Date of Award

2017

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Donna Schwartz-Barcott

Abstract

In 1989, international attention was drawn to the rights of children in a treaty signed by representatives of 190 nations at The Convention on the Rights of the Child. A major emphasis of the treaty was on the rights of all children to be heard across a wide range of contexts. Numerous researchers have been funded to describe and enhance the voice of the child in many settings, albeit few have focused on the child in a hospital setting. Nurse researchers who have begun to investigate the experience of children during hospitalization have identified some of the positive and negative impacts of differing patterns of communication. A number of potential characteristics of an approachable nurse were hinted at in these studies, although none explored the concept of approachability among pediatric nurses. In this study the voices of school age children were sought on their experiences with and perceptions of approachable pediatric nurses.

An exploratory, qualitative, descriptive research design, including semi-structured interviews with 7 school age children (6-12 years old), in a pediatric oncology service was used to gain the children’s general perceptions of nurses who they think and feel are approachable and descriptions of the characteristics, behaviors and impact of these nurses. The setting was an urban children’s hospital in Southern New England wherein school age children with a cancer diagnosis were interviewed both inpatient and from the outpatient oncology clinic within the same facility. Qualitative content analysis was used to analyze the data. All the children had experience with more than one approachable nurse. Common terms used by children to describe the characteristics and behaviors of an approachable nurse included nurses who were funny, took time to listen and talk, were nice, smiled and were happy, made them feel welcome and told them what was going to happen before the occurrence of an intervention. The impact of the approachable nurse was identified as relieving anxiety and fear, along with making these children feel welcome and relaxed while in the hospital. When needing to return to the hospital, the children were less worried because of the behaviors of these approachable nurses. Many described these approachable behaviors as making them feel at home while in the hospital.

Implications of this research aim to provoke future work on concept definition, measurement and theory development, with future consideration being given to symbolic interaction theory. Upcoming educational programs for pediatrics may use this as a point of discussion and nursing administrators may consider this as part of orientation, evaluation and peer review. Clinical practice can be advanced by increased attention to interactions between the nurse and child in the hospital setting.

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