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Patient-Centered Surgical Care for Children in Low and Lower-Middle Income Countries (LMICs) - A Systematic Scoping Review of the Literature.
Sawhney, Riya; Proulx, Kacylia Roy; Gerk, Ayla; Guadagno, Elena; Poenaru, Dan.
Afiliação
  • Sawhney R; Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada. Electronic address: riya.sawhney@mail.mcgill.ca.
  • Proulx KR; Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
  • Gerk A; Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
  • Guadagno E; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
  • Poenaru D; Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
J Pediatr Surg ; 59(5): 900-907, 2024 May.
Article em En | MEDLINE | ID: mdl-38369399
ABSTRACT

PURPOSE:

Studies exploring patient-centered care (PCC) in pediatric surgery have been disproportionately concentrated in high-income countries. This review aims to characterize the adoption of key PCC domains in low and lower-middle income countries (LMICs).

METHODS:

Seven databases were searched from inception until January 2023 to retrieve relevant articles in pediatric surgery in LMICs. We focused on six key PCC domains patient-reported outcomes (PROs), patient-reported experiences (PREs), shared decision-making (SDM), patient/parent education, patient/parent satisfaction, and informed consent.

RESULTS:

Of 8050 studies screened, 230 underwent full-text review, and 48 were finally included. Most were single-center (87.5%), cross-sectional studies (41.7%) from the South-East Asian (35.4%) and Eastern Mediterranean regions (33.3%). Studies most frequently focused on postoperative care (45.8%) in pediatric general surgery (18.8%), and included 1-3 PCC domains. PREs (n = 30), PROs (n = 16) and patient/parent satisfaction (n = 16) were most common. Informed consent (n = 2) and SDM (n = 1) were least studied. Only 13 studies directly elicited children's perspectives. Despite all studies originating in LMICs, 25% of first and 17.8% of senior authors lacked LMIC affiliations.

CONCLUSION:

The adoption of PCC in LMICs appears limited, focusing predominantly on PROs and PREs. Other domains such as informed consent and SDM are rarely addressed, and the voice of children and young people is rarely heard in their care. Opportunities to enhance PCC in LMICs abound, with the potential to improve the surgical care of children in resource-limited settings. LEVEL OF EVIDENCE III.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Assistência Centrada no Paciente / Países em Desenvolvimento Limite: Child / Humans Idioma: En Revista: J Pediatr Surg Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Assistência Centrada no Paciente / Países em Desenvolvimento Limite: Child / Humans Idioma: En Revista: J Pediatr Surg Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos