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Morimoto Y, Lian CPL, Lai C, Kyogoku S, Daida H. Health literacy in medical imaging: a scoping review of current evidence and future directions. Public Health 2024; 234:84-90. [PMID: 38968928 DOI: 10.1016/j.puhe.2024.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE The importance of health literacy in medical imaging is well recognized, yet the current landscape remains inadequately understood. This study aims to explore the extent of health literacy studies contextualized to medical imaging. STUDY DESIGN Scoping review. METHODS A scoping review was conducted using three online bibliographic databases namely, PubMed, ScienceDirect, and CINAHL. We have adopted the concept of health literacy, as a clinical risk and personal asset, to guide this review. RESULTS Of 311 unique articles, 39 met our selection criteria. Five themes (categories) were identified by the authors: appropriate communication with patients who receive medical imaging test results, appropriate usage of medical imaging, classes and characteristics of eHealth literacy, disease/deterioration prevention, and patient education. Additionally, 17 health literacy assessment tools were identified, including 11 original creations. Finally, 11 recommendations have emerged from this scoping review, offering valuable insights into methods, considerations, and strategies for promoting health literacy. CONCLUSIONS Health literacy studies in medical imaging cover both clinical and public health perspectives, benefiting diverse populations, regardless of underlying medical conditions. Notably, the majority of assessment tools used in these studies were author-generated, hindering cross-study comparisons. Given the innate capacity of medical images to convey intuitive information, those images do not solely benefit the patients who are given medical imaging examinations, but they also hold significant potential to enhance public health literacy. Health literacy and medical imaging are closely associated and mutually reinforce each other.
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Affiliation(s)
- Yuh Morimoto
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Cheryl Pei Ling Lian
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore.
| | - Christopher Lai
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Shinsuke Kyogoku
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Radiological Technology, Faculty of Health Science, Juntendo University, Tokyo, Japan
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Cirik VA, Aksoy B, Gül U. The image of nursing in the eyes of Generation Alpha and their parents in Türkiye: A multicenter cross-sectional survey. J Pediatr Nurs 2024; 78:124-132. [PMID: 38917614 DOI: 10.1016/j.pedn.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/15/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND AND PURPOSE Parents' views of nursing may play a key role in what kind of image their children hold of it. This study had three objectives. First, it investigated the image of nursing in the eyes of Generation Alpha and their parents. Second, it addressed whether their views affected each other. Third, it investigated factors that might affect their views. METHODS This multicenter study adopted a descriptive correlational and cross-sectional design. The sample consisted of 1742 children and their parents (n = 3484). Data were collected using a demographic characteristics questionnaire and the Nursing Image Scale (NIS). The data were analyzed using Pearson correlation and stepwise regression analysis. RESULTS Children, mothers, and fathers had a total NIS score of 48.76 (7.57), 42.37 (8.04), and 43.22 (8.99), respectively. Mothers' and fathers' NIS scores were positively associated with children's NIS scores (R2 = 0.286; 0.365, p < .01). Children's and their parents' negative experiences with nurses were negatively associated with their NIS scores (R2 = 0.358; 0.191; 0.155, p < .01). Children described nurses as "coolies," "maids," "machines," "devils," or "white ghosts." Their metaphors were negatively associated with their NIS scores. Almost half the participants stated that nursing was portrayed negatively in the media. CONCLUSION Children have a more positive view of nursing, but their views are also affected by their parents' thoughts. PRACTICE IMPLICATIONS Nurses should be professionally autonomous, promote their professional identity through the media, and interact with their colleagues to have a professional image in the eyes of children and their parents.
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Affiliation(s)
- Vildan Apaydin Cirik
- Karamanoğlu Mehmetbey University, Faculty of Health Sciences, Department of Midwifery, Child Health and Diseases Nursing, Karaman, Turkey
| | - Bahar Aksoy
- Akdeniz University, Kumluca Faculty of Health Sciences, Department of Child Health and Diseases Nursing, Antalya, Turkey.
| | - Uğur Gül
- Akdeniz University, Faculty of Nursing, Department of Child Health and Diseases Nursing, Antalya, Turkey
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Quaye AA, Foster M, Whitehead L, Hallström IK. Parents' experiences of their child's best interests during a hospital stay in Australia. J Child Health Care 2024:13674935241243101. [PMID: 38569118 DOI: 10.1177/13674935241243101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Determining the child's best interests in a hospital setting will ideally involve the combined views of children, parents, and healthcare professionals. However, few studies have explored parents' experiences of their child's best interests when they engage with the healthcare system. Therefore, this study aimed to explore parents' experiences of their child's best interests during hospitalisation. A descriptive qualitative inductive design using face-to-face parent-child combined interviews, analysed by latent content analysis, was used. Sixteen parents recruited from a tertiary hospital in Western Australia were interviewed. Collaboration, development of trustworthy relationships, and effective communication were essential in shaping parents' experiences of their child's best interests during hospitalisation.
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Affiliation(s)
- Angela Afua Quaye
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Mandie Foster
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
- School of Nursing and Midwifery, Edith Cowan University, Perth, WA, Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Perth, WA, Australia
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
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Dahlawi N, Milnes L, Swallow V. Children's behavioural and emotional reactions towards living with congenital heart disease in Saudi Arabia: A grounded theory study. Health Expect 2024; 27:e13959. [PMID: 38411365 PMCID: PMC10897868 DOI: 10.1111/hex.13959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND A high incidence of children with congenital heart disease (CHD) was found in Saudi Arabia (SA). International literature reports that children with CHD exhibit behavioural and emotional issues due to experiencing hospitalisation and clinical treatments combined with a dearth of qualitative understanding of the experiences of younger children with CHD. Therefore, the aim was to explore the behaviour and emotions of 4-10-year-olds with CHD in SA through children's accounts of their own experiences and parental proxy reports of children's behaviour and emotions. METHODS Charmaz's constructivist grounded theory (GT) approach was used. Twenty single semi-structured interviews of 10 child/parent dyads were undertaken at a hospital clinic in SA. Children's interviews were combined with an arts-based approach using drawings, pictures and faces of emotions (emojis). Constant comparison analysis was undertaken. Consolidated Criteria for Reporting Qualitative Research guidelines was followed in reporting this study. FINDINGS A substantive GT: children's behavioural and emotional reactions towards stressors related to living with CHD was developed and provides new insights into children's and parents' perceptions of the children's behavioural and emotional reactions to living with CHD in SA. The theory proposes that children's reactions to living with CHD relate to medical treatment stressors, sociocultural stressors and physical change stressors. Several further factors influenced children's responses to these stressors. CONCLUSION Children and parents in SA contributed to a new understanding of the relationship between CHD and children's behavioural and emotional reactions. In addition, findings support the need for early assessment of behaviour and emotions among children with CHD and the application of preventative and supportive measures for the children and their families in SA. PATIENT OR PUBLIC CONTRIBUTION Before the research commenced, the developmental appropriateness of the proposed arts-based data collection tools was tested with three healthy children aged 6-9 years old; the tools were then revised accordingly before the interviews were undertaken.
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Affiliation(s)
- Nada Dahlawi
- Nursing Faculty, King Abdulaziz University, Jeddah, Saudi Arabia
- School of Healthcare, University of Leeds, Leeds, UK
| | - Linda Milnes
- School of Healthcare, University of Leeds, Leeds, UK
| | - Veronica Swallow
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
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Caruana K, Hayre C, Makanjee C. Radiographers' perceptions on the quality of managing general radiographic paediatric examinations through the use of a reflective tool. PLoS One 2023; 18:e0295603. [PMID: 38060598 PMCID: PMC10703265 DOI: 10.1371/journal.pone.0295603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Paediatric patients are a vulnerable population that require additional care by healthcare professionals. Quality managing these examinations ensures that effective and quality care is provided to individual patients, whilst encouraging consistency within the medical imaging department. This study explored radiographers' perspectives on quality management strategies of general radiographic paediatric examinations using a paediatric imaging reflective checklist. METHODS A quantitative descriptive research design with qualitative questions was used through a purposive sampling method from both public and private Australian diagnostic imaging qualified radiographers who had experience in paediatric imaging examinations. The paediatric imaging service reflective tool consisted of 65 items in total. Data analysis entailed Microsoft Excel version 16.16.6 and Jamovi version 2.3.21 for the closed-ended questions and for the open-ended responses a thematic analysis. RESULTS The participation rate was 13.2% and the most significant findings were: lead shielding was still being used at their organisation, despite recent recommendations to suspend its use; access to paediatric patient related information resources is limited; there was no involvement of families and communities regarding policy development or quality improvement measures as advocated in literature; and there was a need for enhanced specialised paediatric education, training and protocols. CONCLUSION Using the paediatric patient-centred imaging reflective checklist, radiographers had an opportunity to identify quality improvement indicators as well as issues that could further enhance best practice principles. Further studies could inform on the validity of this reflective tool.
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Affiliation(s)
- Kate Caruana
- Department of Medical Imaging, The Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Chris Hayre
- Department of Health and Care Professions, University of Exeter, Exeter, Devon, United Kingdom
| | - Chandra Makanjee
- Department of Medical Radiation Science, University of Canberra, Bruce, Australian Capital Territory, Australia
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Bray L, Wilkinson C, Bruce C, Davidson N, Satchwell C, Carter B. 'It's my back…'; developing the coming to spinal clinic resource to improve the health literacy of young people with adolescent idiopathic scoliosis and their parents. J Child Health Care 2023; 27:628-642. [PMID: 35435029 PMCID: PMC10676617 DOI: 10.1177/13674935221083767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study focussed on identifying the key concerns and information needs of young people with Adolescent Idiopathic Scoliosis (AIS) and their parents and examined what resources might help improve young people's 'participativeness' and health literacy during clinic consultations. A qualitative participatory design underpinned the study. Workshops involving multiple methods were used to engage with young people with AIS and their parents, who were recruited through a regional children's hospital. The study design was informed by patient and public consultation with eight young people and two parents. 10 young people (aged 14-16 years) and 11 of their parents participated in the study. Young people and their parents reported uncertainty and anxiety before coming to clinic and faced issues participating in the consultation, being involved in decision-making and understanding the information and language. These challenges resulted in unmet information needs. Young people's health literacy relating to an AIS diagnosis and treatment is facilitated by them being prepared and informed before coming to clinic and be actively supported to be involved during the consultation. We collaboratively developed the 'Coming to Spinal Clinic' resource to help young people with AIS and parents prepare for and get the most out of their visit.
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Affiliation(s)
- Lucy Bray
- Faculty of Health Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Catherine Wilkinson
- Faculty of Health Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Colin Bruce
- Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
| | - Neil Davidson
- Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
| | - Candice Satchwell
- Centre for Excellence in Learning and Teaching (CELT), University of Central Lancashire, Preston, UK
| | - Bernie Carter
- Faculty of Health Social Care and Medicine, Edge Hill University, Ormskirk, UK
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Unal A, Bektaş M, Turan Mantar N, Ateş O, Hakgüder FG. Developing the pediatric surgery patient satisfaction scale and assessment of its validity and reliability. J Child Health Care 2023; 27:667-679. [PMID: 36349442 DOI: 10.1177/13674935221137405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Aim of this study was to develop a patient satisfaction scale for needs and expectations of pediatric surgery patients and to propose a new measurement tool in this field. Population of study consisted of all patients between May 2018 and February 2020 at a pediatric surgery service of a university hospital in Turkey. A pool of 70 items was prepared for scale. Two items were removed in line with expert opinions and suggestions. As a result of content validity and test application, 36 items were removed, and scale was revised. Data were transferred to SPSS Statistics 23 and AMOS 22 program. After evaluating scope validity of scale, Content Validity, Structural Validity, Exploratory Factor Analysis, and finally Reliability Analysis were examined. As a result of the analyses, 32 items with eight sub-dimensions were obtained from scale. Eight-factor scale explained 60.42% of total variance. Cronbach Alpha internal consistency of scale was found to be 0.88. Item factor loads of scale were created and the reliability of scale were obtained at desired level. The scale is suitable for patients aged 6 to 18 years old.
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Affiliation(s)
- Aysun Unal
- Nursing Management Department, Akdeniz University, Antalya, Turkey
| | - Murat Bektaş
- Department of Child Health and Diseases Nursing, Dokuz Eylul University Faculty of Nursing, İzmir, Turkey
| | | | - Oğuz Ateş
- Department of Pediatric Surgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Faika Gülce Hakgüder
- Department of Pediatric Surgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Segers EW, Ketelaar M, de Man MACP, Schoonhoven L, van de Putte EM, van den Hoogen A. How to support children to develop and express their coping preferences around minor invasive medical procedures: children's and parents' perspectives. Eur J Pediatr 2023; 182:5553-5563. [PMID: 37787922 PMCID: PMC10746775 DOI: 10.1007/s00431-023-05222-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/14/2023] [Accepted: 09/16/2023] [Indexed: 10/04/2023]
Abstract
Invasive medical procedures in hospitals are major sources of stress in children, causing pain and fear. Non-pharmacological interventions are indispensable in effective pain and fear management. However, these interventions must be personalized to be effective. This qualitative study aims to gain insight into children's and parents' experiences, needs, and wishes related to supporting children to develop and express their coping preferences for dealing with pain and fear during minor invasive medical procedures in order to decrease pain and fear. A qualitative study using thematic analysis was performed. Data were collected through semi-structured interviews with children and parents who had undergone at least five minor invasive medical procedures in the last year. Nineteen children (8-18 years) and fourteen parents were interviewed individually. The experiences, needs, and wishes expressed in the interviews could be classified into one overarching theme, that of the personal process, and two content-related sub-themes: feeling trust and gaining control. The personal process was divided into two different phases, that of developing and of expressing coping preferences. Children and parents both reported it as a continuous process, different for every child, with their own unique needs. Children and parents expected personalized attention and tailored support from professionals. Conclusion: Professionals must combine clinical skills with child-tailored care. In the process of searching for and communicating about coping preferences, children's unique needs and personal boundaries will thereby be respected. This gives children and parents increased trust and control during invasive medical procedures. What is Known: • Untreated pain and stress caused by medical procedures can have severe and important short- and long-term consequences for children. Personalized non-pharmacological interventions are an essential element of procedural pain management. What is New: • A personalized coping strategy is important for children when undergoing medical procedures. Each individual child has a personal way of expressing their own coping strategy. Children and their parents need information and the space to develop and express their individual coping preferences. • Children and parents expect to receive child-tailored care from professionals including respect for their own, unique needs and boundaries. Professionals should build trustful relationships and provide appropriately tailored autonomy around medical procedures.
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Affiliation(s)
- Elisabeth W Segers
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marjorie A C P de Man
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands
| | - Lisette Schoonhoven
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Elise M van de Putte
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands
| | - Agnes van den Hoogen
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands
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Paalimäki-Paakki K, Virtanen M, Henner A, Vähänikkilä H, Nieminen MT, Schroderus-Salo T, Kääriäinen M. Effects of a 360° virtual counselling environment on patient anxiety and CCTA process time: A randomised controlled trial. Radiography (Lond) 2023; 29 Suppl 1:S13-S23. [PMID: 36280541 DOI: 10.1016/j.radi.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION This study investigated whether a 360° virtual counselling environment (360°VCE) was more effective at decreasing patients' anxiety than routine standard of care counselling for patients undergoing coronary computed tomography angiography (CCTA), and if there was any difference in the process times for both of these groups. METHODS A total of 86 patients underwent CCTA in this randomised controlled trial. Patients were randomly assigned to intervention and control groups. The 360°VCE was developed using spherical panoramic images and non-immersive 360° technology. The primary outcome, anxiety, was measured using the State-Trait Anxiety Inventory (STAI). The secondary outcome, CCTA process time, was measured from the time of arrival in the department until end of examination. RESULTS Pre-scan anxiety was lower among patients in the 360°VCE group immediately before CCTA in comparison to patients in the control group (p = 0.015). Women demonstrated higher levels of anxiety than men in both groups. No between-group differences were discerned in CCTA process time. CONCLUSION Access to 360°VCE can reduce patients' pre-CCTA anxiety levels. IMPLICATIONS FOR PRACTICE The presented results can be used to improve patient counselling and care, reduce anxiety among patients undergoing CCTA, and optimise the CCTA examination procedure.
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Affiliation(s)
- Karoliina Paalimäki-Paakki
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland.
| | - Mari Virtanen
- School of Rehabilitation and Examination, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland
| | - Anja Henner
- Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Hannu Vähänikkilä
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Miika T Nieminen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Tanja Schroderus-Salo
- Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Oulu University Hospital, Oulu, Finland
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Saron H, Bray L, Carter B, Wilkinson C. Communication during children's X-ray procedures and children's experiences of the procedure: A scoping review. Radiography (Lond) 2023; 29 Suppl 1:S87-S95. [PMID: 36872135 DOI: 10.1016/j.radi.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/28/2023] [Accepted: 02/10/2023] [Indexed: 03/06/2023]
Abstract
INTRODUCTION Communication is a central part of radiological procedures and influences children's experiences. Previous research concentrates on communication and experiences during complex radiological procedures such as magnetic resonance imaging (MRI). Less is known about the communication that occurs with children undergoing procedures, such as non-urgent X-ray procedures, or the impact communication has on a child's experience. OBJECTIVES This scoping review examined evidence relating to the communication which occurs between children, parents and radiographers during children's X-ray procedures and how children experience undergoing X-ray procedures. KEY FINDINGS The comprehensive search identified eight papers. Evidence shows that radiographers dominate communication during X-ray procedures, with their communication in many cases being instructional, closed and limiting the opportunities for children to be involved. Evidence indicates that radiographers have a role in facilitating children in actively engaging in communication during their procedure. The papers that sought children's first-hand experiences highlight children's mainly positive experiences of having an X-ray, and the importance of informing children about their X-ray before and during the procedure. CONCLUSIONS The scarcity of literature highlights a need for research exploring communication during children's radiological procedures and children's first-hand experiences of undergoing these procedures. Findings highlight a need for an approach that recognises the importance of dyadic (radiographer and child), and triadic (radiographer, parent and child) communication opportunities during an X-ray procedure. IMPLICATIONS FOR PRACTICE This review highlights a need for an inclusive and participatory approach to communication that recognises children's voice and agency in X-ray procedures.
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Affiliation(s)
- Holly Saron
- Faculty of Health, Social Care and Medicine, Edge Hill University, UK.
| | - Lucy Bray
- Faculty of Health, Social Care and Medicine, Edge Hill University, UK
| | - Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, UK
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Bakir E, Briggs M, Mackintosh-Franklin C, Marshall M. Interactions between children, parents and nurses during postoperative pain management: A grounded theory study. J Clin Nurs 2023; 32:558-573. [PMID: 35383409 DOI: 10.1111/jocn.16318] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 01/17/2023]
Abstract
AIM To explore the interactions between children, parents and nurses during postoperative pain management. BACKGROUND Despite the growing evidence relating to postoperative pain management in children and relevant practice guidelines, children still experience moderate to severe pain after surgery. One factor could be related to the relatively unexplored child-parent-nurse interaction. DESIGN A qualitative constructivist grounded theory methodology. METHODS Data were collected from a paediatric hospital in the United Kingdom. Ten children aged between 6 and 11 years old who had undergone surgery, 11 parents and 10 nurses participated. Methods included face-to-face semi-structured interviews. Data were analysed using constant comparison technique, memos and constructivist grounded theory coding levels. The COREQ guidelines were followed for reporting. FINDINGS Three concepts emerged from data, "Parents as a communicator for child-nurse interaction", "Parents' emotional turmoil in child-nurse interaction", and "Parents' actions in child-nurse interaction" which constructed the substantive theory of child-parent-nurse interaction during postoperative pain management: "Facilitating or Inhibiting Interactions: Parental Influence on Postoperative Pain Management". The findings highlight an absence of a three-way interaction between children, parents and nurses and a dyadic interaction process between children and nurses was not apparent. Instead, child-parent-nurse interactions were constructed around two dyads of child-parent and parent-nurse interactions with child-nurse interaction constructed via parents. Parents, as a communicator, influenced the entire postoperative pain management processes between children, parents and nurses by facilitating or inhibiting the interaction processes. CONCLUSIONS This study identifies potentially important evidence about the unique position parents hold between their child and nurses as a central pivotal communicator during children's postoperative pain management. RELEVANCE TO CLINICAL PRACTICES This study may help to explain how and why postoperative pain management remains suboptimal. The substantive theory could support improvements in the management of postoperative pain through a much wider recognition of parents' central pivotal communicator role and the complexity of these child-nurse interactions.
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Affiliation(s)
- Ebru Bakir
- Department of Pediatric Nursing, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Michelle Briggs
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Carolyn Mackintosh-Franklin
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Marie Marshall
- Manchester University NHS Foundation Trust, Manchester, UK
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Demblon MC, Bicknell C, Aufegger L. Systematic review of the development and effectiveness of digital health information interventions, compared with usual care, in supporting patient preparation for paediatric hospital care, and the impact on their health outcomes. FRONTIERS IN HEALTH SERVICES 2023; 3:1103624. [PMID: 37089454 PMCID: PMC10117991 DOI: 10.3389/frhs.2023.1103624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/14/2023] [Indexed: 04/25/2023]
Abstract
Background and aim Elective surgery can be overwhelming for children, leading to pre-operative anxiety, which is associated with adverse clinical and behavioural outcomes. Evidence shows that paediatric preparation digital health interventions (DHIs) can contribute to reduced pre-operative anxiety and negative behavioural changes. However, this evidence does not consider their design and development in the context of behavioural science. This systematic review used the Theoretical Domains Framework (TDF) to evaluate the design and development of DHIs used to support children up to 14 years of age and their parents, prepare for hospital procedures, and determine any correlation to health outcomes. It also considered whether any behavioural frameworks and co-production were utilised in their design. Methods A search of the MEDLINE, EMBASE, PsycINFO, and HMIC databases was carried out, looking for original, empirical research using digital paediatric preparation technologies to reduce pre-operative anxiety and behavioural changes. Limitations for the period (2000-2022), English language, and age applied. Results Seventeen studies were included, sixteen randomised control trials and one before and after evaluation study. The results suggest that paediatric preparation DHIs that score highly against the TDF are (1) associated with improved health outcomes, (2) incorporate the use of co-production and behavioural science in their design, (3) are interactive, and (4) are used at home in advance of the planned procedure. Conclusion Paediatric preparation DHIs that are co-produced and designed in the context of behavioural science are associated with reduced pre-operative anxiety and improved health outcomes and may be more cost-effective than other interventions. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022274182.
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Involving Children in Health Literacy Research. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010023. [PMID: 36670574 PMCID: PMC9856879 DOI: 10.3390/children10010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022]
Abstract
Despite the volume and breadth of health literacy research related to children, children's involvement in that research is rare. Research with children is challenging, but the principles of involvement and engagement underpin all health promotion work, including health literacy. This commentary reflects on the process of setting up a Children's Advisory Group to consult on an institutional ethnography study of health literacy work from children's standpoint. The Children's Advisory Group contributed feedback on the study ethics and design and piloted methods for rapport-building and data collection, including livestreamed draw-and-describe and modified Interview to the Double. Consulting with the Children's Advisory Group highlighted the importance of listening to children and recognizing and valuing children's imaginative contributions to methods for involving children in health literacy research. Insights from this commentary can be used to foreground equity-focused approaches to future research and practice with children in the field of health literacy.
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14
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Garcia De Avila MA, Prata RA, Jacob FLDS, Nóbrega FMDO, De Barros GR, Sugiura BMG. Educational intervention through a comic book for preoperative anxiety in children, adolescents, and their parents: A randomized clinical trial. J Pediatr Nurs 2022; 67:e208-e214. [PMID: 35871148 DOI: 10.1016/j.pedn.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Reducing preoperative anxiety can help optimize surgical care. AIM To analyze the effectiveness of verbal guidance by nurses versus verbal guidance combined with a comic book on preoperative anxiety in children and their parents. METHODS We conducted a randomized parallel, two-group controlled clinical trial in the pediatric ward and a blinded anxiety assessment in the operating room of a Brazilian hospital. Individuals aged 6-14 years undergoing surgical procedures of up to 4 h for the first time were included in the study. Parents who were adults, literate, and able to communicate verbally were included. The primary outcome was the children's anxiety, measured by the Children Anxiety Questionnaire (CAQ), Visual Analog Scale (VAS), and the modified Yale Preoperative Anxiety Scale (mYPAS); the secondary outcome was the parents' anxiety, assessed by the Hamilton Anxiety Rating Scale. Participants were divided into the intervention (IG; n = 60) and control (CG; n = 60) groups. FINDINGS The two groups were homogeneous. The median age of the children was 8 years. No significant differences were observed in the CAQ and VAS scores between the two assessment time points or in the mYPAS scores between the IG and CG. However, parents' anxiety significantly decreased in both groups. APPLICATION TO PRACTICE Preoperative guidance by nurses, either verbal only or verbal information with a comic book proved beneficial in reducing parental anxiety. However, both interventions, performed on the day of surgery, failed to reduce preoperative anxiety in children and adolescents upon admission to the operating room. We recommended the process of preparing the child should begin after scheduling the surgery.
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Affiliation(s)
| | - Rafaela Aparecida Prata
- Department of Nursing, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, Brazil
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15
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Sørensen K, Skirbekk H, Kvarstein G, Wøien H. Home administration of needle injections for children with rheumatic diseases: A qualitative study on nurses' perception of their educational role. J Pediatr Nurs 2022; 66:e137-e144. [PMID: 35491289 DOI: 10.1016/j.pedn.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/05/2022] [Accepted: 04/14/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To explore nurses' perceptions of their educational role, pedagogical competence, and practice in teaching children with rheumatic diseases and their parents to manage subcutaneous injections at home. DESIGN AND METHODS In this qualitative study, we used thematic analysis to analyze data from three focus groups with 14 nurses responsible for patient education at one pediatric ward and two outpatient clinics. RESULTS We identified three main themes capturing nurses' perceptions of their educational role: myriad expectations, awareness of own competence, and facilitation and prioritization of patient education. Nurses perceived patient education as an expected but challenging duty of their work. They described a lack of pedagogical competence, insecurity in managing parents' and children's fears and worries, and limited organizational structures guiding their educational role. Nurses who worked in outpatient clinics felt freer to individualize education compared to ward nurses. CONCLUSIONS Nurses perceive their educational role as significant in enabling children and parents to manage subcutaneous injections at home; however, they require pedagogical competence integrated with daily practice to provide high-quality care. Short-term admissions require a different organization of patient education than before. PRACTICAL IMPLICATIONS Nurses need increased training in communication and management of children's pain and fear during needle injections. Competence development should include opportunities for reflection and guidance in clinical practice. Pediatric specialist nurses at outpatient clinics seem to have better competence to provide individual patient education for these families. The potential advantage of web-based solutions for nurses' patient education is a promising avenue for future research.
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Affiliation(s)
- Kari Sørensen
- Department of Nursing Science, Medical Faculty, University of Oslo, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Department of Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway.
| | - Helge Skirbekk
- Department of Health Management and Health Economics, Medical Faculty, University of Oslo, Norway; Department of Undergraduate Studies, Lovisenberg Diaconal University College, Norway.
| | - Gunnvald Kvarstein
- Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Norway.
| | - Hilde Wøien
- Department of Nursing Science, Medical Faculty, University of Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Norway.
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16
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Lööf G, Lönnqvist P. Role of information and preparation for improvement of pediatric perioperative care. Paediatr Anaesth 2022; 32:600-608. [PMID: 35167154 PMCID: PMC9311830 DOI: 10.1111/pan.14419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022]
Abstract
The perioperative period is a significant and stressful experience that may cause negative consequences in children, both in a short-term and long-term perspective. Despite a wide base of evidence stating the importance of adequate preparation to reduce anxiety, improve coping, cooperation and enhance recovery, many children continue to report that they feel unprepared for their perioperative experience. To secure children's right to request and need for preparation, the content, format, and availability of existing programs need to be scrutinized. Preparation programs in perioperative care must change from simply providing information to embracing the importance of children's need to process the information provided in order to learn and understand. Interactive web-based technology can function as a significant resource for preparation of children for perioperative procedures. By changing perspective from children's need for information to their need for learning and by developing preparation programs including adequate educational principles, web-based technology can be used to its fullest advantage as a healthcare learning and preparation resource.
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Affiliation(s)
- Gunilla Lööf
- Paediatric Perioperative Medicine and Intensive CareKarolinska University HospitalStockholmSweden,Department of Learning, Informatics, Management and EthicsKarolinska InstitutetStockholmSweden
| | - Per‐Arne Lönnqvist
- Paediatric Perioperative Medicine and Intensive CareKarolinska University HospitalStockholmSweden,Department of Physiology and PharmacologyKarolinska InstitutetStockholmSweden
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17
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Bowden CF, Worsley D, Pettit AR, Doupnik SK. Caregiver Experiences During Their Child’s Acute Medical Hospitalization for a Mental Health Crisis. J Child Health Care 2022; 26:123-138. [PMID: 33787342 PMCID: PMC8858607 DOI: 10.1177/13674935211001222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescents in the United States are increasingly seeking treatment for mental health crises in emergency departments and general medical hospitals. Medical needs are often addressed quickly, yet youth remain hospitalized because further psychiatric treatment is not immediately available. We sought to better understand the experiences of caregivers whose children are "boarding" in a medical hospital while awaiting inpatient psychiatric treatment. We conducted semi-structured interviews with caregivers who were recruited, enrolled, and interviewed during their child's hospital stay. Interviews were audio-recorded, transcribed verbatim, and thematic analysis was facilitated by NVivo 12. Fourteen caregivers enrolled in the study. Themes that emerged included positive hospital and provider experiences; frustration with the medical and mental health care systems; information needs; fears about inpatient psychiatric units; practical challenges and emotional needs; difficulties with caregiver-child communication; difficulties with clinician-caregiver communication; and need for self-care and support. While many caregivers felt positively about the overall experience at the hospital, they also wished for more information about their child's treatment plan and future, as well as social support, emotional comfort for themselves, and self-care skills and resources. Their experiences illuminate ways in which clinical practice can ameliorate concerns and alleviate stress of caregivers related to their child's mental health crisis.
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Affiliation(s)
- Cadence F. Bowden
- Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, Children’s Hospital of Philadelphia
| | - Diana Worsley
- Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, Children’s Hospital of Philadelphia
| | - Amy R. Pettit
- Center for Public Health Initiatives, The University of Pennsylvania
| | - Stephanie K. Doupnik
- Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, Children’s Hospital of Philadelphia,Department of Pediatrics, The Leonard Davis Institute of Health Economics, The University of Pennsylvania
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18
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Bray L, Appleton V, Sharpe A. ‘We should have been told what would happen’: Children’s and parents’
procedural knowledge levels and information-seeking behaviours when coming to hospital for
a planned procedure. J Child Health Care 2022; 26:96-109. [PMID: 33745339 PMCID: PMC8943474 DOI: 10.1177/13674935211000929] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children continue to be poorly prepared and informed about clinical procedures, despite increased evidence of the worth of preparation and the availability of information resources. This study used a concurrent mixed-methods approach to explore the information accessed by children and their parents before attending hospital for a procedure. Information was collected separately from 40 children (aged between 8 and 12 years) and their parents using a paper booklet to examine self-reported perceived procedural knowledge and information-seeking behaviours. Data were analysed using descriptive statistics and content analysis techniques. The findings indicate that many children (70%, n = 28) and their parents (65%, n = 26) have low procedural knowledge levels. The majority of children (85%, n = 36) reported not receiving or seeking information about their procedure, despite identifying a desire and preference for more information. This study shows a mismatch between the current provision of procedural information and children and parents' expectations that information will be provided directly to them by health professionals. In order for this 'information hole' to be filled, there needs to be a concerted effort to develop and systematically use meaningful information materials and for children and their parents to have the opportunity to discuss their procedural knowledge with health professionals.
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Affiliation(s)
- Lucy Bray
- Faculty of Health, Social Care and
Medicine, Edge Hill University, Ormskirk, UK,Lucy Bray, Faculty of Health, Social Care and
Medicine, Edge Hill University, St Helens Road, Ormskirk, UK.
| | - Victoria Appleton
- Faculty of Health, Social Care and
Medicine, Edge Hill University, Ormskirk, UK
| | - Ashley Sharpe
- Faculty of Health, Social Care and
Medicine, Edge Hill University, Ormskirk, UK
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19
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Maia EBS, Banca ROL, Rodrigues S, Pontes EDCD, Sulino MC, Lima RAGD. THE POWER OF PLAY IN PEDIATRIC NURSING: THE PERSPECTIVES OF NURSES PARTICIPATING IN FOCAL GROUPS. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to understand how nurses assess the implementation of therapeutic play by the nursing staff in the care provided to children. Method: qualitative study addressing nurses providing pediatric care in hospitals located in five Brazilian regions. Face-to-face meetings were held with nine focal groups between January and August 2018. The sessions lasted two hours on average and were audio-recorded and transcribed verbatim. Data were analyzed through inductive thematic analysis. Results: 52 nurses reported their perspectives regarding play and therapeutic play implemented in the care provided to children, which revealed The power of Play-Care implemented in nursing care: advancements and challenges and its subthemes: using puppets/dolls and dramatizing procedures; using distraction strategies to perform the procedures; wearing colorful and fun uniforms; recognizing the power of play in nursing care; and barriers challenging the connection between play and care in nursing practice. Conclusion: the power of Play-Care is manifested in the routine of nursing care through playful attitudes; however, these attitudes appear to be individual initiatives rather than systematized in the nursing process. Hence, there is a need to expand the possibilities of teaching this topic by promoting training programs, including practical activities and virtual learning environments.
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20
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San Martín-Rodríguez L, Soto-Ruiz N, Ferraz-Torres M, García-Vivar C, Saralegui-Gainza A, Escalada-Hernández P. The Spanish Version of the Child Medical Fear Questionnaire: Cross-Cultural Adaptation and Validation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:451. [PMID: 35010711 PMCID: PMC8744797 DOI: 10.3390/ijerph19010451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/22/2021] [Accepted: 12/29/2021] [Indexed: 11/17/2022]
Abstract
Having valid and reliable tools that help health professionals to assess fear in children undergoing medical procedures is essential to offer humanised and quality of care in the paediatric population. The aim of this study was to develop the cross-cultural adaptation and the evaluation of the psychometric properties of the Spanish version of the "Child Medical Fear Scale" in its shortened version (CMFS-R). The design consisted of two phases: first, of cross-cultural adaptation and second, of the psychometric validation of the CMFS-R with a sample of 262 children from Spain, applying a cross-sectional design. Confirmatory factor analysis was conducted to assess construct validity and the Cronbach's alpha and the adjusted item-total score correlation coefficients were performed to study reliability. The results confirmed internal consistency and construct validity of the Spanish version of the CMFS-R, indicating that the scale has an acceptable level of validity and reliability. Therefore, this study brings a new version of the scale to assess fear related to medical procedures for use in the Spanish paediatric population.
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Affiliation(s)
- Leticia San Martín-Rodríguez
- Department of Health Sciences, Public University of Navarre (UPNA), Avda. Barañain s/n, 31008 Pamplona, Navarra, Spain; (L.S.M.-R.); (M.F.-T.); (C.G.-V.); (A.S.-G.); (P.E.-H.)
- IdiSNA, Navarra Institute for Health Research, C/Irunlarrea, 3, 31008 Pamplona, Navarra, Spain
| | - Nelia Soto-Ruiz
- Department of Health Sciences, Public University of Navarre (UPNA), Avda. Barañain s/n, 31008 Pamplona, Navarra, Spain; (L.S.M.-R.); (M.F.-T.); (C.G.-V.); (A.S.-G.); (P.E.-H.)
- IdiSNA, Navarra Institute for Health Research, C/Irunlarrea, 3, 31008 Pamplona, Navarra, Spain
| | - Marta Ferraz-Torres
- Department of Health Sciences, Public University of Navarre (UPNA), Avda. Barañain s/n, 31008 Pamplona, Navarra, Spain; (L.S.M.-R.); (M.F.-T.); (C.G.-V.); (A.S.-G.); (P.E.-H.)
- IdiSNA, Navarra Institute for Health Research, C/Irunlarrea, 3, 31008 Pamplona, Navarra, Spain
- Unit of Training and Research, Navarra Hospital Complex, C/Irunlarrea s/n, 31008 Pamplona, Navarra, Spain
| | - Cristina García-Vivar
- Department of Health Sciences, Public University of Navarre (UPNA), Avda. Barañain s/n, 31008 Pamplona, Navarra, Spain; (L.S.M.-R.); (M.F.-T.); (C.G.-V.); (A.S.-G.); (P.E.-H.)
- IdiSNA, Navarra Institute for Health Research, C/Irunlarrea, 3, 31008 Pamplona, Navarra, Spain
| | - Amaia Saralegui-Gainza
- Department of Health Sciences, Public University of Navarre (UPNA), Avda. Barañain s/n, 31008 Pamplona, Navarra, Spain; (L.S.M.-R.); (M.F.-T.); (C.G.-V.); (A.S.-G.); (P.E.-H.)
| | - Paula Escalada-Hernández
- Department of Health Sciences, Public University of Navarre (UPNA), Avda. Barañain s/n, 31008 Pamplona, Navarra, Spain; (L.S.M.-R.); (M.F.-T.); (C.G.-V.); (A.S.-G.); (P.E.-H.)
- IdiSNA, Navarra Institute for Health Research, C/Irunlarrea, 3, 31008 Pamplona, Navarra, Spain
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21
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Getting It Right First Time and Every Time; Re-Thinking Children's Rights when They Have a Clinical Procedure. J Pediatr Nurs 2021; 61:A10-A12. [PMID: 34872648 DOI: 10.1016/j.pedn.2021.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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22
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Carter B, Harris J, Jordan A. How nurses use reassurance to support the management of acute and chronic pain in children and young people: An exploratory, interpretative qualitative study. PAEDIATRIC AND NEONATAL PAIN 2021; 3:36-44. [PMID: 35548850 PMCID: PMC8975211 DOI: 10.1002/pne2.12045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/12/2020] [Accepted: 01/06/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Bernie Carter
- Faculty of Health, Social Care and Medicine Edge Hill University Ormskirk UK
| | - Jane Harris
- Faculty of Health, Social Care and Medicine Edge Hill University Ormskirk UK
| | - Abbie Jordan
- Department of Psychology Centre for Pain Research University of Bath Bath UK
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23
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Bray L, Carter B, Blake L, Saron H, Kirton JA, Robichaud F, Avila M, Ford K, Nafria B, Forsner M, Nilsson S, Chelkowski A, Middleton A, Rullander AC, Mattsson J, Protheroe J. "People play it down and tell me it can't kill people, but I know people are dying each day". Children's health literacy relating to a global pandemic (COVID-19); an international cross sectional study. PLoS One 2021; 16:e0246405. [PMID: 33566813 PMCID: PMC7875343 DOI: 10.1371/journal.pone.0246405] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/19/2021] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to examine aspects of children's health literacy; the information sources they were accessing, their information preferences, their perceived understanding of and their reported information needs in relation to COVID-19. An online survey for children aged 7-12 years of age and parent/caregivers from the UK, Sweden, Brazil, Spain, Canada and Australia was conducted between 6th of April and the 1st of June 2020. The surveys included demographic questions and both closed and open questions focussing on access to and understanding of COVID-19 information. Descriptive statistics and qualitative content analysis procedures were conducted. The findings show that parents are the main source of information for children during the pandemic in most countries (89%, n = 347), except in Sweden where school was the main source of information. However, in many cases parents chose to shield, filter or adapt their child's access to information about COVID-19, especially in relation to the death rates within each country. Despite this, children in this study reported knowing that COVID-19 was deadly and spreads quickly. This paper argues for a community rather than individual approach to addressing children's health literacy needs during a pandemic.
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Affiliation(s)
- Lucy Bray
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Lucy Blake
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Holly Saron
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Jennifer A. Kirton
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | | | - Marla Avila
- Botucatu Medical School—Unesp—Nursing Department, Sao Paulo, Brazil
| | - Karen Ford
- Centre for Education and Research—Nursing and Midwifery, Tasmanian Health Service South and University of Tasmania, Hobart, Australia
| | | | - Maria Forsner
- Department of Nursing, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences and Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andrea Chelkowski
- Centre for Education and Research—Nursing and Midwifery, Tasmanian Health Service South and University of Tasmania, Hobart, Australia
| | - Andrea Middleton
- Centre for Education and Research—Nursing and Midwifery, Tasmanian Health Service South and University of Tasmania, Hobart, Australia
| | | | - Janet Mattsson
- Department of Health Sciences, Department of Learning, The Swedish Red Cross University College, Informatics, Management and Ethics, LIME, Karolinska Institutet, Stockholm, Sweden
| | - Joanne Protheroe
- Keele Medical School, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, United Kingdom
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24
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Bray L, Sharpe A, Gichuru P, Fortune PM, Blake L, Appleton V. The Acceptability and Impact of the Xploro Digital Therapeutic Platform to Inform and Prepare Children for Planned Procedures in a Hospital: Before and After Evaluation Study. J Med Internet Res 2020; 22:e17367. [PMID: 32780025 PMCID: PMC7448172 DOI: 10.2196/17367] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/16/2020] [Accepted: 06/13/2020] [Indexed: 01/06/2023] Open
Abstract
Background There is increasing interest in finding novel approaches to improve the preparation of children for hospital procedures such as surgery, x-rays, and blood tests. Well-prepared and informed children have better outcomes (less procedural anxiety and higher satisfaction). A digital therapeutic (DTx) platform (Xploro) was developed with children to provide health information through gamification, serious games, a chatbot, and an augmented reality avatar. Objective This before and after evaluation study aims to assess the acceptability of the Xploro DTx and examine its impact on children and their parent’s procedural knowledge, procedural anxiety, and reported experiences when attending a hospital for a planned procedure. Methods We used a mixed methods design with quantitative measures and qualitative data collected sequentially from a group of children who received standard hospital information (before group) and a group of children who received the DTx intervention (after group). Participants were children aged between 8 and 14 years and their parents who attended a hospital for a planned clinical procedure at a children’s hospital in North West England. Children and their parents completed self-report measures (perceived knowledge, procedural anxiety, procedural satisfaction, and procedural involvement) at baseline, preprocedure, and postprocedure. Results A total of 80 children (n=40 standard care group and n=40 intervention group) and their parents participated in the study; the children were aged between 8 and 14 years (average 10.4, SD 2.27 years) and were attending a hospital for a range of procedures. The children in the intervention group reported significantly lower levels of procedural anxiety before the procedure than those in the standard group (two-tailed t63.64=2.740; P=.008). The children in the intervention group also felt more involved in their procedure than those in the standard group (t75=−2.238; P=.03). The children in the intervention group also reported significantly higher levels of perceived procedural knowledge preprocedure (t59.98=−4.892; P=.001) than those in the standard group. As for parents, those with access to the Xploro intervention reported significantly lower levels of procedural anxiety preprocedure than those who did not (t68.51=1.985; P=.05). During the semistructured write and tell interviews, children stated that they enjoyed using the intervention, it was fun and easy to use, and they felt that it had positively influenced their experiences of coming to the hospital for a procedure. Conclusions This study has shown that the DTx platform, Xploro, has a positive impact on children attending a hospital for a procedure by reducing levels of procedural anxiety. The children and parents in the intervention group described Xploro as improving their experiences and being easy and fun to use.
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Affiliation(s)
- Lucy Bray
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Ashley Sharpe
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Phillip Gichuru
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | | | - Lucy Blake
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Victoria Appleton
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
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25
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McKeever S. Caring for more than 'our bastard children' in hospitals. J Child Health Care 2019; 23:509-511. [PMID: 31760832 DOI: 10.1177/1367493519886178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Stephen McKeever
- Kingston University and St George's, University of London, London, UK
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26
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Bray L, Horowicz E, Preston K, Carter B. Using participatory drama workshops to explore children's beliefs, understandings and experiences of coming to hospital for clinical procedures. J Child Health Care 2019:1367493519883087. [PMID: 31640399 DOI: 10.1177/1367493519883087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children attending hospital for a clinical procedure such as a scan or blood test can experience anxiety and uncertainty. Children who are informed and supported before and during procedures tend to have a more positive experience. Despite this, there is a lack of empirical evidence directly from children around how they would like to be supported before, during and after a procedure. This qualitative study used improvised drama workshops to investigate children's (n = 15, aged 7-14 years) perceptions and opinions of attending hospital for a procedure and what would help them have a positive encounter. Children portrayed themselves as having a small presence during a hospital procedure, depicted by the two themes of 'having to be brave but feeling scared inside' and 'wanting to get involved but being too afraid to ask'. Within both themes, children described how the directive and reassuring language and actions used by health professionals and parents marginalized their contributions. This study shows that children attending hospital for procedures value the opportunity to have a presence and active role, to express their emotions, join in interactions and be involved in making choices about their care.
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Affiliation(s)
- Lucy Bray
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Ed Horowicz
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | | | - Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
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