10 Chapter 1 whether patients are knowledgeable, involving patients is time consuming, and scheduling meetings with groups of patients is difficult [19-23]. Involving pediatric patients seems to be especially challenging for clinicians, as the competence of children is even more questioned than adults [20,21,24,25]. Also, pediatric patient engagement is complicated by the influence of parents and the lack of experiences by clinicians, policymakers, and researchers [20,25]. Since the United Nations Convention on the Rights of the Child (UNCRC) states that every child has the right to be heard and to have a say in matters that affect them [26], it is necessary to give clinicians more support to involve pediatric patients meaningfully and usefully [27]. However, it is unclear to what extent and in what way patients are engaged in clinical care and research. In addition, currently no tools are available to help clinicians with the engagement of pediatric patients. Figure 2. A multidimensional framework for patient engagement in health care, based on the model of Carman [11]
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