„Child Life Specialist“-Interventionen in der klinischen pädiatrischen Versorgung: Ein systematischer Review zu Effekten auf psychische Gesundheitsparameter von Kindern und Jugendlichen

Zusammenfassung Ziel der Studie Krankenhausaufenthalte können bei Kindern zu psychischen Belastungen führen, die in der Regelversorgung häufig nicht ausreichend adressiert werden. Ein neuer Ansatz ist es, spezialisierte psychosoziale Fachkräfte, sog. Child Life Specialists (CLS), in die klinische Versorgung einzubinden. CLS begleiten Kinder durch den Klinikalltag und können Belastungen durch gezielte Interventionen auffangen und das Wohlbefinden der PatientInnen fördern. Ziel dieser Arbeit ist es, die Effekte von CLS-Interventionen auf Angst, Schmerz und Stress von Kindern im klinischen Kontext zu analysieren. Methodik Es wurde eine systematische Literatursuche in den Datenbanken Medline, Embase und PsycINFO durchgeführt. Die Ergebnisse wurden in tabellarischer und graphischer Form dargestellt. Ergebnisse Es wurden vier randomisierte kontrollierte Studien (RCTs) eingeschlossen, die die Effekte von CLS-Interventionen bei 459 Kindern im Alter von 0–15 Jahren untersuchten. Eine signifikante Verbesserung der Zielkriterien wurde jeweils in mindestens einer Studie berichtet. Bei allen Studien ist von einem mittleren bis hohen Verzerrungsrisiko auszugehen. Schlussfolgerung In den eingeschlossenen RCTs werden positive Effekte von CLS-Interventionen auf Ergebnisvariablen psychischer Gesundheit von Kindern im klinischen Setting berichtet. Aufgrund der geringen Anzahl von Studien sowie deren Heterogenität und Qualität ist weitere Forschung notwendig.

Child life specialists as facilitators of child participation : a thematic literature review

The child's right to participate is a fundamental right outlined in the UN convention on the rights of the child. Canada signed and ratified this convention in 1991. Through secondary literature and the author's personal experience this paper explores the child's right to participate in the context of canadian pediatric medicine. In particular, this paper examines if and how a child is encouraged to participate in their health care, and which members of the health care team facilitate this participation. The paper also outlines a number of factors that limit or enhance child participation. Recommendations and next steps are included in the paper with the purpose of enhancing the quality and amount of participation that is offered to pediatric patients within hospital settings. One recommendation that is developed and discussed is the increased role of the child life profession as a tool for enabling child participation.

Child life specialists as facilitators of child participation : a thematic literature review

The child's right to participate is a fundamental right outlined in the UN convention on the rights of the child. Canada signed and ratified this convention in 1991. Through secondary literature and the author's personal experience this paper explores the child's right to participate in the context of canadian pediatric medicine. In particular, this paper examines if and how a child is encouraged to participate in their health care, and which members of the health care team facilitate this participation. The paper also outlines a number of factors that limit or enhance child participation. Recommendations and next steps are included in the paper with the purpose of enhancing the quality and amount of participation that is offered to pediatric patients within hospital settings. One recommendation that is developed and discussed is the increased role of the child life profession as a tool for enabling child participation.

Connecting home and hospital life : cultural influence in child life practice

The changing demographics of illness necessitate the provision of complex care practices designed to meet the individual needs of families from diverse backgrounds. Providing psychosocial care to paediatric patients, child life specialists integrate processes designed to better understand their patients, thus informing their plans of care. Through the use of Grounded Theory, this study involves 7 child life specialists from a large city in Ontario and explores the processes implemented by child life specialists in getting to know their patients and families. Data obtained from semi-structured interviews and a reflective journaling exercise was examined for evidence of cultural influence and a greater understanding of child life specialists' perceived comfort and ability was explored. The results of this study suggest child life specialists engage in culturally responsive practices, however several barriers and challenges exist. Resource needs are identified and implications for practice are examined.

Challenging child development theory on the understanding of death : learning through the experiences of child life specialists

The purpose of this research was to review the experiences of Child Life Specialists, to determine whether or not children with a terminal illness have a more advanced knowledge of death than traditional child developmental theory suggests. This research was a qualitative design in the form of a questionnaire and examined the experiences of five professional Child Life Specialists in the Greater Toronto Area. The findings revealed that Child Life Specialists have found that there is a difference of understanding of death between a healthy and terminally ill child. This information could lead to better practices for pediatric palliative care by providing those who work with palliative children, a better understanding of their perceptions and understanding of death.

Challenging child development theory on the understanding of death : learning through the experiences of child life specialists

The purpose of this research was to review the experiences of Child Life Specialists, to determine whether or not children with a terminal illness have a more advanced knowledge of death than traditional child developmental theory suggests. This research was a qualitative design in the form of a questionnaire and examined the experiences of five professional Child Life Specialists in the Greater Toronto Area. The findings revealed that Child Life Specialists have found that there is a difference of understanding of death between a healthy and terminally ill child. This information could lead to better practices for pediatric palliative care by providing those who work with palliative children, a better understanding of their perceptions and understanding of death.

Connecting home and hospital life : cultural influence in child life practice

The changing demographics of illness necessitate the provision of complex care practices designed to meet the individual needs of families from diverse backgrounds. Providing psychosocial care to paediatric patients, child life specialists integrate processes designed to better understand their patients, thus informing their plans of care. Through the use of Grounded Theory, this study involves 7 child life specialists from a large city in Ontario and explores the processes implemented by child life specialists in getting to know their patients and families. Data obtained from semi-structured interviews and a reflective journaling exercise was examined for evidence of cultural influence and a greater understanding of child life specialists' perceived comfort and ability was explored. The results of this study suggest child life specialists engage in culturally responsive practices, however several barriers and challenges exist. Resource needs are identified and implications for practice are examined.

Child life specialists' perspectives on collaboration with schools

As paediatric patients transition from the hospital environment, there is a lack to programs and supports to assist in this transitional phase. The child life specialist plays a unique role within the interprofessional team of professionals in the hospital. They provide paediatric patients and their families with psychosocial services such as age and developmentally appropriate coping mechanisms. A mixed-method study was conducted through qualitative semi-structured interviews, and a survey to explore how child life managers and frontline child life specialists perceived their role expanding outside of the hospital. five themes emerged from questions asked in the interviews and surveys. These themes include: role perceptions, collaboration with health care professionals, collaboration with school professionals, challenges to collaboration and recommendations for the role expansion. From these five themes, thirteen sub-themes emerged spontaneously. The findings of this research study indicate that there is a consensus from both child life managers and specialists on the value of expanding their role beyond the hospital. although considered an essential service in some hospitals, further steps need to be taken to ensure child life specialists feel that their services are validated in the hospitals.

Child life specialists' perspectives on collaboration with schools

As paediatric patients transition from the hospital environment, there is a lack to programs and supports to assist in this transitional phase. The child life specialist plays a unique role within the interprofessional team of professionals in the hospital. They provide paediatric patients and their families with psychosocial services such as age and developmentally appropriate coping mechanisms. A mixed-method study was conducted through qualitative semi-structured interviews, and a survey to explore how child life managers and frontline child life specialists perceived their role expanding outside of the hospital. five themes emerged from questions asked in the interviews and surveys. These themes include: role perceptions, collaboration with health care professionals, collaboration with school professionals, challenges to collaboration and recommendations for the role expansion. From these five themes, thirteen sub-themes emerged spontaneously. The findings of this research study indicate that there is a consensus from both child life managers and specialists on the value of expanding their role beyond the hospital. although considered an essential service in some hospitals, further steps need to be taken to ensure child life specialists feel that their services are validated in the hospitals.