JMIR Hum Factors. 2026 Apr 21;13:e89802. doi: 10.2196/89802.
ABSTRACT
BACKGROUND: Child-centered care (CCC) is standard practice in pediatrics, emphasizing the child as an individual with rights while acknowledging the child’s role within the family. A key aspect of CCC is the involvement of the child in health care decisions alongside parents and professionals. Although this is a right recognized by the United Nations Convention on the Rights of the Child, it may not always be applied in practice.
OBJECTIVE: The aim of this study is to explore the participation preferences of 3- to 5-year-old children in health care from both their own viewpoint (the child’s perspective) and the viewpoint of their parents and health care professionals.
METHODS: Q methodology was used to study preferences, comparing responses from 12 children, 14 parents, and 12 health professionals who ranked 25 statements about ways in which children could participate in health care situations. Factor analysis was used to reveal similarities and differences in views on participation preferences. The children’s rankings were also analyzed separately for comparison.
RESULTS: Analysis of rankings from children, their parents, and health care professionals identified 3 perspectives with different preferences: direct communication between the child and healthcare professionals; understanding and shared decision-making; and responsive and child-led participation. A separate analysis of children’s rankings resulted in 3 perspectives: being included in and setting their own terms for participation; small choices, meaningful outcomes; and trust through familiarity and shared decision-making.
CONCLUSIONS: This study suggests that children value shared decision-making and situational control but prefer to leave major decisions to adults. It affirms that preschool-aged children can meaningfully participate in health care when given age-appropriate choices, support, and tools. Children’s perspectives must be acknowledged directly rather than adults assuming their views. The findings support CCC principles and reinforce the United Nations Convention on the Rights of the Child mandate to respect children’s views regarding all issues relevant to them.
PMID:42013468 | DOI:10.2196/89802
