Use of rewards for children in hospitals - Experiences from pediatric nurses: A qualitative interview study

The purpose of this study was to explore and describe current practices on nurse's use of rewards for children in hospitals. Despite being a widespread practice there is little knowledge about the use of rewards in pediatric departments. Knowledge about reward practice can be used to reflect on and promote good practice in the best interests of the child and inform potential guidelines.

A qualitative exploratory method was chosen. Fourteen nurses from four different pediatric departments took part in four semi-structured focus group interviews March-May 2023. The data was analyzed by using thematic method.

Nurses use various kinds of rewards that are both tangible and non-tangible. Nurses' motives for using rewards were for children to have a pleasant experience at the hospital and as motivation or diversion to make children cooperate in procedures. Rewards were also used to make the nurses feel better about themselves. The nurses reward practice was experience based, used for most procedures except some lifelong treatments. They adjusted their reward practice to the child's experience and type of admission. Experienced challenges were related to how prizes lose function when overused, when the child was too afraid, if the child did not complete the procedure or if the child was given too many choices.

The reward practice is important, extensive, and complex and must be individually assessed for each child in each situation- to manage the challenges. It is important that nurses have a conscious relationship to how they use rewards.