How do primary healthcare and social services enable young people’s participation?

Abstract

Background and purpose: Participation is a crucial factor in primary healthcare and social services, enabling clients to maintain their own health and well-being. However, adolescents’ participation in service provision may be compromised because they are often not understood or heard as equal clients in encounters with primary services. The aim of this study was to describe 15- to 17-year-olds’ experiences of participation in primary healthcare and social services’ settings. Methods: Data were collected through group interviews ( N = 27) with 106 participants drawn from upper comprehensive schools, upper secondary schools and youth centres in the region of a city in northern Savonia, Finland. Data were analysed by qualitative content analysis, using typology technique. Results: Four levels of realisation of participation were identified (inviting, allowing, avoiding and excluding), each with distinctive sets of atmospheres, interactions and experiences of the service received. According to the interviewees, the atmosphere varied from caring to cold, interactions from empowering to discouraging and experience of services from meaningful to threatening. Conclusion: Young people’s participation in health services can be strengthened by creating a positive atmosphere, providing possibilities to be heard and ensuring that support corresponds with individual needs. The indications of aspects of atmosphere, interactions, and clients’ experience that promote or deter adolescents’ participation may assist efforts to improve health and social services by signposting ways to raise realization of participation to the ‘inviting’ level. Study findings are useful for evaluating, strengthening and raising awareness of the importance of participation in all aspects of health promotion (practice, management and education).

Factors that influence older patients’ participation in clinical communication within developed country hospitals and GP clinics: A systematic review of current literature

“…These findings also correlate with the literature across all age groups of patients. For example, younger patients (< 17) value accessibility but are best influenced by a person-centred, safe and comfortable atmosphere [ 68 , 69 ]. Furthermore, people of different age groups valued different modes of accessibility for their participation.…”

Adjusting and doing the same: school nurses’ descriptions of promoting participation in health visits with children of foreign origin

“…Previous findings also show nurses balancing the required assignments in the agenda of the health visit with facilitating children’s involvement based on the needs, motivation and interest of the specific child [ 28 ]. Furthermore, some of the school nurses’ specific actions of explaining the purpose and content of the health visit are also described by children, regardless of origin, as promoting their participation in the health care [ 27 ]. Still, the challenges present in encounters between school nurses and children of foreign origin [ 18 , 20 ] might indicate that the cultural and social context of children of foreign origin needs to be further considered in order to promote their participation.…”

“…To participate, children need to understand the purpose of the health visit and to know what the school nurse can assist with [ 26 ]. Such knowledge will help them to trust that nurses will respect their confidentiality [ 26 , 27 ] and to express their own view [ 27 , 28 ]. As there is an asymmetrical distribution of power, where the school nurses are in charge of the agenda of the health visit, the school nurses’ actions of informing the child about the situation and inviting the child to participate is especially important when promoting children’s participation [ 28 ].…”

“…As there is an asymmetrical distribution of power, where the school nurses are in charge of the agenda of the health visit, the school nurses’ actions of informing the child about the situation and inviting the child to participate is especially important when promoting children’s participation [ 28 ]. These actions include school nurses actively listening, creating a pleasant caring atmosphere, providing encouragement and respecting the child’s rights [ 27 ]. The nurses, when observed, are also found to use similar interaction strategies to promote children’s activity and participation in encounters with children [ 5 ].…”

Reading the signs in health visits—Perspectives of adolescents with migration experiences on encounters with school nurses

“…A descriptive qualitative study was conducted to explore experiences of health visits within the school health services from the perspective of adolescents with migration experiences, as their perspective is sparsely included in previous research (Curtis et al, 2018;Spencer et al, 2019). Data were collected through focus groups and individual interviews with the adolescents.…”