An Exploration of the Child’s Experience of Staying in Hospital from the Perspectives of Children and Children’s Nurses using Child-Centered Methodology

Sonya Clarke

doi:10.1080/24694193.2021.1876786

Abstract

ABSTRACT 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.

Highlights

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
This paper presents the findings of an empirical study, which explores the child’s experience of an overnight stay in hospital from the perspective of the child and registered children’s nurse
A proportion of these children would be admitted to hospital and a case for ‘children’ having a voice in respect of an area of health care that clearly affects them is evident within policy and the relating literature

Summary

Introduction

This paper presents the findings of an empirical study, which explores the child’s experience of an overnight stay in hospital from the perspective of the child and registered children’s nurse. It is widely agreed children and young people (CYP) are recognized as significant and unique users of healthcare whose needs differ significantly to those of adults (Carter et al, 2014; Corkin et al, 2012; Glasper & Richardson, 2010; Royal College of Child Health and Paediatrics, 2017; The United Nations Convention for the Rights of the Child, 1989). They have a comparatively high rate of contact with health services for preventive care or management of acute illness and a high possibility of requiring hospital admission at some time during childhood (Scottish Executive, 2005). In today’s society there does appear to be an increasing expectation that children and young people should participate in health and social care decisions that affect them (Franklin & Sloper, 2009).

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Discussion

Conclusion