School of Behavioral Sciences, the Academic College of Tel Aviv, Yaffo, Israel; Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel.
School of Behavioral Sciences, the Academic College of Tel Aviv, Yaffo, Israel.
J Pediatr Nurs. 2022 May-Jun;64:e84-e94. doi: 10.1016/j.pedn.2021.12.024. Epub 2022 Jan 10.
To investigate how pediatric nurses interpret and conceptualize theoretical underpinnings and daily practice scenarios pertaining to their role in pediatric care.
139 pediatric nurses completed a survey in which they were asked to endorse to what extent practices related to pediatric concepts are expected from their role ("Expected") or are actually implemented in their clinical work ("Actual"). Survey items were derived from a nursing textbook that outlines the theoretical tenets of the "art of pediatric nursing", along with scenarios and conflicts encountered in everyday practice, covering family-child centered care, child growth and development, and emotional boundaries.
In both Expected and Actual practices, the highest level of endorsement was for items focused on core elements of family-centered care (80-96%), and moderate-low endorsement levels were observed for items related to therapeutic relationship management and emotional boundaries. A factor analysis yielded 12 factors representing themes related to pediatric nursing. However, the division of items per factor indicated diffusion between key concepts and a discrepancy between theory and practice, especially in regard to maintaining emotional separateness and objectivity, advocacy, managing conflicts within the nurse-child-family triad, and navigating oneself boundaries.
Nurses' ability to manage and contain various types of unclear boundaries is crucial for optimal care provision when working with children and families.
Variability in nurses' theoretical role-perception and practical care provision is largely attributed to the way they navigate various ambiguous boundaries in practice and this could be a focal point in educational programs and on-the-job training.
探讨儿科护士如何解释和概念化与儿科护理角色相关的理论基础和日常实践情景。
139 名儿科护士完成了一项调查，要求他们在多大程度上认可与儿科概念相关的实践是他们角色所期望的（“期望”）还是实际在他们的临床工作中实施的（“实际”）。调查项目源自一本护理教科书，其中概述了“儿科护理艺术”的理论基础，以及日常实践中遇到的情景和冲突，涵盖了以家庭-儿童为中心的护理、儿童生长发育和情感界限。
在期望和实际实践中，对以家庭为中心护理核心要素为重点的项目的认可程度最高（80-96%），而对与治疗性关系管理和情感界限相关的项目的认可程度为中等-低水平。因子分析产生了 12 个代表与儿科护理相关主题的因子。然而，每个因子的项目分配表明关键概念之间存在扩散，以及理论与实践之间存在差异，特别是在保持情感分离和客观性、倡导、管理护士-儿童-家庭三方关系中的冲突以及管理自己的界限方面。
护士在与儿童和家庭一起工作时，管理和控制各种类型的不明确界限的能力对于提供最佳护理至关重要。
护士对理论角色的感知和实际护理提供的差异在很大程度上归因于他们在实践中处理各种模糊界限的方式，这可能是教育计划和在职培训的重点。
