Meaningful everyday life situations from the perspective of children born preterm: A photo-elicitation interview study with six-year-old children

Abstract

Aim The aim of the study was to explore meaningful everyday life situations as perceived by six-year-old children born preterm. Materials and methods The study had a descriptive qualitative design with an inductive approach. Ten, six-year-old children born preterm, not diagnosed with any disabilities, participated. Data was collected by photo-elicitation interviews to stimulate and help the children to describe their meaningful everyday life situations. A qualitative content analysis according to Elo and Kyngäs was applied. Results The children’s descriptions of meaningful everyday life situations can be understood as being in an active and dynamic process, representing the core category. The analysis resulted in three generic categories, as the children described the significance of having significant circumstances and doing things. The experiences the children gain when they do things create their desire for further development. Discussion The results reveal that children born preterm are able to reflect on and give detailed descriptions of situations of importance to them. The study suggests that if six-year-old children born preterm are given the opportunity to share their views they can take an active role e.g. in planning and carrying through of interventions by health care services. Background Meaningful everyday life situations contribute to children’s development as they occur in their immediate environment where they gain experiences, have an active role, and interact socially [1, 2]. Family dinner, play time, and bedtime are examples of these everyday life situations [3, 4] and commonly, typically developed children participate in a diversity of everyday activities [5]. Children’s everyday life situations may be influenced by circumstances such as being born preterm. Research shows that children born preterm can have difficulties in their everyday life situations [6–11]. These difficulties concern self-care routines, mobility [7, 11], play, leisure, and social interaction [8, 9, 11]. However, everyday life situations for children born preterm have mainly been explored from the parents’ perspective, i.e. the parents act as proxies for their child [6–11] and this does not clarify what the difficulties mean for the children themselves or what they perceive as meaningful everyday life situations. The children have the right to be heard in matters that concern them [12] and the evidence of children being trustworthy as informants in matters concerning their everyday life [13, 14] also embraces children born preterm. Children’s perceptions of meaningful everyday life situations may be multidimensional and related to various factors such as personality, development, and context. Also, meaningful everyday life situations can be linked to the child’s preferences i.e opportunity to choose and to be able to take part in activities. Preferences are described, along with activity competence, in the model of Family of Person-related Constructs (fPRC), as intrinsic person-related concepts that are related to children’s participation [15]. The fPRC describes the influence of the intrinsic person-related constructs for past and present participation as influential for future participation outcomes. Furthermore, children’s perceptions of meaningful everyday life situations may differ from their parents’ perceptions on the same issue [16]. Rosenberg and Bart, who use the concept of ‘enjoyment’ rather than meaningfulness, found that children’s enjoyment in everyday life situations was related to their emotional functioning, while their parents related child enjoyment to skills and age [16]. Children’s perceptions of meaningful everyday life situations can be related to their participation in the everyday life situations they prefer or are interested in [15]. This implies that knowledge of children’s perceptions of what is meaningful in their everyday life is acquired by asking the children themselves [17], i.e., by taking the child’s perspective [18]). Children aged four to five have described how having skills in various activities, being able to play a lot and to play with friends are important to them [19]). Furthermore, children aged five to six have described the importance of spending time in the various preschool settings such as playgrounds, the kitchen, and the dressing room where they put on and take off clothes after outdoor activities. These children also describe other children as being their friends and say that having access to specific playthings, e.g., blocks, is important for them in preschool [20]. The knowledge about what is meaningful for children in their everyday life situation does not automatically involve children born preterm. Although most children born preterm do not develop disabilities [21], they may have experiences and difficulties that can affect their development and participation in everyday life situations [22]. Children born preterm are considered a risk group leading to attention and care by health services through childhood to a higher extent than term-born children. Additionally, the experience of a perhaps life-threatening start can influence parenthood. The vulnerability of the preterm baby, as perceived by the parents, may linger through childhood, and manifest a conception of the child as a vulnerable individual. The aim of the study was to explore meaningful everyday life situations as perceived by six-year-old children born preterm.