Publicação
Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters
| Resumo: | Access to pain management is a human right. Nevertheless, research consistently reports that children’s pain is under-recognised and under-treated compared to that of adults. Additionally, younger children are less likely to receive treatment for their pain. The significance of early-life healthcare experiences is often underestimated due to constructions of young children as passive rather than active agents in healthcare. This study addresses this issue by examining how children’s agency is co-constructed within the triad of children, caregivers, and healthcare professionals during childhood vaccination consultations. Field notes were collected describing vaccination consultations involving children aged two months to seven years, with an overrepresentation of children under the age of two due to the study’s focus. Ethnographic observations (~275.5 h) were held in Belgium, Italy, and Portugal, due to their diversity in healthcare system characteristics, vaccination policy, and coverage. Data were analysed using template analysis, a specific type of thematic analysis. Findings illustrate that children inherently possess agency, which can be hindered or facilitated by caregivers and healthcare professionals in the healthcare setting. Although clinical guidelines on pain mitigation for paediatric vaccinations exist, the findings show that these are not consistently applied in practice. Providing a framework for understanding the variability in paediatric pain mitigation, we highlight the socio-cultural conditions by which young children are either socialised into the patient role, or have their status as patients undermined. In pursuit of quality healthcare and pain mitigation for children during vaccination consultations, it is necessary that they are considered and treated as active, embodied healthcare agents. |
|---|---|
| Autores principais: | Lermytte, Esther |
| Outros Autores: | Scavarda, Alice; Hilário, Ana Patrícia; Gariglio, Luigi; Mendonça, Joana; Ceuterick, Melissa |
| Assunto: | Children Agency Pain Healthcare encounter Ethnography Childhood vaccination |
| Ano: | 2025 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| _version_ | 1866810815802245120 |
|---|---|
| author | Lermytte, Esther |
| author2 | Scavarda, Alice Hilário, Ana Patrícia Gariglio, Luigi Mendonça, Joana Ceuterick, Melissa |
| author2_role | author author author author author |
| author_facet | Lermytte, Esther Scavarda, Alice Hilário, Ana Patrícia Gariglio, Luigi Mendonça, Joana Ceuterick, Melissa |
| author_role | author |
| contributor_name_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Lermytte, Esther\"},{\"Person.name\":\"Scavarda, Alice\"},{\"Person.name\":\"Hilário, Ana Patrícia\"},{\"Person.name\":\"Gariglio, Luigi\"},{\"Person.name\":\"Mendonça, Joana\",\"Person.identifier.orcid\":\"0000-0001-7292-5836\"},{\"Person.name\":\"Ceuterick, Melissa\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| datacite.creators.creator.creatorName.fl_str_mv | Lermytte, Esther Scavarda, Alice Hilário, Ana Patrícia Gariglio, Luigi Mendonça, Joana Ceuterick, Melissa |
| datacite.date.Accepted.fl_str_mv | 2025-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2025-07-21T10:52:29Z |
| datacite.date.embargoed.fl_str_mv | 2025-07-21T10:52:29Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_16ec |
| datacite.subjects.subject.fl_str_mv | Children Agency Pain Healthcare encounter Ethnography Childhood vaccination |
| datacite.titles.title.fl_str_mv | Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters |
| dc.contributor.none.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| dc.creator.none.fl_str_mv | Lermytte, Esther Scavarda, Alice Hilário, Ana Patrícia Gariglio, Luigi Mendonça, Joana Ceuterick, Melissa |
| dc.date.Accepted.fl_str_mv | 2025-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2025-07-21T10:52:29Z |
| dc.date.embargoed.fl_str_mv | 2025-07-21T10:52:29Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.5/102271 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Elsevier |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_16ec |
| dc.subject.none.fl_str_mv | Children Agency Pain Healthcare encounter Ethnography Childhood vaccination |
| dc.title.fl_str_mv | Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Access to pain management is a human right. Nevertheless, research consistently reports that children’s pain is under-recognised and under-treated compared to that of adults. Additionally, younger children are less likely to receive treatment for their pain. The significance of early-life healthcare experiences is often underestimated due to constructions of young children as passive rather than active agents in healthcare. This study addresses this issue by examining how children’s agency is co-constructed within the triad of children, caregivers, and healthcare professionals during childhood vaccination consultations. Field notes were collected describing vaccination consultations involving children aged two months to seven years, with an overrepresentation of children under the age of two due to the study’s focus. Ethnographic observations (~275.5 h) were held in Belgium, Italy, and Portugal, due to their diversity in healthcare system characteristics, vaccination policy, and coverage. Data were analysed using template analysis, a specific type of thematic analysis. Findings illustrate that children inherently possess agency, which can be hindered or facilitated by caregivers and healthcare professionals in the healthcare setting. Although clinical guidelines on pain mitigation for paediatric vaccinations exist, the findings show that these are not consistently applied in practice. Providing a framework for understanding the variability in paediatric pain mitigation, we highlight the socio-cultural conditions by which young children are either socialised into the patient role, or have their status as patients undermined. In pursuit of quality healthcare and pain mitigation for children during vaccination consultations, it is necessary that they are considered and treated as active, embodied healthcare agents. |
| dirty | 0 |
| eu_rights_str_mv | restrictedAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.ulisboa.pt/bitstreams/2e4b4f13-59e6-4f71-8a93-c85a8a8c15a9/download |
| funding.funder.alternateName_str_mv | EC |
| funding.funder.identifier_str_mv | http://doi.org/10.13039/501100008530 |
| funding.funder.name_str_mv | European Commission |
| funding.name_str_mv | H2020 |
| id | ul_78fbaf04368b083dd3f55fdb0a7ccc8a |
| identifier.url.fl_str_mv | http://hdl.handle.net/10400.5/102271 |
| instacron_str | ul |
| institution | Universidade de Lisboa |
| instname_str | Universidade de Lisboa |
| language | eng |
| network_acronym_str | ul |
| network_name_str | Repositório da Universidade de Lisboa |
| oai_identifier_str | oai:repositorio.ulisboa.pt:10400.5/102271 |
| organization_str_mv | urn:organizationAcronym:ul |
| person_str_mv | Lermytte, Esther Scavarda, Alice Hilário, Ana Patrícia Gariglio, Luigi Mendonça, Joana Mendonça, Joana https://www.ciencia-id.pt/401C-0F97-5EA8 401C-0F97-5EA8 http://orcid.org/0000-0001-7292-5836 0000-0001-7292-5836 Ceuterick, Melissa |
| publishDate | 2025 |
| publisher.none.fl_str_mv | Elsevier |
| reponame_str | Repositório da Universidade de Lisboa |
| repository_id_str | urn:repositoryAcronym:ul |
| service_str_mv | urn:repositoryAcronym:ul |
| spelling | engElsevierpt_PTAccess to pain management is a human right. Nevertheless, research consistently reports that children’s pain is under-recognised and under-treated compared to that of adults. Additionally, younger children are less likely to receive treatment for their pain. The significance of early-life healthcare experiences is often underestimated due to constructions of young children as passive rather than active agents in healthcare. This study addresses this issue by examining how children’s agency is co-constructed within the triad of children, caregivers, and healthcare professionals during childhood vaccination consultations. Field notes were collected describing vaccination consultations involving children aged two months to seven years, with an overrepresentation of children under the age of two due to the study’s focus. Ethnographic observations (~275.5 h) were held in Belgium, Italy, and Portugal, due to their diversity in healthcare system characteristics, vaccination policy, and coverage. Data were analysed using template analysis, a specific type of thematic analysis. Findings illustrate that children inherently possess agency, which can be hindered or facilitated by caregivers and healthcare professionals in the healthcare setting. Although clinical guidelines on pain mitigation for paediatric vaccinations exist, the findings show that these are not consistently applied in practice. Providing a framework for understanding the variability in paediatric pain mitigation, we highlight the socio-cultural conditions by which young children are either socialised into the patient role, or have their status as patients undermined. In pursuit of quality healthcare and pain mitigation for children during vaccination consultations, it is necessary that they are considered and treated as active, embodied healthcare agents.application/pdfpt_PTPain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encountersLermytte, EstherScavarda, AliceHilário, Ana PatríciaGariglio, LuigiPersonalMendonça, JoanaDSpacehttp://dspace.org/items/a60a4ec2-4bd7-491d-833b-dbc0b3f8fe47DSpacehttp://dspace.org/items/a60a4ec2-4bd7-491d-833b-dbc0b3f8fe47Simão MendonçaJoana MariaCiência IDhttps://www.ciencia-id.pt401C-0F97-5EA8ORCIDhttp://orcid.org0000-0001-7292-5836Ceuterick, MelissaHostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptISSNIsPartOf0277-9536DOIIsPartOf10.1016/j.socscimed.2025.1180452025-07-21T10:52:29Z20252025-01-01T00:00:00ZHandlehttp://hdl.handle.net/10400.5/102271http://purl.org/coar/access_right/c_16ecrestricted accessChildrenAgencyPainHealthcare encounterEthnographyChildhood vaccination663453 bytesEuropean CommissionAddressing vaccine hesitancy in EuropeH2020Crossref Funder IDhttp://doi.org/10.13039/501100008530literaturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_16ecapplication/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/2e4b4f13-59e6-4f71-8a93-c85a8a8c15a9/downloadSocial Science & Medicine37319 |
| spellingShingle | Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters Lermytte, Esther Children Agency Pain Healthcare encounter Ethnography Childhood vaccination |
| status | SINGLETON |
| subject.fl_str_mv | Children Agency Pain Healthcare encounter Ethnography Childhood vaccination |
| title | Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters |
| title_full | Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters |
| title_fullStr | Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters |
| title_full_unstemmed | Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters |
| title_short | Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters |
| title_sort | Pain by proxy: an ethnographic study on the relational co-construction of the agency of young children in healthcare encounters |
| topic | Children Agency Pain Healthcare encounter Ethnography Childhood vaccination |
| topic_facet | Children Agency Pain Healthcare encounter Ethnography Childhood vaccination |
| url | http://hdl.handle.net/10400.5/102271 |
| visible | 1 |