TY - JOUR
T1 - Health professionals' and managers' definitions of developmentally appropriate healthcare for young people
T2 - Conceptual dimensions and embedded controversies
AU - Farre, Albert
AU - Wood, Victoria
AU - McDonagh, Janet E.
AU - Parr, Jeremy R.
AU - Reape, Debbie
AU - Rapley, Tim
PY - 2016/7
Y1 - 2016/7
N2 - Objectives We aimed to (i) explore how health professionals and managers who work with young people seek to define developmentally appropriate healthcare (DAH), (ii) identify the range of conceptual dimensions present in their definitions and (iii) explore the controversies embedded in their characterisations of DAH. Methods A qualitative multisite ethnographic study was conducted across three hospitals in England. We undertook face-to-face semi-structured interviews with health professionals and managers; and non-participant observation in clinics, wards and meetings. Anonymised field notes and interview transcripts were analysed using thematic analysis. The theme conceptualisations of DAH' was then further analysed, and the resulting themes categorised to form conceptual dimensions. Results We recruited 192 participants and conducted 65 interviews (41 with health professionals and 24 with managers) and approximately 1600 hours of non-participant observations (involving 103 health professionals and 72 managers). Despite the wide range of definitions provided by participants, five conceptual dimensions of DAH were identified: (i) biopsychosocial development and holistic care, (ii) acknowledgement of young people as a distinct group, (iii) adjustment of care as the young person develops, (iv) empowerment of the young person by embedding health education and health promotion and (v) interdisciplinary and interorganisational work. Also, some controversies were identified within most dimensions. Conclusions This study illustrates the lack of a generalised definition of DAH for young people among UK health professionals and managers, and presents a set of five core dimensions that can inform future research to help define and evaluate DAH for young people.
AB - Objectives We aimed to (i) explore how health professionals and managers who work with young people seek to define developmentally appropriate healthcare (DAH), (ii) identify the range of conceptual dimensions present in their definitions and (iii) explore the controversies embedded in their characterisations of DAH. Methods A qualitative multisite ethnographic study was conducted across three hospitals in England. We undertook face-to-face semi-structured interviews with health professionals and managers; and non-participant observation in clinics, wards and meetings. Anonymised field notes and interview transcripts were analysed using thematic analysis. The theme conceptualisations of DAH' was then further analysed, and the resulting themes categorised to form conceptual dimensions. Results We recruited 192 participants and conducted 65 interviews (41 with health professionals and 24 with managers) and approximately 1600 hours of non-participant observations (involving 103 health professionals and 72 managers). Despite the wide range of definitions provided by participants, five conceptual dimensions of DAH were identified: (i) biopsychosocial development and holistic care, (ii) acknowledgement of young people as a distinct group, (iii) adjustment of care as the young person develops, (iv) empowerment of the young person by embedding health education and health promotion and (v) interdisciplinary and interorganisational work. Also, some controversies were identified within most dimensions. Conclusions This study illustrates the lack of a generalised definition of DAH for young people among UK health professionals and managers, and presents a set of five core dimensions that can inform future research to help define and evaluate DAH for young people.
KW - Adolescent Health Services
KW - Developmentally Appropriate Healthcare
KW - Qualitative research
KW - Young Adults
KW - Youth-Friendly Health Care
UR - http://www.scopus.com/inward/record.url?scp=84960886184&partnerID=8YFLogxK
U2 - 10.1136/archdischild-2015-309473
DO - 10.1136/archdischild-2015-309473
M3 - Article
C2 - 26945026
AN - SCOPUS:84960886184
VL - 101
SP - 628
EP - 633
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
SN - 0003-9888
IS - 7
ER -