Towards a theory-informed framework of child-centred care in paediatric healthcare: a systematic scoping review.

INTRODUCTION: Child-centred care is increasingly advocated in paediatric healthcare, yet its theoretical foundations remain fragmented and poorly defined. This review aimed to identify and synthesize theoretical perspectives applied to child-centred care in healthcare and to develop a theory-informed framework that clarifies its theoretical foundations and operationalisation. METHODS: The review followed the JBI methodology for systematic scoping reviews and was conducted and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). A comprehensive search of MEDLINE, Embase, and CINAHL was conducted for studies published between 1946 and August 2024. Peer-reviewed studies involving children, parents, or healthcare professionals that applied theoretical perspectives to child-centred care were included. Screening and data extraction were conducted independently by multiple reviewers. Data were synthesized in three steps: (1) grouping studies by theoretical framework, (2) analysing shared elements across six theories, and (3) integrating themes to construct a framework and identify core domains. RESULTS: Thirteen studies were included, identifying six theoretical perspectives underpinning child-centred care. Synthesis of these perspectives resulted in a theory-informed framework comprising three interrelated domains: (1) the competent child, (2) social context and ecologies, and (3) development as a dynamic process. Together, these domains conceptualise child-centred care as a relational, contextual, and developmental process that supports children's participation, agency, and well-being. CONCLUSION: This review advances conceptual clarity by integrating six theoretical perspectives into a theory-informed framework of child-centred care. The framework positions child-centred care as a dynamic, relational, and developmental process linking children's agency, social context, and development. The framework provides a tentative, structured foundation for guiding practice, education, and research. Further research is required to test and refine the framework across diverse cultural, geographic and healthcare contexts.