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Children's communication of emotional cues and concerns during a preoperative needle procedure
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0001-6614-0493
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0002-9194-3244
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
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2022 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 105, no 6, p. 1518-1523Article in journal (Refereed) Published
Abstract [en]

Objective

This study explores children’s expressions of emotional cues and concerns during needle procedures, nurses’ responses and findings in relation to children’s age and sex.

Methods

Twenty-six children aged 6–12 years were video recorded during a preoperative needle procedure. Emotional communication was analyzed using Verona Coding Definitions of Emotional Sequences.

Results

A total of 111 cues or concerns were identified in the observed needle procedures, with a distribution of 77 cues and 34 concerns. A majority of children (85%) expressed emotional cues through non-verbal communication. No differences between child age or sex related to expressed emotion were found. The child elicited the communicated emotion in 98% of sequences. Nurses' responses were coded as not providing space for communication in 75% of sequences.

Conclusion

Children are capable of expressing their emotional distress, primarily non-verbally, during needle procedures. A child showing less overt expressions during a needle procedure does not necessarily experience less fear or pain. The nurses’ communication focused on practical information during the needle procedure, with less attention to the child’s distress.

Practice implications

Nurses need to develop strategies to be aware of emotions the child communicates before, during and after a needle procedure.

Place, publisher, year, edition, pages
2022. Vol. 105, no 6, p. 1518-1523
Keywords [en]
pediatrics, needle-procedure, communicate unpleasant emotions, fear, pain
National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-26789DOI: 10.1016/j.pec.2021.09.035ISI: 000809718300017Scopus ID: 2-s2.0-85116686249OAI: oai:DiVA.org:hb-26789DiVA, id: diva2:1605293
Available from: 2021-10-22 Created: 2021-10-22 Last updated: 2023-10-19
In thesis
1. Barncentrerad vård vid nålprocedurer: Betydelsen av att möta barns rädsla och smärta
Open this publication in new window or tab >>Barncentrerad vård vid nålprocedurer: Betydelsen av att möta barns rädsla och smärta
2023 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Children report needle procedures as the worst source of fear and pain during hospital care and treatment. How children communicate their fear and pain varies, which can be challenging for nurses to understand and meet. Nurses need to be able to recognize and acknowledge children’s emotions for needle procedures to be child centered. 

Aim: To explore the effects of a child centered intervention on fear and pain during needle procedures. 

Methods: Four studies combining qualitative and quantitative approaches, with boys and girls aged 4 – 12 years old undergoing a needle procedure, were conducted. Study I explored child-identified strategies used to manage fear and pain in hospital, with data collected through semi-structured interviews. Data through observations from video recordings were used in Study II to explore children’s expressions of emotional cues and concerns, and nurses’ response to these expressions. To examine whether children experience less fear and pain when receiving standard care with the addition of the intervention iCC compared with the experience of standard care only, self-reported fear and pain before and immediately after a needle procedure were conducted in study III. To further evaluate the effect of the intervention, time required for the procedure, heart rate, success rate for the procedure, behavioral observations, and patient preference to undergo the needle procedure in the same way again, were collected. Study IV evaluated child-nurse emotional communication when using a child centered intervention versus a control group. Data collection consisted of video-observations. 

Main results: The opportunity to choose strategy themselves was particularly supportive to children. Unpleasant emotions were commonly expressed through non-verbal communication, but seldom acknowledged by nurses. Less fear and pain were observed in the intervention group and less time required performing the needle procedure. Most children using iCC intervention were positive to the possibility of undergoing a needle procedure in the same way again in the future. Nurses using the intervention acknowledged the child’s expressed unpleasant emotions to a greater extent. 

Conclusion: Approaching children as active and competent actors during needle procedures contributes positively to nurses’ involvement, to the time a needle procedure takes, and to children’s experiences and emotional state.

Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2023
Series
Skrifter från Högskolan i Borås, ISSN 0280-381X ; 141
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-29843 (URN)978-91-89833-09-8 (ISBN)978-91-89833-10-4 (ISBN)
Public defence
2023-11-17, Sparbankssalen, Järnvägsgatan 5, Borås, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2023-10-20 Created: 2023-05-29 Last updated: 2023-10-19Bibliographically approved

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Kleye, IdaSundler, Annelie JohanssonDarcy, LauraKarlsson, KatarinaHedén, Lena E

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