The Way We Care: Pediatric patient caregiving in the American and Pakistani healthcare systems

Abstract

The Way We Care offers a comparison between pediatric patient caregiving in the American and Pakistani healthcare systems. The central question of this research is what healthcare professionals in America and Pakistan see as the psychosocial care needs of pediatric patients. The significance of this question lies in kindling thoughtful answers to how we may improve and humanize pediatric patient care for children everywhere. Selecting two sites for comparison has provided an opportunity to look within two contrasting environments, in terms of established hospital-based Child Life Services in one and informal, socially constructed care in the other. One intrinsic principle which has guided this research is that professional hospital-based care systems correspond with the idea of humanizing healthcare for children. Another is that pediatric patients everywhere in the world have a right to equitable and socially just care. The study is primarily framed as an ethnography, incorporating and analyzing conversations with twelve interlocutors based in Pakistan. The findings are interwoven with scholarly research on pediatric care in America. The research is contextualized within two selected practices from a very broad topic of Child Life, which are play therapy, and procedure preparation for MRI scans. Of the twelve interlocutors, Group One comprised eight healthcare professionals who were working with pediatric patients. They responded to the question of the psychosocial needs of pediatric patients by exploring their understanding of Child Life Services. They also completed story stems based on play therapy and MRI procedure preparation. Group Two comprised four interlocutors who were working with organizations engaged in healthcare projects. They responded to the question of the psychosocial needs of pediatric patients by exploring their understanding of social justice in child health. Findings relate professional play therapy programs to professional development based on an understanding of child development. They relate socially constructed systems of care to family relationships, social norms and values and social determinants of health, such as education. Findings from procedure preparation shed light on comparative aspects of child-centricity in procedure preparation and also on the sedation debate and the tradeoffs in healthcare finance. Finally, various philanthropic and donor funded models to implement hospital-based Child Life Services were examined. Findings suggest that working with communities from within and strengthening existing healthcare systems has the greatest potential for achieving social justice in pediatric patient care.