Families in Paediatric Oncology Nursing: Critical Incidents From the Nurses' Perspective

• Published in: Journal of pediatric nursing Vol. 44; pp. e28 - e35
• Main Authors: Hopia, Hanna, Heino-Tolonen, Tarja
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2019
• Subjects: Child; Child Behavior; Child, Hospitalized - psychology; Child, Preschool; Critical incident technique; Family nursing; Family Relations; Family-centred care; Female; Finland; Hospitals, University; Humans; Male; Neoplasms - diagnosis; Neoplasms - nursing; Neoplasms - psychology; Nurse's Role; Nurse-Patient Relations; Oncology Nursing - organization & administration; Paediatric nursing; Paediatric oncology nursing; Parent-Child Relations; Parents - psychology; Pediatric Nursing - organization & administration; Stress, Psychological; Finland; Family-centred care; Family nursing; Paediatric nursing; Paediatric oncology nursing; Critical incident technique
• ISSN: 0882-5963; 1532-8449
• DOI: 10.1016/j.pedn.2018.10.013

Paediatric oncology nurses encounter challenges with families on a daily basis. This study explores how nurses describe significant incidents when encountering families and family members during the child's hospitalisation in the paediatric oncology unit. A qualitative study with a phenomenological approach in which 17 paediatric oncology nurses from three different hospitals described critical incidents related to families. The participants' written descriptions were analysed using inductive content analysis. The results indicate three domains where critical incidents occur: 1) Families' capability and resources, 2) parents' behaviour and 3) emotional labour in paediatric oncology nursing. The results indicate that paediatric oncology nurses face situations with patients' parents that can cause them stress and uncertainty, as well as burden them emotionally. Some of the incidents dealt with difficult ethical questions. Because of the challenges that families are facing, as described in the study, nurses need to focus more on helping families identify their resources and empower themselves in order to adapt to a new situation in their lives. The results provide important information not only for paediatric nursing but also for education and management. Since the quality of family nursing does not only depend on the competence of nurses or available resources, support from management concerning the work with families of severely sick children would be beneficial to the nurses. In addition, educational interventions need to be developed in order to strengthen the capability of nurses to successfully respond to challenging situations with families. •Families’ resources and capability to support the development of their children with cancer might be insufficient.•Some children are left without the sufficient presence of their parents during their time in the hospital.•The parents’ behaviour may be inappropriate or threatening towards nurses, which increases the emotional stress•Nurses consider maintaining the family’s trust a vitally important matter.