Partnerships with children

Abstract

Outcomes An important source of resistance to extending the ideals of patient partnership to children is lack of good evidence about the outcomes. Clinicians, parents, and others need to be reassured about the effect on children's wellbeing and about issues such as how families, perhaps with the benefit of hindsight, assign responsibility for “wrong” decisions. In assessing the outcomes of partnership, it is vital to include children's perspectives and to be sensitive to how these may change as children develop. Recent developments in methods for assessing child based outcomes have been encouraging. For example, measures of quality of life in children have begun to move away from using parents as proxies and treating children of all ages as having the same concerns. Instead they ask children directly for their views and are developmentally sensitive.14 The recent use of qualitative approaches is also hopeful.15 Use of these developments for longitudinal assessment of outcomes of different forms of shared decision making should be a research priority.