Communication between children and health professionals in a child hospital setting: a Child Transitional Communication Model.

Aim: This paper is a report of a further analysis of data from an ethnographic study of the nature of communication between children and health professionals in a child hospital setting.

Background: There is a paucity of research on the nature of communication between health professionals and child patients. Additionally, theory has not been developed to any great extent in the communication literature on children.

Method: Using an ethnographic approach, fieldwork took place in one specialized children's hospital during 2005. Forty-nine children, aged 6-16 years, with a variety of medical and surgical conditions, participated. Data were collected through semi-participant observations, unstructured interviews, participatory activities and documentary evidence.

Findings: Health professionals positioned children as either passive bystanders or active participants in the communication process. These two positions, passive bystander and active participant, signified the extent of children's inclusion or exclusion in the communication process and the degree to which children's communication needs were met or not. A Child Transitional Communication Model presented in this paper draws on multiple theoretical perspectives to explain why health professionals placed children as either a passive bystander or an active participant in the communication process.

Conclusion: Children prefer to oscillate between a passive bystander and active participant position within the communication process, depending on their needs at any given point in time. This challenges the insistence for stronger child participation in all matters that affect them, in isolation of debates surrounding children's need for support/protection and any potential negative consequences of children's active participation.