Nurses' perceptions of parental participation in the care of their hospitalised child

Abstract

Parental participation in the care of hospitalized children has been a key principle in paediatric nursing since the publication of the Platt Report in 1959 (BRI, 2001). Sick children are being increasingly cared for in the home by their parents due to early discharge, increased use of day surgery and increase in technological dependent children. Thus, there is now an expectation that parents will be extensively involved in the care of their hospitalized child (Lee, 2004). This dissertation investigated nurses' perceptions of parental participation in the care of their hospitalised child. Nurses are in a critical position to facilitate parental participation in care (O'Haire & Blackford, 2005). Thus it is important to seek their opinions and attitudes on this aspect of their practice. The purpose of this research study was to describe what nurses understand by 'parental participation in care', describe nurses' perceptions on the extent of parental participation in care, and identify factors which facilitate and/or inhibit parental participation. A convenient sample of 12 nurses working in the three local paediatric medical and surgical wards was selected for this study. The data was collected through the use of semi-structured, tape-recorded interviews, developed by the researcher after thorough review of the literature pertinent to the research topic. The interviews were transcribed and analysed using a modified Burnard analysis technique. Analysis of the data collected revealed that the participants' understanding of the term 'parental participation in care' was mainly positive, yet varied. Nurses primarily understood that the parents of the hospitalized child collaborate with healthcare professionals and take part in decision making. In addition, nurses expected parents to take part in the delivery of nurse-oriented tasks, such as recording temperature and administration of treatment. Nurses in the current study agreed that parents participated most of the time, mainly in the delivery of basic physical care and in nurse-oriented tasks. Information-giving, support and encouragement to parents were described as chief factors facilitating parental participation in care. On the other hand, lack of information, parental anxiety, and nurses' approach to parents were deemed as the commonest factors inhibiting parental participation. A series of recommendations were devised to address the findings of the research study. The need for nurses to develop relationships with parents that foster clear communication and understanding of roles was indicated. In addition, the importance of classifying a hierarchy of levels of parental participation and the formalization of the process of negotiation between parents and nurses were highlighted. Research into the parents' expectations of parental participation was recommended. This could increase nurses' understanding of parents' and hospitalised child's needs. Furthermore, the importance of using observational methods of data collection in future research into parental participation was outlined. It was also acknowledged that a greater emphasis on the development of communication, interpersonal and negotiation skills within nurse education, together with the inclusion of the concepts of partnership in care and family-centred care in nursing courses are needed, so that attitudes and respect for the child and family are included within all aspects of the educational curriculum.