IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v373y2025ics0277953625003752.html
   My bibliography  Save this article

Pain by proxy: An ethnographic study on the relational co-construction of the agency of young children in healthcare encounters

Author

Listed:
  • Lermytte, Esther
  • Scavarda, Alice
  • Hilário, Ana Patrícia
  • Gariglio, Luigi
  • Mendonça, Joana
  • Ceuterick, Melissa

Abstract

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.

Suggested Citation

  • Lermytte, Esther & Scavarda, Alice & Hilário, Ana Patrícia & Gariglio, Luigi & Mendonça, Joana & Ceuterick, Melissa, 2025. "Pain by proxy: An ethnographic study on the relational co-construction of the agency of young children in healthcare encounters," Social Science & Medicine, Elsevier, vol. 373(C).
    • Handle: RePEc:eee:socmed:v:373:y:2025:i:c:s0277953625003752
    DOI: 10.1016/j.socscimed.2025.118045
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953625003752
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2025.118045?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Santah, Colette & Bröer, Christian, 2022. "Agency through medicalization: Ghanaian children navigating illness, medicine and adult resistance," Social Science & Medicine, Elsevier, vol. 315(C).
    2. Gabe, Jonathan & Olumide, Gillian & Bury, Michael, 2004. "'It takes three to tango':: a framework for understanding patient partnership in paediatric clinics," Social Science & Medicine, Elsevier, vol. 59(5), pages 1071-1079, September.
    3. Allison James, 2011. "To Be (Come) or Not to Be (Come): Understanding Children’s Citizenship," The ANNALS of the American Academy of Political and Social Science, , vol. 633(1), pages 167-179, January.
    4. Clemente, Ignasi & Lee, Seung-Hee & Heritage, John, 2008. "Children in chronic pain: Promoting pediatric patients' symptom accounts in tertiary care," Social Science & Medicine, Elsevier, vol. 66(6), pages 1418-1428, March.
    5. Kristi Paron, 2024. "Exploring Child-Patient Autonomy: Findings from an Ethnographic Study of Clinic Visits by Children," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 17(1), pages 99-121, February.
    6. Wilson, Marisa & McLennan, Amy, 2019. "A comparative ethnography of nutrition interventions: Structural violence and the industrialisation of agrifood systems in the Caribbean and the Pacific," Social Science & Medicine, Elsevier, vol. 228(C), pages 172-180.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Carmel, Simon, 2006. "Health care practices, professions and perspectives: A case study in intensive care," Social Science & Medicine, Elsevier, vol. 62(8), pages 2079-2090, April.
    2. Kath MacDonald & Lindesay Irvine & Margaret Coulter Smith, 2015. "An exploration of partnership through interactions between young ‘expert’ patients with cystic fibrosis and healthcare professionals," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(23-24), pages 3528-3537, December.
    3. Stacey, Clare Louise & Henderson, Stuart & MacArthur, Kelly R. & Dohan, Daniel, 2009. "Demanding patient or demanding encounter?: A case study of a cancer clinic," Social Science & Medicine, Elsevier, vol. 69(5), pages 729-737, September.
    4. Laura Boland & France Légaré & Daniel I. McIsaac & Ian D. Graham & Monica Taljaard & Simon Dècary & Dawn Stacey, 2019. "SURE Test Accuracy for Decisional Conflict Screening among Parents Making Decisions for Their Child," Medical Decision Making, , vol. 39(8), pages 1010-1018, November.
    5. Ellen A. Lipstein & William B. Brinkman & Maria T. Britto, 2012. "What Is Known about Parents’ Treatment Decisions? A Narrative Review of Pediatric Decision Making," Medical Decision Making, , vol. 32(2), pages 246-258, March.
    6. Ellis, Katie & Johnston, Claire, 2024. "Care and education: Instability, stigma and the responsibilisation of educational achievement," Children and Youth Services Review, Elsevier, vol. 156(C).
    7. Sara F. Brouwer, 2023. "Kumusha and masalads: (inter)generational foodways and urban food security in Zimbabwe," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 40(2), pages 761-775, June.
    8. Henrice Altink, 2020. "Tackling child malnutrition in Jamaica, 1962–2020," Palgrave Communications, Palgrave Macmillan, vol. 7(1), pages 1-14, December.
    9. Bria Hall & Allison Tegge & Cesia Cotache Condor & Marie Rhoads & Terri-Ann Wattsman & Angelica Witcher & Elizabeth Creamer & Anna Tupetz & Emily R Smith & Mamata Reddy Tokala & Brian Meier & Henry E , 2024. "Understanding family-level decision-making when seeking access to acute surgical care for children: Protocol for a cross-sectional mixed methods study," PLOS ONE, Public Library of Science, vol. 19(6), pages 1-15, June.
    10. Guell, Cornelia & Brown, Catherine R & Iese, Viliamu & Navunicagi, Otto & Wairiu, Morgan & Unwin, Nigel, 2021. "“We used to get food from the garden.” Understanding changing practices of local food production and consumption in small island states," Social Science & Medicine, Elsevier, vol. 284(C).
    11. Nelson, Pauline Anne & Caress, Ann-Louise & Glenny, Anne-Marie & Kirk, Susan A., 2012. "‘Doing the "Right" Thing’: How parents experience and manage decision-making for children’s ‘Normalising’ surgeries," Social Science & Medicine, Elsevier, vol. 74(5), pages 796-804.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:373:y:2025:i:c:s0277953625003752. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.