PDF(Pubmed)
Abstract：
BACKGROUND: The usual output following health consultations from paediatric services is a clinical letter to the referring professional or primary care provider, with a copy sent to the patient\'s caregiver. There is little research on how patients and caregivers perceive the letter content. We aimed to: first understand child, young people and caregiver experiences of and preferences for receiving a health feedback letter about the child/young person\'s health measures within a healthy lifestyle programme; and second to provide a set of recommendations for designing letters to children, young people and their families within a healthy lifestyle programme.
METHODS: This qualitative study, informed by Kaupapa Māori principles, included focus groups of children aged 5-11 years and young people aged 12-18 years who were participants in a healthy lifestyle programme in Taranaki, Aotearoa New Zealand and of their respective caregivers (total n = 47). Discussions were audio-recorded, transcribed and analysed using thematic analysis.
RESULTS: Key themes were identified: letters sometimes acted as \'discourses of disempowerment\'-some participants experienced a lack of safety, depersonalisation with medical jargon and \'feeling like a number\'. Participants described the need for acknowledgement and affirmation in written communication-health feedback should include validation, choice regarding content, respectful tone and a strengths-based approach to health messages.
CONCLUSIONS: Letters to referrers, copied to families, can be perceived as disempowering, and participant and caregiver perspectives of content should be considered. This study challenges conventional practice in communicating health feedback with broader implications for written communication in healthcare. We propose separate letters aimed at the child/young person and their caregiver that offer choice in the information they receive. The administrative burden of multiple letters can be mitigated by advances in digital health.
UNASSIGNED: This study originated in response to feedback from service users that current health feedback was not meeting their needs or expectations. Patient perspectives, especially from children, are rarely considered in the generation of clinic letters from health professionals. Participants were child participants in the community-based clinical service and their caregivers, and care was taken to represent the demographic backgrounds of service users. Collection and interpretation of Māori data were led by researchers who were local community members to ensure prioritisation and preservation of participant voice. Where possible, results are illustrated in the text by direct quotes from participants, whose identities are protected with a pseudonym.
METHODS: This qualitative study, informed by Kaupapa Māori principles, included focus groups of children aged 5-11 years and young people aged 12-18 years who were participants in a healthy lifestyle programme in Taranaki, Aotearoa New Zealand and of their respective caregivers (total n = 47). Discussions were audio-recorded, transcribed and analysed using thematic analysis.
RESULTS: Key themes were identified: letters sometimes acted as \'discourses of disempowerment\'-some participants experienced a lack of safety, depersonalisation with medical jargon and \'feeling like a number\'. Participants described the need for acknowledgement and affirmation in written communication-health feedback should include validation, choice regarding content, respectful tone and a strengths-based approach to health messages.
CONCLUSIONS: Letters to referrers, copied to families, can be perceived as disempowering, and participant and caregiver perspectives of content should be considered. This study challenges conventional practice in communicating health feedback with broader implications for written communication in healthcare. We propose separate letters aimed at the child/young person and their caregiver that offer choice in the information they receive. The administrative burden of multiple letters can be mitigated by advances in digital health.
UNASSIGNED: This study originated in response to feedback from service users that current health feedback was not meeting their needs or expectations. Patient perspectives, especially from children, are rarely considered in the generation of clinic letters from health professionals. Participants were child participants in the community-based clinical service and their caregivers, and care was taken to represent the demographic backgrounds of service users. Collection and interpretation of Māori data were led by researchers who were local community members to ensure prioritisation and preservation of participant voice. Where possible, results are illustrated in the text by direct quotes from participants, whose identities are protected with a pseudonym.
摘要：
背景：儿科服务的健康咨询后通常的输出是给转介专业或初级保健提供者的临床信函，并将副本发送给患者的护理人员。关于患者和护理人员如何看待字母内容的研究很少。我们的目标是：首先了解孩子，年轻人和照顾者在健康生活方式计划中收到关于儿童/年轻人健康措施的健康反馈信的经验和偏好；第二，为设计给儿童的信件提供一套建议，年轻人和他们的家人在一个健康的生活方式方案。
方法：这项定性研究，根据考帕帕毛利人的原则，包括参加塔拉纳基健康生活方式计划的5-11岁儿童和12-18岁年轻人的焦点小组，Aotearoa新西兰及其各自的照顾者（总计n=47）。讨论是录音的，使用主题分析进行转录和分析。
结果：确定了关键主题：字母有时充当“剥夺权力的话语”-一些参与者缺乏安全感，用医学术语和“感觉像一个数字”去人格化。与会者描述了书面沟通中确认和确认的必要性-健康反馈应包括验证，关于内容的选择，尊重的语气和基于优势的健康信息方法。
结论：给推荐人的信，复制到家庭，可以被视为剥夺权力，应考虑参与者和护理人员对内容的看法。这项研究挑战了传达健康反馈的传统做法，对医疗保健中的书面交流具有更广泛的意义。我们建议针对儿童/年轻人及其看护人的单独信件，为他们收到的信息提供选择。数字健康的进步可以减轻多个字母的管理负担。
■这项研究源于服务用户的反馈，即当前的健康反馈不能满足他们的需求或期望。患者观点,尤其是儿童，在健康专业人员的临床信函中很少考虑。参与者是社区临床服务的儿童参与者及其照顾者，并注意代表服务用户的人口背景。毛利人数据的收集和解释由当地社区成员的研究人员领导，以确保优先考虑和保留参与者的声音。在可能的情况下,结果在文本中通过参与者的直接引用来说明，他们的身份是用假名保护的.
方法：这项定性研究，根据考帕帕毛利人的原则，包括参加塔拉纳基健康生活方式计划的5-11岁儿童和12-18岁年轻人的焦点小组，Aotearoa新西兰及其各自的照顾者（总计n=47）。讨论是录音的，使用主题分析进行转录和分析。
结果：确定了关键主题：字母有时充当“剥夺权力的话语”-一些参与者缺乏安全感，用医学术语和“感觉像一个数字”去人格化。与会者描述了书面沟通中确认和确认的必要性-健康反馈应包括验证，关于内容的选择，尊重的语气和基于优势的健康信息方法。
结论：给推荐人的信，复制到家庭，可以被视为剥夺权力，应考虑参与者和护理人员对内容的看法。这项研究挑战了传达健康反馈的传统做法，对医疗保健中的书面交流具有更广泛的意义。我们建议针对儿童/年轻人及其看护人的单独信件，为他们收到的信息提供选择。数字健康的进步可以减轻多个字母的管理负担。
■这项研究源于服务用户的反馈，即当前的健康反馈不能满足他们的需求或期望。患者观点,尤其是儿童，在健康专业人员的临床信函中很少考虑。参与者是社区临床服务的儿童参与者及其照顾者，并注意代表服务用户的人口背景。毛利人数据的收集和解释由当地社区成员的研究人员领导，以确保优先考虑和保留参与者的声音。在可能的情况下,结果在文本中通过参与者的直接引用来说明，他们的身份是用假名保护的.
