannis Erickson

Naveen Poonai

Candice McGahern

Laura Weingarten

Bethany Lerman

Marie-Christine Auclair

Helen Wong

Lisa Hartling

Kurt Schreiner

Shannon Scott

Samina Ali

Affiliations

Soon will be listed here.

Abstract

Background: Optimizing a child's emergency department (ED) experience positively impacts their memories and future healthcare interactions. Our objectives were to describe children's perspectives of their needs and experiences during their ED visit and relate this to their understanding of their condition.

Methods: 514 children, aged 7-17 years, and their caregivers presenting to 10 Canadian pediatric EDs completed a descriptive cross-sectional survey from 2018-2020.

Results: Median child age was 12.0 years (IQR 9.0-14.0); 56.5% (290/513) were female. 78.8% (398/505) reported adequate privacy during healthcare conversations and 78.3% (395/504) during examination. 69.5% (348/501) understood their diagnosis, 89.4% (355/397) the rationale for performed tests, and 67.2% (338/503) their treatment plan. Children felt well taken care of by nurses (90.9%, 457/503) and doctors (90.8%, 444/489). Overall, 94.8% (475/501) of children were happy with their ED visit. Predictors of a child better understanding their diagnosis included doctors talking directly to them (OR 2.21 [1.15, 4.28]), having someone answer questions and worries (OR 2.51 [1.26, 5.01]), and older age (OR 1.08 [1.01, 1.16]). Direct communication with a doctor (OR 2.08 [1.09, 3.99]) was associated with children better understanding their treatment, while greater fear/ 'being scared' at baseline (OR 0.59 [0.39, 0.89]) or at discharge (OR 0.46 [0.22, 0.96]) had the opposite effect.

Interpretation: While almost all children felt well taken care of and were happy with their visit, close to 1/3 did not understand their diagnosis or its management. Children's reported satisfaction in the ED should not be equated with understanding of their medical condition. Further, caution should be employed in using caregiver satisfaction as a proxy for children's satisfaction with their ED visit, as caregiver satisfaction is highly linked to having their own needs being met.

Citing Articles

A national cross-sectional survey of health literacy of caregivers attending Canadian pediatric emergency departments.

Rajagopal M, Ali S, Ma K, Yaskina M, Morrison A, Schreiner K PLoS One. 2024; 19(12):e0314826.

PMID: 39705272 PMC: 11661602. DOI: 10.1371/journal.pone.0314826.

Low caregiver health literacy is associated with non-urgent pediatric emergency department use.

Jensen K, Morrison A, Ma K, Alqurashi W, Erickson T, Curran J CJEM. 2024; 27(1):17-26.

PMID: 39331337 DOI: 10.1007/s43678-024-00771-8.

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