P-203: Towards a theory-informed framework for child-centred care in paediatric healthcare a scoping review
P DeCosta, D Grabowski, T H Andersen, I CoyneAbstract
Introduction
Child-centred care (CCC) is increasingly promoted across paediatric healthcare, yet remains inconsistently defined and operationalised. This lack of conceptual clarity limits its application in clinical practice, where children’s participation and psychosocial needs are central to care.
Objectives
To identify and synthesise theoretical perspectives underpinning CCC and develop a coherent framework to inform research and paediatric healthcare practice.
Methods
A systematic scoping review was conducted in accordance with JBI methodology. MEDLINE, Embase, and CINAHL were searched (1946–2024). Peer-reviewed studies involving children, parents, or healthcare professionals applying theory to CCC were included. Dual screening and data extraction were performed. Theoretical perspectives were synthesised through thematic analysis to identify shared constructs and domains.
Results
Thirteen studies were included, identifying six key theories: ecological systems theory, the child’s perspective, zone of proximal development, resilience theory, trust theory, and the SECI model. Synthesis revealed three interrelated domains: (1) the competent child (agency and participation), (2) social context and ecologies (relationships and systems), and (3) development as a dynamic process. Across theories, CCC emerges as relational, participatory, and context-dependent, supported by mechanisms such as trust-building, play-based engagement, and guided participation.
Conclusions
Theory identifies the active ingredients of child-centred care, highlighting children’s agency, relational contexts, and development as central mechanisms. The framework provides guidance for healthcare professionals to support meaningful participation, tailor care to children’s needs, and strengthen psychosocial outcomes across paediatric settings.