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Creating a shielding place for children with leukaemia during sedation for intrathecal chemotherapy: A grounded
Carina Sjöberg1, Ing-Marie Carlsson2, Jeanette Källstrand2
1Region Halland and School of Health and Welfare, Halmstad University, Halmstad, Sweden.
Insights
Healthcare professionals developed strategies to reduce pediatric patients' discomfort during intrathecal chemotherapy sedation. This "shielding" approach improved care quality and patient safety by minimizing distress.
Area of Science:
- Pediatric Oncology
- Pain Management
- Healthcare Quality Improvement
Background:
- Childhood cancer significantly impacts a child's life and treatment experience.
- Children often perceive cancer treatments, like intrathecal chemotherapy, as more distressing than the disease itself.
- Sedation for intrathecal chemotherapy requires careful management to minimize patient discomfort.
Purpose of the Study:
- To explore how healthcare professionals enhance care for children undergoing sedation for intrathecal chemotherapy.
- To understand the process of improving the patient experience during this procedure.
Main Methods:
- A constructivist grounded theory approach was employed.
- Qualitative interviews were conducted with various healthcare professionals, including pediatricians, anaesthetists, pediatric nurses, and nurse anaesthetists.
Main Results:
- The "creating a shielding place" theory emerged, describing healthcare professionals' behaviors during sedation for pediatric leukemia intrathecal chemotherapy.
- Core category 'shielding' involves strategies like de-dramatizing, de-exposing, and minimizing trespassing to reduce patient suffering.
- These strategies aim to mitigate discomfort and distress associated with the procedure and treatment.
Conclusions:
- The "creating a shielding place" theory enhances understanding of patient-centered care during pediatric intrathecal chemotherapy.
- Healthcare professionals' strategies improve care sensitivity, quality, and patient safety.
- Findings can inform evidence-based guidelines for sedating children with leukemia for intrathecal chemotherapy.
Purpose:
Childhood cancer invades the child's daily life and has a strong influence on their living conditions and lifestyle. The treatment is an unpleasant experience and the children often perceive the treatment as worse than the actual disease. The aim of the present study was thus to explore the process of how healthcare professionals improved care for children undergoing sedation for intrathecal chemotherapy.
Method:
A constructivist grounded theory approach was applied and qualitative interviews with paediatricians (n = 2), anaesthetists (n = 2), paediatric nurses (n = 3) and nurse anaesthetists (n = 5).
Results:
The theory of creating a shielding place emerged and conceptualized the pattern of behavior of healthcare professionals throughout the procedure of sedation for intrathecal chemotherapy for pediatric leukaemia. The theory explains the core category 'shielding' and the process of how healthcare professionals developed strategies to resolve their main concern: a striving to reduce discomfort and suffering induced by the procedure and the treatment. These strategies, used throughout the procedure, were; de-dramatizing, de-exposing and minimizing trespassing.
Conclusions:
The theory of creating a shielding place offers a greater understanding of how healthcare professionals included the child's perspective in their work and thereby enabled a more sensitive and supportive care that had an impact on both quality of care and patient safety. The results from the study contributes with theoretical knowledge that can be used for developing evidence-based care guidelines for the procedure of sedating a child with leukaemia for intrathecal chemotherapy.
