A national survey of children's experiences and needs when attending Canadian pediatric emergency departments

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; Pediatric Emergency Research Canada Family Needs study team

doi:10.1371/journal.pone.0305562

A national survey of children's experiences and needs when attending Canadian pediatric emergency departments

PLoS One. 2024 Jun 25;19(6):e0305562. doi: 10.1371/journal.pone.0305562. eCollection 2024.

Authors

Keon Ma¹, Asa Rahimi², Manasi Rajagopal², Maryna Yaskina³, Ran D Goldman⁴, Ashley Jones¹, Tannis Erickson⁵, Naveen Poonai⁶, Candice McGahern⁷, Laura Weingarten⁸, Bethany Lerman⁹, Marie-Christine Auclair¹⁰, Helen Wong¹¹, Lisa Hartling², Kurt Schreiner¹², Shannon Scott^{3

13}, Samina Ali^{2

3}; Pediatric Emergency Research Canada Family Needs study team

Affiliations

¹ Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
² Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
³ Women and Children's Health Research Institute (WCHRI), University of Alberta, Edmonton, AB, Canada.
⁴ Department of Pediatrics, University of British Columbia and BC Children's Hospital Research Institute, Division of Emergency Medicine, The Pediatric Research in Emergency Therapeutics (PRETx) Program, Vancouver, BC, Canada.
⁵ Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
⁶ Departments of Paediatrics, Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
⁷ Division of Pediatric Emergency Medicine, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
⁸ Division of Pediatric Emergency Medicine, McMaster Children's Hospital, Hamilton, ON, Canada.
⁹ Division of Emergency Medicine, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
¹⁰ Centre de recherche du CHU Sainte-Justine, Montréal, QC, Canada.
¹¹ Faculty of Health, Dalhousie University, Halifax, NS, Canada.
¹² Pediatric Emergency: Advancing Knowledge (PEAK) Research Team, University of Alberta, Edmonton, AB, Canada.
¹³ Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.

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.

Copyright: © 2024 Ma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Adolescent
Canada
Child
Cross-Sectional Studies
Emergency Service, Hospital* / statistics & numerical data
Female
Humans
Male
Patient Satisfaction / statistics & numerical data
Surveys and Questionnaires

Grants and funding

This work was supported by the Women and Children’s Health Research Institute via both a Clinical/Community Research Integration Support Program grant secured by SA and SS (2018-2022) through a generous donation from the Stollery Children’s Hospital Foundation. SF is supported by the Alberta Children’s Hospital Foundation’s Professorship in Child Health and Wellness. LH is supported by a Canada Research Chair in Knowledge Synthesis and Translation and is a Distinguished Researcher with the Stollery Science Lab supported by the Stollery Children’s Hospital Foundation. SS is supported by Stollery Science Lab Distinguished Researcher funding from the Women and Children’s Health Research Institution. The funders of the study had no role in study design, data collection, data analysis, decision to publish, or in the preparation of this manuscript. There was no additional external funding received for this study.