Nurse-child interaction on an inpatient paediatric unit

This paper reports a study to evaluate patterns of nurse-child-parent interaction and identify the characteristics nurse-child and nurse-parent interactions in an inpatient paediatric unit.

Positive nurse-patient interaction is a critical component of effective nursing care. The ability to interact positively with patients and their families who are facing crisis during illness and hospitalization is essential for professional nursing care. However, little is known about the patterns of interaction between nurses, hospitalized children and their parents.

Eight triads of nurses, patients and their mothers were videotaped. The triads were videotaped for 4 hours each day over a 2-day period as they interacted with each other on the inpatient unit. Both verbalizations and descriptions of nonverbal behaviour were recorded from the videotapes. The data were coded and analysed using Bales' Interaction Process Analysis. The interactions were evaluated for frequency, time, purpose of interaction and interaction dynamics. The data were collected between December 2001 and February 2002.

The total amount of interaction over the 2-day period (8 hours) was 39.75 minutes and the average per interaction was 4.24 minutes. Interaction episodes consisted of nursing activities, which included nurses making patient rounds to monitoring their patient as well as providing patient care. Nurses initiated the majority of interactions between child and nurse. Affective (both positive and negative) behaviours were more frequent between nurses and children, whereas neutral behaviours were more common between nurses and mothers.

Children remained passive participants in the interactions. Interaction strategies are needed to help children to learn how they can actively interact with their nurses. These strategies may contribute to the children feeling more in control in these interactions and in their care.