Mothering children at a paediatric intensive care unit with strict visiting hours: A qualitative study.

Abstract

Although a child- and family-centred care (CFCC) philosophy has been emphasized and adopted for decades in paediatric critical care settings in several countries, numerous issues from parents' perspectives regarding the philosophy remain unresolved. To facilitate the full translation of CFCC into clinical practice, health care professionals need an in-depth understanding of family experiences. Real-life mothering experiences, including maternal roles and identities, remain largely unknown at paediatric intensive care units (PICUs) in the Republic of Korea, where family visitation, presence, and participation are restricted. To explore mothering experiences at a PICU where family visitation is strictly constrained, and to identify maternal needs and values. We conducted a qualitative descriptive study of eight individual in-depth interviews with seven mothers of hospitalized children. Qualitative data were analysed using inductive thematic analysis. Five major themes, along with four subthemes, emerged: (1) shifts in maternal roles and responsibilities, (2) shifts in interpersonal relationships, (3) desire for CFCC in the PICU, (4) practising self-defined mothering roles, and (5) reconstructing maternal identities. The themes revealed the experiences of becoming mothers of a child in a constrained PICU. Ultimately, mothers demanded that the unit improve its physical and cultural environments through, for example, liberalized family visitation and participation in the care of their children. Nursing professionals should lead the charge for humanizing a restrictive PICU in the Republic of Korea by ensuring a safe and open environment and mothering continuity based on child- and family-centred holistic care. Effective interventions must be developed and tested to globally establish and fully implement strong evidence-based CFCC in PICUs; constant co-commitment among children, families, health care professionals, and institutions is also necessary.