Balancing personal and social identities for the care of priority populations in a paediatric hospital setting: a qualitative study

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BACKGROUND: The Providing Enhanced Access to Child Health Services (PEACH) initiative at the Sydney Children’s Hospitals Network (SCHN) aims to reduce inequity in healthcare access and outcomes for priority population children and young people (including Aboriginal and/or Torres Strait Islander, culturally and linguistically diverse, from refugee or asylum seeker backgrounds, living in out-of-home care or recipients of the National Disability Insurance Scheme). Central to PEACH is active children and caregivers engagement through co-design, recognising the importance of understanding their experiences to facilitate enhanced healthcare provision. This qualitative study explored the experiences of priority population children and caregivers at SCHN before the implementation of PEACH initiatives, with the aim of identifying strengths, limitations, and recommendations for enhancing healthcare services tailored to priority population needs. METHODS: Guided by an experience-based co-design methodology, 28 qualitative semi-structured interviews were carried out with a total of 38 participants from priority population group(s) who had accessed care at SCHN. The data were analysed via inductive thematic analysis. RESULTS: The findings are presented through the lens of the concept of identity, delineated into personal and social identity. Personal identity is related to person before problem and demography, while social identity is linked to cultural responsiveness. Participants emphasised both the significance of social identities in health service design, and the importance of an individualised approach that recognises and respects their unique personal identities within the broader social context. CONCLUSIONS: This research advocates for a person-centred approach to healthcare delivery that recognises and responds to the dynamic interconnected relationship between personal and social identities.

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