Department of Nursing Science, University of Turku, Turku, Finland.
Department of Education, University of Jyväskylä, Jyväskylä Yliopisto, Finland.
Int J Qual Stud Health Well-being. 2024 Dec;19(1):2356927. doi: 10.1080/17482631.2024.2356927. Epub 2024 May 27.
This study's purpose was to investigate how nurses, using a picture schedule, enable or hinder the realization of disabled children's agency in the preparation for an MRI procedure carried out under general anaesthesia.
A qualitative observation study was used to explore the interaction of nurses and children. The data consisted of video recordings of 25 preparation situations of 3 (3-8 years old) children (with challenges in communication and/or cognitive skills) with 4 nurses. Verbal and nonverbal communication was analysed with interventionist applied conversation analysis.
What was most crucial was how the picture schedule was used during the interaction. Reciprocal information sharing, responding to the child's initiatives by negotiating and allowing the child to take physical action with the picture schedule enabled the realization of the child's agency.
The preparation process should aim to help the child prepare in his/her own way. The preparation tools should encourage reciprocal interaction in informing and in responding to the children's initiatives. The preparation practices should include enough time for the child's initiatives and physical participation. The results can be used in assessing preparation tools and how they are used from the perspective of the child's agency.
本研究旨在探讨护士如何通过图片日程表，在全身麻醉下进行磁共振成像（MRI）检查的准备过程中，促进或阻碍残疾儿童实现自主性。
采用定性观察研究方法，以探索护士与儿童的互动。数据包括对 3 名（3-8 岁）儿童（有沟通和/或认知技能障碍）和 4 名护士的 25 种准备情况的视频记录。使用干预性应用会话分析方法对言语和非言语交流进行分析。
最重要的是图片日程表在互动中是如何使用的。通过协商，护士对儿童的主动行为做出回应，并允许儿童用图片日程表进行身体操作，从而实现了儿童的自主性。
准备过程应旨在帮助儿童以自己的方式做好准备。准备工具应鼓励信息的双向交流，并对儿童的主动行为做出回应。准备过程中应为儿童的主动行为和身体参与留出足够的时间。研究结果可用于评估从儿童自主性的角度来看，准备工具及其使用情况。
