Clarke Sonya
School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK.
Compr Child Adolesc Nurs. 2021 Apr 1;45(1):105-118. doi: 10.1080/24694193.2021.1876786.
Globally the needs of children differ to those of adults; consequently, the "voice" of children in health care delivery is paramount to its effectiveness as a service. This qualitative study aims to present a contemporary "slice" of life in four children's wards in a typical United Kingdom children's hospital in the 21st century from the perspective of the service user (child) and significant service giver (Registered Children's Nurse). Phase one of the study involved the development of a child research advisory group (CRAG) with five local primary school children (aged 10-11 years) to assist in the co-production of research questions and data collection tool for child participants - two talking cartoon characters (Sprinkle Cupcake and Ronaldo Football) via an app/iPad. In phase two (main study), hospitalized children (n = 18) and Registered Children's Nurses (n = 8) were interviewed on one occasion within their ward setting using a semi-structured approach in July 2017. The emerging broad themes (using thematic analysis), were (1) children - the child's needs, relationships, fears, and concerns, alongside (2) nurses - children's nursing, job pressures, safe and effective care. Themes were then presented as tensions in that they represent the relationship between variables where the different elements in the relationship are held in tension, such that a change in one impacts upon the other. Similarities between the children and nurse participants include issues with the environment, lack of time to care (nurse), effects of nurse-led interventions, and valued role of play. Differences are largely around the role of the parent. The development and work of the CRAG and use of "tensions" to more effectively present the complexity of the findings are unique to this study. In conclusion, this study contributes to the development of a generalized knowledge base for policy, nursing education, and clinical practice by shedding light in how the complex hospital environment can be challenging for the child and children's nurse.
在全球范围内，儿童的需求与成人不同；因此，儿童在医疗服务提供过程中的“声音”对于医疗服务的有效性至关重要。这项定性研究旨在从服务使用者（儿童）和重要服务提供者（注册儿童护士）的角度，呈现21世纪英国一家典型儿童医院四个儿童病房的当代生活“片段”。研究的第一阶段涉及组建一个儿童研究咨询小组（CRAG），小组成员包括五名当地小学儿童（年龄在10至11岁之间），他们协助共同制定针对儿童参与者的研究问题和数据收集工具——通过一款应用程序/平板电脑的两个会说话的卡通角色（纸杯蛋糕斯普林克和足球罗纳尔多）。在第二阶段（主要研究），2017年7月，研究人员在病房环境中采用半结构化方法，对18名住院儿童和8名注册儿童护士进行了一次访谈。通过主题分析得出的新出现的广泛主题包括：（1）儿童——儿童的需求、人际关系、恐惧和担忧，以及（2）护士——儿童护理、工作压力、安全有效的护理。这些主题随后被呈现为张力，因为它们代表了变量之间的关系，关系中的不同元素处于紧张状态，以至于一个元素的变化会影响另一个元素。儿童和护士参与者之间的相似之处包括环境问题、缺乏护理时间（护士方面）、护士主导干预的效果以及游戏的重要作用。差异主要围绕父母的角色。CRAG的发展和工作以及使用“张力”来更有效地呈现研究结果的复杂性是本研究独有的。总之，本研究通过揭示复杂的医院环境对儿童和儿童护士来说如何具有挑战性，为政策制定、护理教育和临床实践的通用知识库的发展做出了贡献。
