The Child's Best Interests during Hospitalisation - What does it imply?

Introduction
The child’s best interest has moral foundations in medicine and has existed for decades in the field of paediatrics. Indeed, there are recommendations for the child’s best interests to be a primary consideration in all matters that concern the child. However, there is uncertainty in the literature over how the child’s best interests may be safeguarded within healthcare.

Aim
The aim of this thesis was to elucidate from various perspectives, the experiences of the child’s best interests during hospitalisation.

Methods
A naturalistic paradigm was used, employing qualitative exploratory and qualitative descriptive designs. Data were collected from paediatic units in Sweden and Australia. Thirty-two observations of the interactions between children, their parents and healthcare professionals were graded using the Scale of Degrees of Self-Determination and normative assessments. The same 32 observations were also analysed using inductive content analysis and abductive reasoning. Further, inductive thematic analysis of interviews with nine children, and inductive content analysis of interviews with 16 parents was conducted.

Results
The findings show that interpersonal relationships, an enhancing environment, effective communication, mutual negotiations and collaborations, and active participation are essential to safeguarding the child’s best interests during hospitalisation.

Conclusion
The factors involved in safeguarding the child’s best interests during hospitalisation are interconnected and nested in a rather complex system and can be further understood using Bronfenbrenner’s bioecological model. The child’s best interests are context-dependent, situational, flexible, and dependent on all actors involved and actual decisions made. Safeguarding the child’s best interests during hospitalisation requires a case-by-case approach and a holistic view of the child, beyond their clinical treatment.