284 Addendum Summary Patient-centered care (PCC) is characterized by the provision of care that respects and responds to individual patient preferences, needs and values, and ensures that patient’s wishes guide all clinical decisions. PCC places the patient, not the disease, at the center of health care and promotes a collaboration between patient, family, and clinicians to provide care that is tailored to the patient’s wishes and needs. Providing PCC has many benefits for both patient and organization, including improved individual health outcomes, increased patient satisfaction, greater job satisfaction, and a reduction of health care costs. Although the importance of PCC is recognized, implementation is difficult because it requires a different mindset and changing roles of patients, parents, and clinicians. This thesis focused on scientific approaches and the development of tools to enhance PCC in children. Three aspects of PCC were investigated. The first part focused on pediatric patient engagement, the second part focused on Patient Reported Outcome Measures, and the third part focused on Patient Reported Experience Measures. In Chapter 1, the general introduction, the different parts of PCC are described and the context of the research in this thesis is illustrated. Part 1: Pediatric patient engagement The involvement of children in the decision-making in clinical care and research with the aim to improve health (care) is defined as pediatric patient engagement. Pediatric patient engagement is an essential aspect of providing PCC and its importance is established in the United Nations Convention on the Rights of the Child. However, clinicians and researchers struggle with the engagement of pediatric patients. To help clinicians in engaging pediatric patients, the first part of this thesis provided information and tools to meaningfully engage children. Chapter 2 gave an overview of the existing literature on pediatric patient engagement. This review showed that interest in pediatric patient engagement has increased over the past decades. Pediatric patients, especially those between the ages 9 to 17 years, have been involved in a wide variety of health care projects more often. Although pediatric patient engagement is increasing, this review also showed that children are still rarely engaged in research projects. This suggests that researchers need more tools and support to engage pediatric patients. Therefore, Chapter 3 described the development of a patient engagement tool, called All Voices Count. In co-creation with adolescents (N=23), the game All Voices Count was developed in several steps. First, ten themes were identified that were important to adolescents regarding their illness, treatment, and hospital care: visiting the hospital,
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