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Health professionals’ and managers’ definitions of developmentally appropriate healthcare for young people: conceptual dimensions and embedded controversies
  1. Albert Farre1,
  2. Victoria Wood2,
  3. Janet E McDonagh3,
  4. Jeremy R Parr4,
  5. Debbie Reape5,
  6. Tim Rapley2,
  7. on behalf of the Transition Collaborative Group
  1. 1Institute of Applied Health Research, University of Birmingham, Birmingham, UK
  2. 2Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
  3. 3Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
  4. 4Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
  5. 5Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
  1. Correspondence to Dr Albert Farre, Institute of Child Health, University of Birmingham & Birmingham Children's Hospital NHS Foundation Trust, Whittall Street, Birmingham B4 6NH, UK; a.farre{at}bham.ac.uk

Abstract

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.

  • Developmentally Appropriate Healthcare
  • Adolescent Health Services
  • Young Adults
  • Youth-Friendly Health Care
  • Qualitative research

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