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Santos ACPDO, de Camargo CL, Vargas MADO, Araújo CNVD, Whitaker MCO, Zilli F, Martins RD, Gomes NP. A critical perspective on institutional violence against hospitalized children: Testimonies by health professionals and family members. Nurs Inq 2024:e12665. [PMID: 39138913 DOI: 10.1111/nin.12665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/15/2024]
Abstract
The purpose of this study is to understand institutional violence (IV) in the relationships between health professionals, hospitalized children, and family members. This is a qualitative study developed at the pediatric inpatient unit of a university hospital in the city of Salvador, Bahia, Brazil. The research participants consisted of 39 health professionals who specialized in pediatrics and 10 family members of hospitalized children. Semi-structured interviews were the method used for data collection. Using discourse analysis as a basis and taking a Foucauldian perspective, the researchers observed that the expressions of IV could be traced to abusive power relations within the system. We found four discursive forms within the data set: communication problems as IV, violence through inattention and neglect, violence as an action and consequent materialization on the body, and psychological violence as a submission mechanism. Based on these findings, we argue that professionals, managers, the scientific community, and users might be able to better guarantee the safety of children by recognizing IV and effectively intervening in it.
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Affiliation(s)
| | | | | | | | | | - Francielly Zilli
- Federal University of Santa Catarina, R. Delfino Conti, S/N - Trindade, Florianópolis, SC, Brazil
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Carvalhais MD, Oliveira ARM, Fontoura PCF, Soares CS, Pinho BFC, Fernandes ACLB, Azevedo VS, Santos SCS, Fernandes MIT, Oliveira IDJ. Children's satisfaction with nursing care during hospitalization: A cross-sectional study. J Pediatr Nurs 2024; 77:e270-e275. [PMID: 38653665 DOI: 10.1016/j.pedn.2024.04.039] [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: 11/26/2023] [Revised: 03/22/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE To assess hospitalized children's satisfaction with nursing care. DESIGN AND METHODS Cross-sectional study using the "Children Care Quality at Hospital" questionnaire. 61 children admitted to the Pediatrics Department of a hospital in the Northern Region of Portugal were enrolled. RESULTS The ranged age of the participants was 6 to 15 (10,61 ± 2,66 years), and most were male (52.46%; n = 32). The mean score in the three domains was 128 (77.11%), reflecting children's high satisfaction with the nursing care provided during hospitalization. The domain most valued was Nurse Characteristics, while the least valued was Nursing Environment. CONCLUSION Results provide essential input for the dimensions to be considered when planning nursing care for children, managing care, and the physical environment in the wards. IMPLICATIONS FOR PRACTICE These results highlight the need to hear children's voices. This must encourage nurses to reflect on how children evaluate nursing care and, by doing so, to increase the quality of nursing care provided in Pediatrics settings.
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Affiliation(s)
- Maribel Domingues Carvalhais
- Portuguese Red Cross Northern Health School, Rua da Cruz Vermelha, Cidacos, 3720-126, Oliveira de Azeméis, Portugal.
| | - Andrea Raquel Melo Oliveira
- Centro Hospitalar de Entre o Douro e Vouga, Rua Dr. Cândido Pinho 5, 4520-211 Santa Maria da Feira, Portugal
| | | | - Catarina Sousa Soares
- Santa Casa da Misericórdia de Vale de Cambra, Rua do hospital s/n, Vila Chã, Vale de Cambra, Portugal
| | | | | | - Vanessa Silva Azevedo
- Red Cross Northern Health School, Rua da Cruz Vermelha, Cidacos, 3720-126, Oliveira de Azeméis, Portugal
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Chang LC, Chen CJ, Chen CI, Sun FK. The initial experiences of junior nursing college students when communicating with children during pediatric clinical practicum: A phenomenological study. J Pediatr Nurs 2024; 76:e77-e84. [PMID: 38336568 DOI: 10.1016/j.pedn.2024.01.022] [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: 07/16/2023] [Revised: 01/20/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE Nursing students feel stressed during pediatric clinical practicum due to limited communication encounters with hospitalized children. The purpose of this study was to describe junior nursing college students' experiences of communicating with children during pediatric clinical practicums. DESIGN AND METHODS A qualitative phenomenological research design was used. Purposive sampling was used to recruit 18 junior nursing college students who completed their pediatric clinical practicum. Data were collected using semi-structured interviews and were analyzed using Colaizzi's seven-step method for data analysis. RESULTS Three themes emerged from the data. (1) Difficulties in communicating during initial practicum: fear, rejection, self-doubt of communication abilities, and unfamiliarity with the application of communication techniques posed frustrations among nursing students. (2) Efforts to learn during practicum: self-empowerment, seeking a diverse support system, adjusting communication methods, and striving to establish good relationships allowed nursing students to adapt to the pediatric curriculum. (3) Effective communication at the later stages of practicum: mastering fundamental communication techniques and exercising pediatric therapeutic communication techniques allowed nursing students to feel accomplished. CONCLUSIONS Junior nursing college students initially encountered difficulties and frustration when communicating with children during their pediatric clinical practicum. This study serves as a guide for educators of pediatric nursing to design courses on communication with hospitalized children. PRACTICE IMPLICATIONS These findings could be used to develop foundation courses on communicating with children for first-time pediatric nursing practicum students; for example, formulating a course on therapeutic play for children that encompasses communication techniques, pediatric ward simulation, and introduction to therapeutic play.
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Affiliation(s)
- Li-Chuan Chang
- Department of Nursing, National Tainan Junior College of Nursing, No.78 Min Zu road section 2, Tainan 700007, Taiwan, ROC.
| | - Chen-Jung Chen
- Department of Nursing, MacKay Medical College, No.46 Zhongzheng road section 3, Sanzhi Dist., New Taipei City 252, Taiwan, ROC.
| | - Chiu-I Chen
- Department of Nursing, Chang Jung Christian University, No.1 Changda road, Gueiren Dist., Tainan 711301, Taiwan, ROC.
| | - Fan-Ko Sun
- Second Degree Bachelor of Science in Nursing, National Taiwan University, No.1 Jen Ai road section 1, Taipei 100, Taiwan, ROC; Department of Nursing, National Taiwan University Hospital Yunlin Branch, Taiwan, ROC.
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Demirbağ S, Ergin D. Hospital quality of life for children: development of a new measurement tool for hospitalised children. J Res Nurs 2024; 29:32-42. [PMID: 38495322 PMCID: PMC10939021 DOI: 10.1177/17449871231222158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Background Hospitalisation affects children's quality of life (QoL) regardless of illness, treatment and care. Aims The objective of this study was to create an instrument for evaluating QoL of hospitalised children aged 7 to 18 years. Methods Initially, 46 items for the preliminary Hospital Quality of Life for Children Scale (HQL-children) were developed through a combination of literature reviews and individual interviews. The study was conducted with 230 participants from a general paediatric ward of a hospital. Exploratory and confirmatory factor analyses were conducted to examine the construct, convergent and discriminant validities of the measure. Criterion validity was assessed by confirming split-half reliability, whereas reliability was established using Cronbach's alpha coefficient. Results The HQL-child scale consists of 17 items and the total variance is 51.14%. The scale is categorised into five sub-dimensions: illness, fear, activity, hospital and perception. The scale demonstrated construct, convergent and divergent validity, discriminant and split-half reliability, with Cronbach's alpha coefficient 0.75. Conclusions The scale is a promising instrument to determine children's perception by capturing their experiences on hospitalisation. Assessing the QoL in hospitalised children is crucial for enhancing patient satisfaction and facilitating the development of health policies based on patient self-reporting in Turkey.
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Affiliation(s)
- Selin Demirbağ
- Research Assistant, Department of Child Health and Disease Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
| | - Dilek Ergin
- Professor, Department of Child Health and Disease Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
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Barbosa GM, Weber A, Garcia APRF, Toledo VP. Nursing team's perceptions on care for children and adolescents hospitalized with mental disorders. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0187en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract Objective to know the perceptions of the nursing team about the care of hospitalized children and adolescents with mental disorders. Method social phenomenological qualitative study whose data collection was carried out with 12 members of the nursing teams by means of phenomenological interviews. Results “Reasons why” described in two categories: the perception of the nursing team in view of the care provided and actions and care of the nursing team of the child with mental disorders. “Reasons for” expressed in the category: the recovery of the child with mental disorder and his return home. Conclusions and Implications for practice The possibility of establishing a face-to-face relationship between the team, the family, and the child to apprehend the biographical situation and the body of knowledge of the subjects involved, and then understand their real needs and demands promotes comprehensive care. Through Alfred Schutz's social phenomenology, it brings as implications for practice the possibility of understanding the perception of the nursing staff about the relevance of the face-to-face relationship in caring for children and adolescents with mental disorders.
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Barbosa GM, Weber A, Garcia APRF, Toledo VP. Percepções da equipe de enfermagem sobre cuidados de crianças e adolescentes internados com transtornos mentais. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0187pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumo Objetivo conhecer as percepções da equipe de enfermagem ante o cuidado de crianças e adolescentes com transtornos mentais internados. Método estudo qualitativo fenomenológico social cuja coleta de dados foi realizada com 12 membros das equipes de enfermagem por meio de entrevista fenomenológica. Resultados “Motivos porque” descritos em duas categorias: a percepção da equipe de enfermagem em face dos cuidados prestados e ações e cuidados da equipe de enfermagem da criança com transtornos mentais. “Motivos para” expressos na categoria: a recuperação da criança com transtorno mental e o seu retorno para casa. Conclusões e Implicações para a prática a possibilidade do estabelecimento da relação face a face entre equipe, família e criança como forma de apreender a situação biográfica e o acervo de conhecimento dos sujeitos envolvidos e, então, entender as suas reais necessidades e demandas promovem um cuidado integral. Através da fenomenologia social de Alfred Schutz, traz-se como implicação para a prática a possibilidade de compreender a percepção da equipe de enfermagem sobre a relevância da relação face a face no cuidado de crianças e adolescentes com transtornos mentais.
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da Silveira AC, Leite ÁJM, Cabral PC, de Oliveira AC, de Oliveira KA, de Lira PIC. Toxic stress, health and nutrition among Brazilian children in shelters. BMC Pediatr 2021; 21:112. [PMID: 33676454 PMCID: PMC7936454 DOI: 10.1186/s12887-021-02577-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background Living in a shelter is an adverse experience that generates toxic stress. This situation can cause the dysregulation of the hypothalamic-pituitary-adrenal axis and exert a negative impact on health.The aim of the present study was to determine the association between toxic stress and social, clinical and nutritional characteristics in children at welfare institutions in a city of northeastern of Brazil. Methods An analytical, cross-sectional study was conducted with male and female children up to 60 months of age who live in shelters. Hair cortisol was used for the assessment of stress (immunoassay). The anthropometric data collected were height for age, body mass index for age, arm circumference for age, and head circumference for age (expressed in z-scores). We also evaluated food intake using markers proposed by the Brazilian Dietary and Nutritional Vigilance Surveillance System as well as the occurrence of dental caries and anemia. Results Sixty-three children one to 60 months of age participated in the present study. Asthma was the most frequent disease (11.1%). The prevalence of short stature, anemia and dental caries in the sample was 22.2, 22.2 and 9.4%, respectively. Cortisol levels ranged from 0.93 pg/mg to 391.29 pg/mg (median: 6.17 pg/mg). Higher cortisol levels were found in children with illnesses (p = 0.012) and those who had been hospitalized after being admitted to the institutions (p = 0.001). Conclusions The majority of children had unhealthy eating behavior. The cortisol concentrations found in the present study were suggestive of dysregulation of the hypothalamic-pituitary-adrenal axis. Hypercortisolism was associated with illness and hospitalization.
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Affiliation(s)
| | | | - Poliana Coelho Cabral
- Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Ariclécio Cunha de Oliveira
- Laboratory of Endocrine Physiology and Metabolism of the Institute of Biological Sciences of the State University of Ceará, Fortaleza, Ceará, Brazil
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Coelho HP, Souza GDSDD, Freitas VHDS, Santos IRAD, Ribeiro CDA, Sales JKDD, Oliveira JDD, Gonçalves GAA, Castro APRD. Percepção da criança hospitalizada acerca do brinquedo terapêutico instrucional na terapia intravenosa. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo analisar a percepção da criança hospitalizada quanto ao uso do brinquedo terapêutico instrucional no preparo para a terapia intravenosa. Método estudo descritivo, com abordagem qualitativa, realizado em um hospital pediátrico público no município de Juazeiro do Norte - Ceará, entre os meses de julho a setembro de 2019. Participaram do estudo 31 crianças em idade pré-escolar e escolar. Os dados foram coletados por meio de uma entrevista semiestruturada e, posteriormente, analisados por meio do software IRAMUTEQ. Resultados diante da percepção das crianças acerca da terapia intravenosa, foi averiguado que elas compreenderam a técnica a partir da utilização do brinquedo terapêutico instrucional. Quando a criança tem a oportunidade de brincar e dramatizar a terapia intravenosa, por meio do brinquedo terapêutico instrucional, a ansiedade, a dor, a angústia, a solidão, o medo e o choro são atenuados. Conclusões e implicações para a prática orientar as crianças quanto à realização da terapia intravenosa favorece sua compreensão quanto aos reais benefícios desta técnica para a sua saúde, possibilitando, ainda, a compreensão do enfermeiro quanto às condições que representam riscos para a criança e intervenha em tempo hábil por meio da utilização de estratégias que favoreçam a recuperação da saúde e a minimização de traumas subsequentes advindos da hospitalização.
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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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Franco LF, Bonelli MA, Wernet M, Barbieri MC, Dupas G. Patient safety: perception of family members of hospitalized children. Rev Bras Enferm 2020; 73:e20190525. [PMID: 32667396 DOI: 10.1590/0034-7167-2019-0525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/20/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to know the meaning attributed by family members to the health safety of pediatric patients, with attention to the possibilities of their collaboration. METHODS this qualitative study was conducted with eighteen family members of children hospitalized in a pediatric unit, from January to July 2018. Symbolic Interactionism was used as a theoretical framework, and Inductive Content Analysis as method. RESULTS child hospitalization poses risks to possible incidents and adverse events. Participants and professionals are responsible for patient safety. Thus, their actions focus on error prevention. Therefore, they seek information and observe in a vigil way professional care in classic aspects of safety. They conceive essential and favoring safety the approach centered on children and family members. Final Considerations: family members recognized the chances of errors and care damage, identified themselves as support in minimizing damage and were in partnership with the professional, increasing chances of effecting safety.
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Affiliation(s)
| | | | - Monika Wernet
- Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | | | - Giselle Dupas
- Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
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Loureiro F, Rodrigues Araújo B, Borges Charepe Z. Adaptation and Validation of the Instrument ‘Children Care Quality at Hospital’ for Portuguese. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.4.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective: adapt and validate the instrument Children Care Quality at Hospital (CCQH) to assess the quality of nursing care of hospitalized children for the Portuguese language of Portugal. Materials and Methods: content, language, and conceptual validity methodological study, with translation, feedback, and reflection. A non-probabilistic simple was used of 252 children between 7 and 11 years of age, hospitalized due to acute disease in nine services of six Portuguese hospitals. The reliability and validity of the results were determined to measure the psychometric properties of the instrument. Construct validity was calculated through exploratory factor analysis of main components with Varimax rotation and the internal consistency by determining the Cronbach’s alpha coefficient. Results: the internal consistency has adequate psychometric characteristics suitable for the Portuguese population (Cronbach’s alpha values between 0.66 and 0.82). The instrument maintained 49 items grouped into three categories: characteristics, activities, and environment. The psychometric characteristics of the CCQH, adapted and validated for Portuguese, guarantees its reliability and validity to measure satisfaction with the quality of nursing care from the perspective of school-aged children. Conclusions: the instrument could be used to assess children’s satisfaction with the quality of nursing care during their hospitalization.
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