Department of Children, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
Eur J Pediatr. 2024 Dec;183(12):5291-5301. doi: 10.1007/s00431-024-05802-1. Epub 2024 Oct 9.
Children with negative procedural experiences have an increased risk of fear and distress, with psychological consequences for subsequent procedures and future healthcare behaviors. Gaining control and feeling trust are important aspects for children to decrease fear. To enable professionals providing personal care during medical procedures, a systematic, evidence-based approach that supports children in expressing their preferences is needed. This study will gain insight into the experiences and needs of professionals involved in small invasive medical procedures to meet the coping strategies and preferences of children undergoing these procedures. A qualitative design was used to gain insight into professionals' perspectives. Data were collected through online focus groups with various professionals involved in medical procedures, such as anesthetists, laboratory staff, nurses, and pediatricians. Five interdisciplinary focus groups, with a total of 32 participants, were held. One overarching theme was revealed: "Balancing between different actors within the context of the hospital." Professionals reported they had to deal with different actors during a medical procedure: the child, the parent, the colleague, and themselves. Each actor had its own interests. They were aware of the child and parents' priority to gain control and feel trust. Nevertheless, they perceive organizational and personal aspects that hinder addressing these needs.
To provide personalized care, professionals experience balancing between the needs and interests of diverse actors during medical procedures. The findings underscore the importance of a policy supporting HCPs in integrating patient-centered care into practice through practical tools and training initiatives such as scenario training.
• Unresolved pain and stress arising from medical procedures can have significant short- and long-term impacts on children. Empowering children to gain control and fostering a sense of trust are crucial factors in reducing fear associated with medical procedures. • 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.
• Healthcare professionals vary in their awareness of children's needs during a medical procedure. Beside this, the organizational dynamics of the hospital, along with the presence of actors such as the child, parent, colleague, and oneself, collectively influence the conduct of medical procedures. • Providing person-centered care during medical procedures can present challenges. The results highlight the significance of a policy to assist healthcare professionals in incorporating patient-centered care into their practice through practical tools and a culture of self-reflections regarding patient-centered values.
有负面手术经历的儿童更有可能感到恐惧和痛苦，并对后续手术和未来的医疗保健行为产生心理影响。获得控制感和信任感对于减少儿童的恐惧很重要。为了使在医疗过程中提供个人护理的专业人员能够支持儿童表达自己的意愿，需要采用一种系统的、基于证据的方法。这项研究将深入了解参与小型侵入性医疗程序的专业人员的经验和需求，以满足接受这些程序的儿童的应对策略和偏好。研究采用定性设计来深入了解专业人员的观点。通过在线焦点小组收集了各种参与医疗程序的专业人员的数据，例如麻醉师、实验室工作人员、护士和儿科医生。共进行了 5 个跨学科焦点小组，共有 32 名参与者。揭示了一个总体主题：“在医院背景下平衡不同参与者之间的关系”。专业人员报告说，他们在医疗程序中必须与不同的参与者打交道：儿童、父母、同事和他们自己。每个参与者都有自己的利益。他们意识到儿童和父母的首要任务是获得控制感和信任感。然而，他们认为存在组织和个人方面的因素会阻碍这些需求的满足。
为了提供个性化护理，专业人员在医疗过程中体验到在不同参与者的需求和利益之间进行平衡。研究结果强调了政策的重要性，该政策通过实践工具和培训计划（如情景模拟培训）支持医疗保健专业人员将以患者为中心的护理融入实践。
• 未解决的疼痛和压力源于医疗程序可能会对儿童的短期和长期产生重大影响。赋予儿童控制感并培养信任感是减少与医疗程序相关的恐惧的关键因素。• 儿童和父母希望从专业人员那里获得量身定制的护理，包括尊重他们自己独特的需求和界限。专业人员应该建立信任关系，并在医疗程序方面提供适当的自主权。
• 医疗专业人员在医疗过程中对儿童需求的意识存在差异。此外，医院的组织动态以及儿童、父母、同事和自己等参与者的存在，共同影响了医疗程序的进行。• 在医疗过程中提供以人为本的护理可能会带来挑战。结果强调了政策的重要性，该政策可以通过实践工具和自我反思患者为中心价值观的文化来帮助医疗保健专业人员将以患者为中心的护理纳入他们的实践。
