Children’s and adolescents’ experiences of outpatient visits across settings and age: an integrative review

As increasing numbers of children and youth with co-morbid conditions attend multiple outpatient services, their experiences across settings remain under-researched, despite the need for more integrated and coherent care. The purpose of this integrative review was to synthesize existing literature on how children and adolescents experience visiting outpatient clinics and identify similarities and differences across age and settings. Studies of all methodologies following the eligibility criteria were included, resulting in 22 papers, of which 11 were qualitative studies, 7 were cross-sectional studies, and 4 were of different methodologies. Six studies were conducted in child and adolescent psychiatric outpatient settings, and 16 in pediatric outpatient clinics, with participants ranging from 0 to 18 years. The primary outcomes in quantitative studies included satisfaction, experience, anxiety, therapeutic alliance, and provider qualities. From the thematic analysis of the qualitative studies, four themes emerged: 1) anxiety and uncertainty, 2) relational continuity, 3) participatory involvement and age-appropriate communication, and 4) the impact of physical environment and play. The findings highlight patterns across settings and age, strengthening the justification for integrated outpatient care. Age-appropriate communication, participatory involvement, and age-adapted environments are crucial for a positive experience of the outpatient visit in both children and adolescents across the settings.