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Constructing Relational Safety in Pediatric Surgery: The Pediatric Perioperative Relational Safety Theory
Inês Martins Esteves1,2,3, Márcia Pestana-Santos3,4, Margarida Reis Santos5
1School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal (Ms Martins Esteves and Dr Reis Santos).
None:
Children undergoing surgery experience heightened relational vulnerability associated with separation, loss of control, bodily exposure, and transitions of consciousness. The Pediatric Perioperative Relational Safety Theory advances a middle-range nursing theory that conceptualizes relational safety as a dynamic, nurse-mediated process co-constructed among nurses, children, and families across perioperative phases. Five interrelated constructs - Congruent Communication, Integrated Parental Presence, Supported Child Agency, Protected Personal Integrity, and Transitional Continuity - specify modifiable relational mechanisms. Nine propositions articulate pathways linking these mechanisms to proximal perioperative responses and longer-term psychosocial trajectories. The Pediatric Perioperative Relational Safety Theory positions relational safety as a central nursing safety function, extending and integrating perioperative theory, research, and practice.
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