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Tokenism or true partnership: Parental involvement in a child's acute pain care
Jackie Vasey1, Joanna Smith2, Marilynne N Kirshbaum3
1University of Huddersfield, Huddersfield, UK.
Insights
Parental involvement in children's acute pain care is crucial for better outcomes. However, nurses sometimes unintentionally hinder this partnership, despite parents' efforts to advocate for their child.
Area of Science:
- Pediatric Nursing
- Pain Management
- Family-Centered Care
Background:
- Children continue to experience acute pain despite guidelines.
- Parental involvement is recognized as essential for effective pediatric pain management.
Purpose of the Study:
- To explore parental involvement in children's acute pain care.
- To identify methods for nurses to facilitate and enhance parental preferences for involvement.
Main Methods:
- Qualitative ethnographical study utilizing nonparticipant observation and semi-structured interviews.
- Data collected from 14 nurses, 41 parents, and 30 children.
- Analysis employed the framework approach, adhering to COREQ guidelines.
Main Results:
- Key themes included parents as advocates, nurses promoting partnership, and nurses unintentionally hindering involvement.
- Varied levels of parental involvement were observed.
- Family-centered care principles were inconsistently implemented, with parents actively advocating regardless of nurse support.
Conclusions:
- Parental involvement enhances children's pain experience, reduces parental anxiety, and improves satisfaction.
- Nurses' intentions to involve parents in pain care were not always reflected in practice.
- The study proposes the 'Partnership in Pain Care Model' to better support parental advocacy.
Aims And Objectives:
To explore parental involvement in the child's acute pain care and establish ways in which parental preferences for involvement in their child's care can be identified, facilitated and enhanced by nurses.
Background:
Despite growing evidence supporting effective acute pain management in children and the availability of national and international practice guidelines, children still experience acute pain. Involving parents in their child's pain care has been identified as being a central tenet of pain management in children.
Design And Methods:
A qualitative study using an ethnographical approach with nonparticipant observation and follow-up semi-structured interviews was undertaken. Nurses (n = 14), parents (n = 41), grandparents (n = 2), other relative (n = 1) and children (n = 30) participated. The framework approach underpinned data analysis. Consolidated criteria for reporting qualitative research (COREQ) enabled comprehensive reporting of the study.
Results:
Three concepts emerged from the data: "parents as advocates for their child," "nurses promoting involvement and partnership" and "nurses unintentionally preventing involvement and partnership." Variations in the way parents were involved in their child's pain care were identified. Despite family-centred care being the dominant model of involving families in their child's care, evidence of this being implemented was limited. Parents attempted to advocate effective pain care for their child, whether or not they were supported by nurses.
Conclusions:
Parental involvement in their child's acute pain care can improve the child's pain experience, reduce parental anxiety and increase parents' satisfaction in care. Nurses aspired to involve parents in pain care, but did not always enact this in practice.
Relevance For Practice:
Children deserve optimum pain care, which includes parental involvement. Parental involvement underpinned by the principles of family-centred care was poorly implemented. Parents attempted to be involved and advocate for their child's pain care whether or not they were supported by nurses. An alternative approach for supporting parents to advocate in their child's acute pain care is offered, the "Partnership in Pain Care Model."
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