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De Rosa R, Siano MA, Colucci A, De Anseris AGE, Siani P, Vajro P, Savarese G, Mandato C. Perceptions and Expectations of Youth Regarding the Respect for Their Rights in the Hospital. CHILDREN (BASEL, SWITZERLAND) 2024; 11:222. [PMID: 38397334 PMCID: PMC10887615 DOI: 10.3390/children11020222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 01/28/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Information obtained from children themselves regarding the characteristics of the ideal hospital that ensure well-being during a hospital stay is scarce. Here, we report the opinions, perceptions, and expectations of 700 children and adolescents about their experiences, assessed through a mixed-method research approach with age-appropriate questionnaires, three open-ended questions, and an analysis of optional pictorial and textual narratives. Most children indicated that, while they acknowledged the expertise of hospital staff, they also noted several shortcomings, e.g., insufficiently understandable medical information as well as emotional and cognitive support. The continuity of schooling and the right to suffer as little as possible were also critical issues. Adolescents valued in particular the quality of care and services provided, the hospital's adherence to equality and non-discrimination rights, and protection systems but negatively perceived several aspects related to play and participation. Significant differences in the co-occurrences of the most frequently used text terms with the keywords "hospital" and "child/adolescent" between age groups highlight variations in the way patients perceive and articulate their experiences within the hospital setting depending on the cognitive processes linked to age. In drawings, prevailing attention was placed on the physical context of the hospital room, with figures expressing mostly negative emotions. Specifically, in this regard, the main emotion in children was sadness, and, in adolescents, it was fear. Overall, these insights are pivotal in the context of our research objectives as they shed light on the nuanced preferences, needs, and perspectives of children and adolescents during their hospital stays. Recognizing the identified shortcomings, we propose recommendations emphasizing the improvement of medical communication clarity, enhancement of emotional and cognitive support, and the improvement of programs to avoid instructional gaps during hospital stays. Addressing these specific needs is critical for a more comprehensive approach to pediatric healthcare provision.
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Affiliation(s)
- Roberta De Rosa
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | - Maria Anna Siano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | | | - Paolo Siani
- Pediatrics, AORN Santobono-Pausilipon Children’s Hospital, 80122 Naples, Italy;
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | - Giulia Savarese
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Psychology Section, University of Salerno, 84081 Salerno, Italy;
| | - Claudia Mandato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
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Claridge AM, J Powell O. Children's experiences of stress and coping during hospitalization: A mixed-methods examination. J Child Health Care 2023; 27:531-546. [PMID: 35324345 DOI: 10.1177/13674935221078060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children often experience hospitalization as stressful. To better understand children's experiences, this current study involved interviews with and assessments of 17 children who were currently admitted at a U.S. children's hospital. On average, they reported low levels of distress on the Facial Affective Scale (FAS) (M = .34) and moderate levels of anxiety on the Child Drawing: Hospital (M = 107.01). Results revealed themes in children's experiences including stressors in the hospital, such as pain, disruptions to normalcy, and uncertainty. Children also reported factors that contributed to coping, including social support from parents and peers, and distractions from the medical routine such as leaving their hospital room. When children were grouped into clusters based on coping, those who were younger and who had received child life specialist services tended to be coping well. Regardless of understanding of diagnosis, those who demonstrated high levels of stress (distress and anxiety) in assessments tended to be categorized as not coping well. The findings inform interventions to support children's coping during hospitalization.
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Ullán AM, Belver MH. Visual Arts in Children's Hospitals: Scoping Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:339-367. [PMID: 33779344 DOI: 10.1177/19375867211003494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this work was to review scientific publications related to the use of visual arts in pediatric hospitals. BACKGROUND Visual arts, particularly painting, have historically played an important role in the design and atmosphere of healthcare spaces, especially hospitals. METHODS From 2000 to 2019, 79 publications located in relevant databases and manual searches were identified and analyzed. RESULTS Sixty of these publications include empirical studies and 19 theoretical models, comments, or reflections on the use of art in children's hospitals. Their analysis allows us to differentiate four groups of works: (a) "environmental" includes works whose purpose is to know how visual artistic interventions in the hospital can affect the people who see them, mainly pediatric patients, families, and health workers; (b) "participatory" includes studies aimed at knowing the effect of developing visual arts activities in the hospital; (c) "exploratory" includes works whose purpose was to know more about the children's perspective using their artistic expressions; and (d) "diagnostic" includes those that use children's drawings as a tool to diagnose diverse processes related to the pediatric patients' experience. CONCLUSIONS Taken together, the works we analyzed in our study support the use of visual arts in hospitals as a resource to enhance the well-being of children and families and their experience in the hospital. We indicate two particularly relevant aspects in this sense: the importance of the visual arts in improving the symbolic quality of hospitalization settings and the communication processes that occur in these environments.
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Affiliation(s)
- Ana M Ullán
- Department of Social Psychology, 16779University of Salamanca, Spain
| | - Manuel H Belver
- Department of Sculpture and Art Education, 16734Complutense University, Madrid, Spain
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Instrumentos de avaliação da ansiedade da criança hospitalizada. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ar02505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Baghdadi ZD, Jbara S, Muhajarine N. Children's Drawing as a Projective Measure to Understand Their Experiences of Dental Treatment under General Anesthesia. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E73. [PMID: 32635145 PMCID: PMC7401887 DOI: 10.3390/children7070073] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/06/2020] [Accepted: 06/26/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE The overall aim of the study was to gain a deeper understanding of 3 to 10 year-old children's experiences, main concerns, and how they manage attending hospital for dental treatment under general anesthesia (DTGA). METHODS Twelve children aged 3-10 who were scheduled for DTGA were interviewed. In addition to tape-recorded interviews, data were collected using video diaries, participant observations, and pre-, peri-, and postoperative drawings. The children's drawings (n = 43) were analyzed using the Child Drawing: Hospital Manual (CD:H) and Vygotsky postulations for context readings, with the aim to explore what it means for children to undergo DTGA. RESULTS The analysis found that the main concern for children during the pre-operative period was that they were forced to prepare for an unknown experience, which elicited stress. This situation was handled during the peri-operative period by trying to recover control and to cooperate despite fear, stress, and anxiety. Drawings completed post-operatively showed the surgical mask, "stinky" smell of the anesthetic gas, and multiple extraction of teeth were the main troubling experiences for children. Several weeks after DTGA, children tried to regain normalcy in their lives again. CONCLUSION This study contributed to a deeper understanding of how children as young as 3 years undergoing DTGA experience and express their lived experiences: emotional, psychological, physiological, or physical stress in the context of DTGA.
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Affiliation(s)
- Ziad D. Baghdadi
- Dr. Gerald Niznick College of Dentistry, University of Manitoba, P131B, 780 Bannatyne Avenue, Winnipeg, MB R3E0W2, Canada;
| | - Saffana Jbara
- Dr. Gerald Niznick College of Dentistry, University of Manitoba, P131B, 780 Bannatyne Avenue, Winnipeg, MB R3E0W2, Canada;
| | - Nazeem Muhajarine
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada;
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Foster M, Whitehead L. Using drawings to understand the child's experience of child-centred care on admission to a paediatric high dependency unit. J Child Health Care 2019; 23:102-117. [PMID: 29807461 DOI: 10.1177/1367493518778389] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.
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Affiliation(s)
- Mandie Foster
- 1 Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
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Broadbent E, Schoones JW, Tiemensma J, Kaptein AA. A systematic review of patients’ drawing of illness: implications for research using the Common Sense Model. Health Psychol Rev 2018; 13:406-426. [DOI: 10.1080/17437199.2018.1558088] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Elizabeth Broadbent
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Jan W. Schoones
- Walaeus Library, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Jitske Tiemensma
- Psychological Sciences, University of California, Merced, Merced, CA, USA
| | - Ad A. Kaptein
- Department of Medical Psychology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
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Pala SP, Nuvvula S, Kamatham R. Expression of pain and distress in children during dental extractions through drawings as a projective measure: A clinical study. World J Clin Pediatr 2016; 5:102-111. [PMID: 26862509 PMCID: PMC4737684 DOI: 10.5409/wjcp.v5.i1.102] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 10/16/2015] [Accepted: 12/04/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate the efficacy of drawings as a projective measure of pain and distress in children undergoing dental extractions.
METHODS: Children in the age range of 4-13 years with existence of untreatable caries or over-retained primary teeth, indicated for extractions were included. Pain was assessed using one behavioral, faces, legs, activity, cry and consolability (FLACC) scale; and a self report measure; faces pain scale-revised (FPS-R), at two points of time, after completion of local anesthetic administration and after extraction. The general behavior of children was assessed with Wright’s modification of Frankl rating scale. At the end of the session, children were instructed to represent, themselves along with the dentist and their experiences of the dental treatment through drawing. The drawings were scored utilizing Child drawing: Hospital scale (CD: H) manual and correlated with FLACC, FPS-R and Frankl using Pearson correlation test.
RESULTS: A positive correlation, though statistically not significant, was observed between CD: H scores and all other considered parameters (Frankl, FPS-R and FLACC) in the present study.
CONCLUSION: Drawings could not act as surrogate measure of child’s pain; however, they acted as a narrative of his/her experiences and reflection of inner emotions. Hence, drawings can be used as an additional dental armamentarium.
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Foster M, Whitehead L, Maybee P. The Parents', Hospitalized Child's, and Health Care Providers' Perceptions and Experiences of Family-Centered Care Within a Pediatric Critical Care Setting: A Synthesis of Quantitative Research. JOURNAL OF FAMILY NURSING 2016; 22:6-73. [PMID: 26706128 DOI: 10.1177/1074840715618193] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Family-centered care (FCC) purports that unlimited presence and involvement of the family in the care of the hospitalized child will optimize the best outcome for the child, family, and institution. A systematic appraisal was conducted of peer-reviewed, English-language, primary quantitative research conducted within a pediatric critical care setting reported from 1998 to 2014. The aim of this review was to explore the parents', hospitalized child's, and health care providers' perception of FCC within pediatric critical care. Fifty-nine articles met the criteria that generated themes of stress, communication, and parents' and children's needs. This review highlighted that communication tailored to meet the parents' and child's needs is the key to facilitating FCC and positive health outcomes. Health care providers need to be available to provide clinical expertise and support throughout the health care journey. Future initiatives, education, and research are needed to evaluate the benefits of parent- and child-led FCC practice.
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Affiliation(s)
- Mandie Foster
- 1 University of Otago, Christchurch, New Zealand
- 2 Christchurch Hospital, New Zealand
| | - Lisa Whitehead
- 3 Edith Cowan University, Joondalup, Western Australia, Australia
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Burns-Nader S, Hernandez-Reif M, Porter M. The relationship between mothers' coping patterns and children's anxiety about their hospitalization as reflected in drawings. J Child Health Care 2014; 18:6-18. [PMID: 23749253 DOI: 10.1177/1367493512468361] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study explored the relationships between hospitalized children's anxiety level, mothers' use of coping strategies, and mothers' satisfaction with the hospital experience. Twenty-four hospitalized children and their mothers participated in this study. Children were asked to draw a person in the hospital, which was then coded as a projective measure of anxiety; mothers were asked to complete questionnaires on their coping behaviors and their satisfaction with their child's hospital experience. The use of more coping strategies by the mothers was related to less anxiety in the children. In addition, the more coping strategies the mothers used, the higher they reported their satisfaction. The findings suggest the importance of providing resources aimed at increasing maternal coping and satisfaction with the quality of care of a child's hospitalization in order to minimize the negative effects of the hospitalization on the children.
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Child Drawings and Salivary Cortisol in Children Undergoing Preoperative Procedures Associated With Day Surgery. J Perianesth Nurs 2013; 28:361-7. [DOI: 10.1016/j.jopan.2013.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 03/25/2013] [Accepted: 05/15/2013] [Indexed: 11/24/2022]
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Tunney AM, Boore J. The effectiveness of a storybook in lessening anxiety in children undergoing tonsillectomy and adenoidectomy in northern ireland. ACTA ACUST UNITED AC 2013; 36:319-35. [DOI: 10.3109/01460862.2013.834398] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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KARIMI R, FADAIY Z, NIKBAKHT NASRABADI A, GODARZI Z, MEHRAN A. Effectiveness of orientation tour on children's anxiety before elective surgeries. Jpn J Nurs Sci 2012; 11:10-5. [DOI: 10.1111/j.1742-7924.2012.00223.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wennström B, Nasic S, Hedelin H, Bergh I. Evaluation of the Swedish version of the Child Drawing: Hospital Manual. J Adv Nurs 2011; 67:1118-28. [DOI: 10.1111/j.1365-2648.2010.05550.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Aminabadi NA, Ghoreishizadeh A, Ghoreishizadeh M, Oskouei SG. Can drawing be considered a projective measure for children's distress in paediatric dentistry? Int J Paediatr Dent 2011; 21:1-12. [PMID: 20642462 DOI: 10.1111/j.1365-263x.2010.01072.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Several tools have been developed for the measurement of emotional status of the child in paediatric dental clinics including nonverbal self-report techniques. Subjective methods like drawing and Child Drawing: Hospital (CD:H) score have recently been applied in hospitalized children. Studies, however, have not attempted to analyse children's drawings as an aid to investigate the subjective feelings of children in paediatric dental settings. AIM To assess drawing as a measure for child's distress in paediatric dental settings. DESIGN Fifty-four children, aged 4-11 years, participated in this study. After finishing the first therapeutic session, the child was instructed to draw a picture of a person in a dental clinic. The pictures were scored using CD:H score sheet and the findings were compared with SEM and Frankl scores. RESULTS CD:H was correlated with both Frankl (correlation coefficient = -0.550) and SEM (correlation coefficient = +0.483) scales (P < 0.001). CONCLUSION Drawing is a useful measure of children's emotional status in dental settings in a way that is easier, familiar and more enjoyable for the child patient.
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Affiliation(s)
- Naser Asl Aminabadi
- Department of Paediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
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Board R, Dai J. Effects of five parent-and-child risk factors on salivary cortisol levels and symptoms of posttraumatic stress disorder in school-age, critically ill children: pilot study. Heart Lung 2010; 40:236-46. [PMID: 20723987 DOI: 10.1016/j.hrtlng.2010.05.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Revised: 05/17/2010] [Accepted: 05/18/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We examined the contributions of risk factors to the psychological and neuroendocrine status of children admitted to a pediatric intensive care unit (PICU), and explored the feasibility of a full-scale study of these risk factors. METHODS A prospective, correlational design was used. Risk factors included parental stress, parental anxiety, child anxiety, severity of the child's illness, and invasive procedures administered to the child. Outcomes variables were pediatric posttraumatic stress disorder (PTSD) symptoms and salivary cortisol levels. Measures were taken at 3 time points over 3 months. RESULTS The mothers' state anxiety significantly increased over time, whereas the children's PTSD symptoms decreased. Most children with average or high anxiety demonstrated varying degrees of PTSD symptomatology, whereas children with low anxiety exhibited doubtful or mild symptoms of PTSD. As the severity of PTSD symptoms increased over time, the level of salivary cortisol decreased at two weeks and three months after hospital discharge. CONCLUSIONS Predicted trends in data were found and warrant further investigation, using a similar methodology in a full-scale study with an emphasis on recruiting the most seriously ill children.
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Affiliation(s)
- Rhonda Board
- School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts 02115, USA.
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Roohafza H, Pirnia A, Sadeghi M, Toghianifar N, Talaei M, Ashrafi M. Impact of nurses clothing on anxiety of hospitalised children. J Clin Nurs 2009; 18:1953-9. [DOI: 10.1111/j.1365-2702.2008.02745.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wennström B, Hallberg LRM, Bergh I. Use of perioperative dialogues with children undergoing day surgery. J Adv Nurs 2008; 62:96-106. [DOI: 10.1111/j.1365-2648.2007.04581.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Not much is known about how children perceive the quality of care that they receive in hospitals. This study set out to describe elements of quality in children's drawings of an ideal hospital. Thirty-five drawings were collected from children aged between 4 and 11 years during their stay in a university hospital in Finland. They were coded using the method of content analysis. The two main categories extracted from the analysis were the environment and the people of their ideal hospital. The emphasis was on the environment; patients, parents, and nurses appeared less frequently in the drawings. The findings showed that children are capable of offering valuable insights into the elements of quality through the medium of drawing.
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Affiliation(s)
- Tiina Pelander
- Department of Nursing Science, University of Turku, Turku, Finland.
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Affiliation(s)
- Naomi Matsumori
- Department of Nursing, Prefectural University of Hiroshima, Japan.
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Masferrer R, Prendergast V, Hagell P. Colored pain drawings: preliminary observations in a neurosurgical practice. Eur J Pain 2003; 7:213-7. [PMID: 12725843 DOI: 10.1016/s1090-3801(02)00113-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Black and white pain drawings were introduced as a proposed means to identify patients, presenting with low back pain, who demonstrated functional overlay upon neurological testing. The use of color may enhance the usefulness of such pain drawings, but has not been described for adult patients. AIMS To retrospectively explore the use of colored pain drawings in patients with neck, low back, or radicular pain. METHODS Patients with neck, low back, or radicular pain referred to a community-based neurosurgical practice for evaluation during 1 year (n=359) depicted their pain on anatomical drawings using colored pencils representing different pain characteristics. Patients with abnormal (n=55) and normal (n=54) pain drawings were selected for this study. Use of medications, findings on physical examination, radiographic findings, activity levels, Waddell signs, and pending litigation were recorded and compared between patients with normal and abnormal pain drawings, as assessed according to the Ransford penalty point system. RESULTS Patients whose colored pain drawings were abnormal, demonstrated a greater use of medications, more non-focal clinical findings, Waddell signs, impaired activity levels, involvement in pending litigation, and significantly fewer pathological radiographic findings than patients with normal pain drawings. CONCLUSIONS Our findings agree with previous observations using black and white pain drawings, indicating that colored pain drawings are no less useful than the black and white approach. Further research is necessary to examine the psychometric properties and clinical usefulness of colored pain drawings to predict outcomes and/or determine treatment.
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